• 한국병원경영학회지
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• 제26권1호
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• pp.17-25
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• 2021

This study aimed to analysis factors related to in-hospital death of injured patients by patient safety accident. A total of 1,529 inpatients were selected from Korea Centers for Disease Control and Prevention database(2013-2017). Frequency, Fisher's exact test, t-test, ANOVA, logistic regression analyses by using STATA 12.0 were performed. Analysis results show that the mortality rate was lower for female than male but the mortality rate was higher for the older age, the higher the CCI, head (or neck), multiple, systemic damage sites, internal and others, metropolitan cities based on Seoul and 300-499 based on the bed size of 100-299. Based on these findings, the possibility of using the in-depth investigation of discharge damage from the Korea Centers for Disease Control and Prevention as a data source for the patient safety survey conducted to understand the actual status of patient safety accident types, frequency, and trends should be reviewed. Also, it is necessary to prevent injury and minimize death by identifying factors that affect death after injury by patient safety accident.

• 보건행정학회지
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• 제23권3호
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• pp.233-243
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• 2013

Background: This study was conducted to evaluate the individual and community level factors which were influencing the severe injury patients' death and transfer at discharge. Methods: Analysis data is based on Korean National Hospital Discharge In-depth Survey Data released by the Korea Center for Disease Control and Prevention from 2006 to 2008. Study subjects was 11,026 inpatients with of severe injury. For multi-level analysis, socio-demographic characteristics, injury related characteristics, hospitalization related characteristics were used as individual level factors, and socio-environmental characteristics and health care resource characteristics were used as community level factors. Results: As to community level factors affecting mortality of severe injury, the possibility of death was also high in cases of less numbers of surgeons per a population of 100,000 and more number of operation beds. As to community level factors affecting transfer of severe injury, vulnerable areas with higher social deprivation index and low population density had higher possibility of transfer. Conclusion: Both individual level factors and community level factors affected clinical outcomes of treatment for severe injury. In particular, since there happened higher death and transfer of severe injury in socioeconomic and medical vulnerable areas, special efforts for establishing preventive policy and care system for injury in national and area level should be directed toward such areas.

• International journal of advanced smart convergence
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• 제11권1호
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• pp.127-133
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• 2022

This study aims to find out the associative relationship between dementia and comorbidities. To conduct this study, we used KNHDIS(Korea National Hospital Discharge In-depth Injury Survey) data from 2009 to 2018 provided by the KDCA(Korean Disease Control and Prevention Agency) annually. We used MySQL for data preprocessing and R for data analysis. As a result of applying the Apriori algorithm criteria of support(≥0.01), confidence(≥ 0.6), and lift(>1), seventeen rules related to dementia were discovered. The diseases associated with dementia were diabetes mellitus, hypertension, disorders of lipoprotein metabolism, glomerular disorders in diabetes mellitus, renal diseases, cardiovascular disease, cerebrovascular disease, and other urinary system disorders. This study can be utilized as primary data for the care of patients with dementia and provides implications for improving effective dementia prevention policies.

• 한국학교ㆍ지역보건교육학회지
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• 제23권1호
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• pp.29-40
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• 2022

Objectives: The purpose of this study is to identify the relationship between metabolic syndrome factor diseases and falls in the elderly aged 65 years or older and use them as basic data to reduce the risk of falls. Methods: The method of this study was to compare the injury-related characteristics of the fall and non-fall groups with a factor disease of metabolic syndrome in Korea over 65 years of age. Data from the 14th National Hospital Discharge In-depth Injury Survey in 2018 were used to conduct the study. A total of 7,991 data were analyzed using SPSS 23.0. Results: Among the total injuries, the fall group with metabolic syndrome factor disease accounted for 69.0% and the non-fall group 31.0%. Falls occurred in 86.3% of households. In the fall group with metabolic syndrome factor disease, the number of females was 1.9~2.1 times higher than that of males. Compared to 65~69 years of age, the incidence of falls was 1.4~1.5 times higher in 70~79 years, 1.7~2.2 times higher in 80~89 years, and 2.5~3.6 times higher in 90-year-olds and older. In NISS, the incidence of falls was 1.7 times higher in moderate compared to mild. In principle diagnosis, the incidence of falls was 2.2 times higher in S40-S99 compared to S00-S19. Conclusion: The elderly with metabolic syndrome factor disease should continue to promote health through light exercise that can strengthen muscle strength to prevent falls.

• 디지털융복합연구
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• 제11권5호
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• pp.371-384
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• 2013

본 연구에서는 한국 및 미국의 퇴원환자 자료를 이용하여 한국 및 미국의 중증도 보정 사망 모형을 개발하고 개발된 중증도 보정 사망모형에 따라 중증도 보정 사망률 지표를 산출 및 비교한 다음 이를 통해 국내 의료기관 사망률 관리 방안을 제시하고자 하였다. 한국 및 미국 의료기관의 중증도 보정 사망 모형은 데이터마이닝기법인 다중 로지스틱회귀분석 기법, 의사결정나무분석 기법을 이용하여 개발하였다. 개발된 의료기관의 중증도 보정 사망모형에 따라 한국 및 미국 의료기관의 중증도 보정 사망률을 산출한 결과 한국은 매년 증가하고 있는 반면 미국은 매년 감소하고 있는 것으로 나타나 한국과 미국간에 차이가 있었다. 의료기관의 병상규모별 중증도 보정 사망률의 변이 또한 한국이 미국보다 높았다. 국내 의료기관의 사망률 관리를 위해서는 의료기관 자체내에서 사망환자 관리가 가능한 대형 의료기관들의 경우 의료기관 중증도 보정 사망률 평가 결과 공개를 통해 지속적으로 사망률 관리를 유도하고, 의료기관 자체내에서 사망률 관리가 힘든 중소병원들은 국가 차원에서 파악한 국내 의료기관 사망환자 관리의 문제점 및 이를 개선할 수 있는 개선방안을 토대로 사망률 관리 컨설팅을 시행하는 등 의료기관 사망환자 관리 사업을 진행하여야 한다.

• 보건행정학회지
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• 제24권4호
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• pp.322-329
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• 2014

Background: As most of people in Korea are covered by National Health Insurance (NHI), the disease information collected in NHI provides high availability for health policy. Nevertheless, the validity of disease codes in NHI data has been controversial till now. So we tried to evaluate the validity of them by comparing the NHI claims data with Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) data. Methods: We compared the NHI patients sample data (2009) with the KNHDIIS data (2009). We selected the inpatient data of KNHDIIS and NHI patients sample. The weighted number of patients from NHI patients sample was 5,551,210 and the number of patients from KNHDIIS was 5,559,874. We classified the disease codes into principal diagnoses and other diagnoses, and we compared as one, two, three unit level. Also we calculated the agreement rate of each of them. Results: In the comparison of principal diagnoses, NHI claims data had more C code than KNHDIIS data did, whereas KNHDIIS data had more Z code than NHI claims data did. In the comparison of other diagnoses, NHI claims data had 2, 3 more codes than KNHDIIS data did. The overall agreement rate at three unit level was 76.5% in principal diagnoses and 46.8% in other diagnoses. Conclusion: Considering the large difference between the two data, the validity of disease codes in NHI Claims data seems to be low. To increase the validity of them, the definite detail coding indicator, the reinforcement of coding education, and the reform of system are needed.

• 한국산학기술학회논문지
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• 제13권2호
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• pp.747-754
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• 2012

이 연구의 목적은 질병관리본부의 퇴원손상환자조사 자료를 이용하여 경제적 수준이 낮은 지역이 그렇지 않은 지역에 비해 다른 운수사고 양상을 보이는지를 규명하는 것이었다. 지역의 경제적 수준은 재정자립도를 지표로 삼아 5개로 구분하였다. 이 연구의 주요 결과는 다음과 같다. 첫째, 운수사고는 25-44세 그룹까지 증가하다가 그 이후에는 감소하는 양상을 보였다. 둘째, 운수사고의 유형은 승용차의 빈도가 가장 높았고 길 또는 간선도로에서 가장 많은 사고가 발생하였다. 셋째, 지역에 따라 운수사고 유형에 차이가 있었다. 넷째, 응급 입원율은 지역에 따라 차이를 보였으나, 소득수준에 따른 차이는 없었다. 마지막으로 소득수준이 낮은 지역은 골절, 자상, 개방성 상처와 같이 심각한 손상이 주로 발생하고 소득수준이 높은 지역은 염좌, 긴장, 탈구와 같이 상대적으로 덜 심각한 손상이 주로 발생하는 등 손상 양상의 지역간 차이가 발생하고 있었으며 이러한 지역간 차이는 통계적으로 유의하였다(p<0.05). 따라서, 지역간 소득 수준에 따라 운수사고 양상이 차이가 발생하고 있으므로 정부 및 지방자치단체는 이를 고려한 차별화된 운수사고 예방전략을 수립해야 할 것이다.

• 한국병원경영학회지
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• 제19권4호
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• pp.21-33
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• 2014

This study was conducted to propose an insight into the appropriateness of hospital length of stay(LOS) by developing a severity-adjusted LOS model for patients with pneumonia, organism unspecified. The pneumonia risk-adjustment model developed in this paper is based upon the 2006-2010 the Korean National Hospital Discharge in-depth Injury Survey. Decision tree analysis revealed that age, admission type, insurance type, and the presence of additional disorders(pleural effusion, respiratory failure, sepsis, congestive heart failure etc.) were major factors affecting the severity-adjusted model using the Clinical Classifications Software(CCS). Also there was a difference in LOS among the regional hospitals, especially the hospital LOS has not been efficiently managed in Gyeongsangbuk-do, Jeollanam-do, Jeollabuk-do, Daejeon, and Busan. To appropriately manage hospital LOS, reliable statistical information about severity-adjusted LOS should be generated on a national level to make sure that hospitals voluntarily reduce excessive LOS and manage main causes of delayed discharge.

• 한국학교ㆍ지역보건교육학회지
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• 제23권4호
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• pp.29-39
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• 2022

Objectives: The purpose of this study was to assess the incidence of delivery and puerperium complications in South Korea and analyze the correlations between the patient's characteristics and delivery and complications before and after 10 years. Methods: This study used the data from an Korean National Hospital Discharge In-depth Injury Survey. Cases of which the principal diagnosis and second diagnoses were disease classification ICD code O00-O99(Pregnancy, childbirth and the puerperium) were defined as the study subjects, and the first study group was divided as the year of discharge from 2005 to 2007, and the second study group from 2015 to 2017. Results: The number of patients discharged whose principal diagnosis or second diagnoses was O00-O99 was 21,598(Weighted 423,306) from 2005 to 2007 and 19,028(Weighted 364,384) from 2015 to 2017, which decreased by 13.9% compared to 10 years ago. The average age of discharged patients increased by about 2 years and was statistically significant (p<.0001). Factors associating spontaneous delivery, caesarean section and puerperium complication were hospitalization route, bed size, maternal age, length of hospital stay, and the year of discharge. Conclusion: Based on the results of this study, health and education policies and economic support for medical care for high-risk pregnancy and delivery management would be necessary continuously. In addition, policies to strengthen the medical system for high-risk pregnancy management in non-metropolitan areas with high fertility rates would also be needed.

• 한국산학기술학회논문지
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• 제14권10호
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• pp.4910-4918
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• 2013

본 연구는 급성심근경색환자의 효율적인 재원일수 관리를 위해 재원일수에 대한 중증도 보정 모형을 개발하고자 하였다. 2004-2009년 퇴원손상심층조사 자료에서 주진단이 I21인 급성심근경색환자 6,074명을 추출하였으며, 모형 개발 시 데이터마이닝 기법(다중회귀분석, 의사결정나무, 신경망 기법)을 적용하였다. 개발된 모형들 중에서 의사결정나무 모형이 가장 우수한 모형으로 판정되어 이를 본 연구의 중증도 보정 모형으로 채택하였다. 급성심근경색 환자의 재원일수의 중증도 보정에 영향을 미치는 주요한 요인은 관상동맥우회술 시행유무, 퇴원 시 사망유무, 동반지수 등 이였으며, 병상규모와 의료기관 소재지 별로 중증도 보정 재원일수와 실제 재원일수에 차이가 있었다. 급성심근경색환자의 재원일수 변이를 줄이고 효율적으로 관리하기 위해서는 개발된 모형에 각 의료기관의 자료를 적용하여 중증도를 보정한 후, 차이가 나는 요인을 규명하여 이를 해결하는 활동이 수행되어야 할 것이다.