• Title/Summary/Keyword: Inpatient Disease

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Predictors of Readmission after Inpatient Plastic Surgery

  • Jain, Umang;Salgado, Christopher;Mioton, Lauren;Rambachan, Aksharananda;Kim, John Y.S.
    • Archives of Plastic Surgery
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    • v.41 no.2
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    • pp.116-121
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    • 2014
  • Background Understanding risk factors that increase readmission rates may help enhance patient education and set system-wide expectations. We aimed to provide benchmark data on causes and predictors of readmission following inpatient plastic surgery. Methods The 2011 National Surgical Quality Improvement Program dataset was reviewed for patients with both "Plastics" as their recorded surgical specialty and inpatient status. Readmission was tracked through the "Unplanned Readmission" variable. Patient characteristics and outcomes were compared using chi-squared analysis and Student's t-tests for categorical and continuous variables, respectively. Multivariate regression analysis was used for identifying predictors of readmission. Results A total of 3,671 inpatient plastic surgery patients were included. The unplanned readmission rate was 7.11%. Multivariate regression analysis revealed a history of chronic obstructive pulmonary disease (COPD) (odds ratio [OR], 2.01; confidence interval [CI], 1.12- 3.60; P=0.020), previous percutaneous coronary intervention (PCI) (OR, 2.69; CI, 1.21-5.97; P=0.015), hypertension requiring medication (OR, 1.65; CI, 1.22-2.24; P<0.001), bleeding disorders (OR, 1.70; CI, 1.01-2.87; P=0.046), American Society of Anesthesiologists (ASA) class 3 or 4 (OR, 1.57; CI, 1.15-2.15; P=0.004), and obesity (body mass index ${\geq}30$) (OR, 1.43; CI, 1.09-1.88, P=0.011) to be significant predictors of readmission. Conclusions Inpatient plastic surgery has an associated 7.11% unplanned readmission rate. History of COPD, previous PCI, hypertension, ASA class 3 or 4, bleeding disorders, and obesity all proved to be significant risk factors for readmission. These findings will help to benchmark inpatient readmission rates and manage patient and hospital system expectations.

Analysis on the utilization Pattern of a General Hospital - With Cases of General Hospital Inpatients in the Provincial Area - (종합병원 이용형태에 관한 분석 - 지방소재 종합병원 입원환자 중심 -)

  • Jung, Yong-Mo;Jun, Sun-Kyong;Lee, Yong-Chul
    • The Korean Journal of Health Service Management
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    • v.3 no.1
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    • pp.14-24
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    • 2009
  • This study aims at deriving any useful information necessary to strengthen the competitiveness for growth through empirical analyses on general hospital located in a province in order to countermeasure the opening and competition of medical markets. The characteristics of user were identified on the basis of disease groups under KCD in the research method. In addition, the analysis on the expenses of diagnosis and treatment was divided into the treatment progress and degree of hospital resource utilization And the regression was carried out to identify the impacts of characteristics of inpatient users on the degree of hospital resource utilization. As a result of major research, the inpatient users of the general hospital located in the provincial area in consideration of inpatient users were formed around the inpatient disease groups representative for Korea(diseases of the respiratory system, injury and poisoning & certain other consequences of external causes). And it was understood that most of residents within a distance of 40 minute by the public transportation were using. And mostly were under the age of 9 or over 60, and the provision of medical features such as the degree of consultation and operational functions were inadequate. When we classify inpatient treatment cost for each resource application as the medical cost being the center of patient care function, the equipment and human resource application sector are constituted over half. Accordingly, the following suggestions are made as plans to strengthen the competitiveness for the growth of general hospitals located in the provincial areas on the basis of analytical results. First, it is necessary to have the characterization matching to the age and disease groups with a high frequency. Second, it is necessary to increase the degree of hospital resource utilization according to the characterization. Third, it is necessary to concentrate on public relations. The above suggestion, as a method for securing image improvement and competitive power as a general hospital, and through expansion of social function that a regional general hospital needs to secure not only as an individual institution but also as a general hospital, it can be seen that a general improvement of image as a regional general hospital is possible.

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Impact of Admission Diagnosis on the Smoking Cessation Rate: A Brief Report From a Multi-centre Inpatient Smoking Cessation Programme in Singapore

  • See, Jason Jia Hao;See, Kay Choong
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.5
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    • pp.381-386
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    • 2020
  • Objectives: Few studies have been published regarding the relevance of the admission diagnosis to the smoking cessation rate. We studied smoking cessation rates in relation to admission diagnoses in our inpatient smoking cessation programmes. Methods: This retrospective study included all patients recruited into our inpatient smoking cessation programmes at 2 institutions in Singapore between June 2008 and December 2016. Patients were given individualized intensive counselling and were followed up via phone interviews for up to 6-month to assess their smoking status. Multivariable logistic regression was used to analyse potential associations between admission diagnoses and 6-month abstinence. Results: A total of 7194 patients were included in this study. The mean age was 54.1 years, and 93.2% were male. In total, 1778 patients (24.7%) were abstinent at the 6-month follow-up call. Patients who quit smoking tended to be of Chinese ethnicity, have initiated smoking at a later age, be better educated, and have lower Fagerström Test of Nicotine Dependence scores. After adjusting for these factors, patients with a cardiovascular admission diagnosis had a significantly higher probability of quitting tobacco use than patients with a respiratory or other diagnosis. Conclusions: In patients acutely admitted to the hospital, a diagnosis of cardiovascular disease was associated with the highest quit rate. Smoking cessation interventions need to be incorporated into all cardiovascular disease treatment pathways to leverage the patient's motivation and to improve the quit rate. In addition, patients in groups with lower quit rates may benefit from more intensive programmes to increase the rate of successful cessation.

Analysis of Operational Characteristics and Substantiality Plan of Inpatient Diets for Foreigners in Hospitals (의료기관의 외국인 대상 환자식 운영 현황 및 내실화 방안 분석)

  • Kim, Hyung-Mi;Kim, Eun-Mi;Kim, Hye-Jin;Baek, Hee-Joon;Park, Mi-Sun;Lee, Geum-Ju;Lee, Hae-Young
    • Journal of the Korean Dietetic Association
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    • v.22 no.2
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    • pp.118-130
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    • 2016
  • The objectives of this study were to analyze the operational characteristics and to explore the substantiality plan of inpatient diets for foreigners in hospitals. Questionnaires were mail-delivered to 128 hospitals, and a total of 62 questionnaires were usable with a response rate of 48.4 percent. Statistical data analysis was completed using SPSS Win 11.0 for descriptive analysis, independent t-test, and ${\chi}^2$ test. Results can be summarized as follows. The average number of inpatient meals for foreigners in the last 6 months were 405 and 53 for general therapeutic diets and special therapeutic diets, respectively. The rates of hospitals with an exclusive department and exclusive staff for foreign inpatients were 48.4% and 53.2%, respectively. Major nationalities of foreign inpatients were China (37.5%) and Russia (31.3%), and their major medical departments were internal medicine (43.9%) and surgery (39.0%). The number of hospitals that provided inpatient diet only for foreigners was 42 (72.4%) and influencing factors were number of permitted beds (P<0.05), an exclusive department (P<0.001), and exclusive staff (P<0.01). The main type of menu was USA European style (61.1%), and the price of inpatient meals for foreigners was mostly \10,000~\25,000 (62.0%). As 75.9% of hospitals did not possess dietary slip manuals for foreigners, the case of preparing inpatient meals for foreigners in the form of a general therapeutic diet partially-modified according to disease was the majority (55.4%). Dietitians felt the need for nutrition management guidelines and dietary slip manuals (47.3%) as a substantiality plan of inpatient diets for foreigners. There is a need for exclusive foodservice standards for foreign inpatients in the changing medical environment.

A Study on the Facility Eligibility Inspection & Effect of Environment Improvement for National Inpatient Isolation Units (국가지정 입원치료 격리병상 시설적격성 및 환경개선효과 분석에 관한 연구)

  • Lee, Du Ru Na;Kwon, Soon Jung;Sung, Min Ki;Yoon, Hyung Jin;Hong, Jin Kwan
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.23 no.4
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    • pp.67-75
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    • 2017
  • Purpose: This study is for the facility eligibility and improvement evaluation analysis for the patient care environment of 7 facilities which has national inpatient isolation units. Methods: For the evaluation, first of all, the patient care environment of national inpatient isolation units are scrutinized by the checklist which is used on from 2014 with the 4 fields of criteria : architectural planning and layout, general requirement and condition for operating the negative pressured isolated patient room, HVAC system, and waste water discharging system. Finally, the evaluation results are compared with that of 2014. Results: The result shows that the average value of facility eligibility is 89.3 percent and which is 8.9 percent higher than the value before the MERS occurred. Implications: It is clear that facility remodeling of 7 institutions is being performed continuously, and the result of facility eligibility evaluation is reflected on design of a new 21 national inpatient isolation units those are going to be constructed from 2016. Therefore, it is expected that this study is used as a practical reference to establish the criteria of patient care environment management and safety management for both infectious disease outbreak and general service condition.

Relationship between Local Extinction Index and Medical Service Uses of Chronic Diseases (지역 소멸위험지수와 지역의 만성질환 의료이용의 관계)

  • Lee, Hyun-Ji;Oh, Jae-Hwan;Kim, Jae-Hyun;Lee, Kwang-Soo
    • Health Policy and Management
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    • v.31 no.3
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    • pp.301-311
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    • 2021
  • Background: This study purposed to analyze the relationship between the local extinction index and medical service uses of chronic diseases. The local extinction index is an indicator of the demographic structure and population aging of the region. Methods: The 2014-2018 statistics of National Health Insurance Corporation and Korean Statistical Information Service data were used for the analysis. First, descriptive statistics were used to analyze the general status of research variables. Second, a panel analysis was performed to analyze the relationship between the local extinction index and medical service uses of chronic diseases (hypertension, diabetes mellitus, periodontal disease, arthritis, mental health, epidemic disease, liver disease). Medical service uses were measured by the number of visits/inpatient days and medical charges of seven chronic diseases. Results: Panel analysis results showed that higher local extinction risks (meaning lower local extinction index) had a positive relationship with the number of visits/inpatient days and medical charges of chronic diseases. But the relationships were varied when the seven chronic diseases were analyzed separately. Conclusion: This study showed a significant relationship between the local demographic structure and medical service uses of chronic disease. Analyzing the local demographic structure will be an essential prerequisite step for implementing appropriate regional health care policies.

Analysis on the Multiple Frequency Disease Trend of Yeongbuk in Gangwon-do (강원도 영북권역 다빈도 질환 추세분석)

  • Lee, Si-Kyoung
    • Journal of the Health Care and Life Science
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    • v.8 no.2
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    • pp.135-142
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    • 2020
  • The purpose of this study was to analyze the frequency of use of hospitalization/outpatient care of patients with addresses in Yeongbuk-gu, Gangwon-do to identify the medical demand and status of medical use in Yeongbuk-do. The National Health Insurance Corporation (www.data.go.kr) conducted an analysis of health insurance and medical benefits (inpatient/outpatient) claims data from 2003 to 2017. The order of the highest frequency of chronic disease was ranked from 1st to 60th according to 'Healing Case and %'. In addition, the use of patients at Sokcho Medical Center, the only hospital in the Yeongbuk region, was analyzed at the same time. According to the analysis, the use of outpatient treatment and In-patients in the Yeongbuk area of Gangwon-do is increasing due to chronic non-infectious diseases from the past acute diseases. In particular, it is necessary to expand the functions of schizophrenia and obstetrics and gynecology and to carry out specific health projects necessary for the health care of the local community. Through this, we should improve the quality of life in Yeongbuk, Gangwon Province.

Analysis of Healthcare Quality Indicator using Data Mining and Decision Support System

  • Young M.Chae;Kim, Hye S.;Seung H. Ho
    • Proceedings of the Korea Inteligent Information System Society Conference
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    • 2001.01a
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    • pp.352-357
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    • 2001
  • This study presents an analysis of healthcare quality indicators using data mining for developing quality improvement strategies. Specifically, important factors influencing the inpatient mortality were identified using a decision tree method for data mining based on 8,405 patients who were discharged from the study hospital during the period of December 1, 2000 and January 31, 2001. Important factors for the inpatient mortality were length of stay, disease classes, discharge departments, and age groups. The optimum range of target group in inpatient healthcare quality indicators were identified from the gains chart. In addition, a decision support system was developed to analyze and monitor trends of quality indicators using Visual Basic 6.0. Guidelines and tutorial for quality improvement activities were also included in the system. In the future, other quality indicators should be analyze to effectively support a hospital-wide continuous quality improvement (CQI) activity and the decision support system should be well integrated with the hospital OCS (Order Communication System) to support concurrent review.

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Determinants of Hospital Inpatient Costs in the Iranian Elderly: A Micro-costing Analysis

  • Hazrati, Ebrahim;Meshkani, Zahra;Barghazan, Saeed Husseini;Jame, Sanaz Zargar Balaye;Markazi-Moghaddam, Nader
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.3
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    • pp.205-210
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    • 2020
  • Objectives: Aging is assumed to be accompanied by greater health care expenditures. The objective of this retrospective, bottom-up micro-costing study was to identify and analyze the variables related to increased health care costs for the elderly from the provider's perspective. Methods: The analysis included all elderly inpatients who were admitted in 2017 to a hospital in Tehran, Iran. In total, 1288 patients were included. The Mann-Whitney and Kruskal-Wallis tests were used. Results: Slightly more than half (51.1%) of patients were males, and 81.9% had a partial recovery. The 60-64 age group had the highest costs. Cancer and joint/orthopedic diseases accounted for the highest proportion of costs, while joint/orthopedic diseases had the highest total costs. The surgery ward had the highest overall cost among the hospital departments, while the intensive care unit had the highest mean cost. No statistically significant relationships were found between inpatient costs and sex or age group, while significant associations (p<0.05) were observed between inpatient costs and the type of ward, length of stay, type of disease, and final status. Regarding final status, costs for patients who died were 3.9 times higher than costs for patients who experienced a partial recovery. Conclusions: Sex and age group did not affect hospital costs. Instead, the most important factors associated with costs were type of disease (especially chronic diseases, such as joint and orthopedic conditions), length of stay, final status, and type of ward. Surgical services and medicine were the most important cost items.