• 제목/요약/키워드: Inpatient care

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Application of Patient Safety Indicators using Korean National Hospital Discharge In-depth Injury Survey (퇴원손상심층자료를 이용한 환자안전지표의 적용)

  • Kim, Yoo-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.5
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    • pp.2293-2303
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    • 2013
  • Objective: This study aims to determine whether national patient safety indicators (PSIs) can be calculated. Methods: Using PSI criteria from Organization for Economic Co-Operation and Development (OECD) Health Technical Papers 19 based on the Agency for Healthcare Research and Quality (AHRQ), PSIs were identified in the Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) database for 875,622 inpatient admissions between 2004 and 2008. Logistic regression was used to estimate factors of variations for PSIs. Results: From 2004 to 2008, 3,084 PSI events of 8 PSIs occurred for over 80 thousands discharges. Rates per 1,000 events for decubitus ulcer (PSI3, 4.88), foreign body left during procedure (PSI5, 0.05), postoperative sepsis (PSI13, 1.32), birth trauma-injury to neonate (PSI17, 7.92) and obstetric trauma-vaginal delivery (PSI18, 32.81) are all identified between ranges from maximum to minimum of OECD rates, respectively. However, rates per 1,000 events for selected infections due to medical care (PSI7, 0.22), postoperative pulmonary embolism or deep vein thrombosis (PSI12, 0.90) and accidental puncture or laceration (PSI15, 0.71) are below the minimum of OECD range. 7 PSIs except PSI 18 showed statistically significant relationship with number of secondary diagnoses. When adjusting patient characteristics, there are statistically significant different rates according to bed size or location of hospitals. Conclusion: This is the first empirical study to identify nationally number of adverse events and PSIs using administrative database. While many factors influencing these results such as quality of data, clinical data and so on are remain, the results indicate opportunities for estimate national statistics for patient safety. Furthermore outcome research such as mortality related to adverse events is needed based on results of this study.

Validation of initial nutrition screening tool for hospitalized patients (입원 환자용 초기 영양검색도구의 타당도 검증)

  • Kim, Hye-Suk;Lee, Seonheui;Kim, Hyesook;Kwon, Oran
    • Journal of Nutrition and Health
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    • v.52 no.4
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    • pp.332-341
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    • 2019
  • Purpose: Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared. Methods: Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool. Results: The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools. Conclusion: This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.

The Characteristics of Child and Adolescent Suicide Attempters Admitted to a University Hospital (일 대학병원에 자살 시도 후 입원한 소아청소년들의 특성)

  • Bang, Yeon-Sik;Lee, Jinhee;Min, Seongho;Ahn, Joung-Sook;Park, Ki-Chang;Kim, Min-Hyuk
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.135-144
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    • 2018
  • Objectives : The purpose of this study was to identify the differences of demographic and clinical characteristics between child-adolescents who received medical inpatient care and non-hospitalized adolescents after suicide attempts. Methods : The study included 35 child-adolescents who were hospitalized (Admission group) and 114 child-adolescents who were not hospitalized (Non-Admission group) as a result of a suicide attempt from 2009 to 2015. We compared sociodemographic, clinical, and suicide attempt-related characteristics through a chi-square test and logistic regression analysis to evaluate the differences between the two groups. Results : Child-adolescents of this study most commonly attempted suicide by poisoning, and for motivation of interpersonal problems. Admission group had significantly fewer attempts through injury by sharp objects (${\chi}^2=4.374$, p=0.037) and attempted suicide with a higher chance of actually dying when compared to Risk-Rescue Rating Scale (t=1.981, p=0.049). In addition, Admission group had relatively common motivation for academic problems (${\chi}^2=12.082$, p=0.001) and less motivation for interpersonal difficulties. (${\chi}^2=9.869$, p=0.002) Psychiatric diagnosis at the time of visiting the emergency department showed higher rates of depression in the admission group than Non-Admission group (${\chi}^2=8.649$, p=0.003). The results of logistic regression showed that depression affects hospitalization (OR=2.783, 95% CI 1.092-7.089, p=0.032). Conclusions : This study is meaningful in that it revealed the social and clinical characteristics of all child-adolescents who were hospitalized at a university hospital after attempting suicide. This study identified differences in motivation, methods, and psychiatric diagnosis of hospitalized adolescents and those who were not. Therefore, the results may help adolescent suicide attempters to get a discriminatory approach based on their admission.

A Study on the Characteristics of Inpatients in Korean Medicine Ophthalmology, Otolaryngology & Dermatology Clinic -From March, 2012 to February, 2018, Korean Medicine Hospital of Daejeon University- (한방안이비인후피부과 입원환자의 특성 연구 -2012년 3월부터 2018년 2월까지 대전대학교 둔산한방병원을 중심으로-)

  • Hwang, Mi-Lee;Jung, Hun-A
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.1
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    • pp.16-31
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    • 2019
  • Objective : The purpose of this study is to analyze the charcateristics of inpatients in Ophthalmology, Otolaryngology & Dermatology Clinic by gender, age, season, and department of medical care after hospitalization from March, 2012 to February, 2018. Method : From March 1, 2012 to February 28, 2018, patients who were admitted to the Ophthalmology, Otolaryngology & Dermatology Clinic of Korean Medical Hospital were classified by gender, age, department, and season, and their relationship, hospitalization period, number of outpatient visits Differences were analyzed objectively using various statistical methods using IBM SPSS 18.0. Results : 1. The number of inpatients was 432, including duplication. Of these, 317 were female and 115 were male. The number of female patients was 2.8 times higher. 2. The average age of the inpatients was 43.9 years and the number of middle-aged 40-50 patients was 48.6%. 3. The number of inpatients in the departments was in the order of dermatology, otology, laryngology, rhinology, and ophthalmology. The most hospitalized diseases were eczema in the dermatology department, sudden hearing loss in the otology department, tonsillitis/peritonsillar abscess, rhinitis in the rhinology department, and dry eye syndrome in ophthalmology. 1) The effect of gender on the difference in the number of inpatients by subdivision was statistically significant. 2) The effect of age on the difference in the number of inpatients by subdivision was statistically significant. 3) The effect of seasons on the difference in the number of inpatients was not statistically significant. 4. The number of inpatients by season was in the order of winter, spring, summer, autumn, and the number of inpatients decreased significantly in autumn. 1) The effect of gender on the difference in the number of hospitalized patients by season was not statistically significant. 2) The effect of age on the difference in the number of hospitalized patients by season was not statistically significant. 5. The average length of hospital stay for inpatients was 10.7 days. 1) The effect of gender on length of hospital stay was not statistically significant. 2) The effect of age on hospital stay was not statistically significant. 3) The effect of the subdivision on hospital stay was statistically significant. 4) The effect of the season on hospital stay was not statistically significant. Conclusion : As a result of this study, the most distinctive feature of the present study was the high rate of inpatients with otic disease like idiopathic hearing loss and Meniere 's syndrome and the high rate of female patients. This may be related to the increased prevalence of the disease and the severity of the disease. In addition, the high rate of female patients suggests that women are more likely to be affected by illnesses, as well as to have more medical use and severe symptoms requiring hospitalization. In the future, it would be better to provide various treatment plans and policies for patients with otic diseases and female patients. Also it would be good if studies on these fields are made in the future.