• Nutrition Research and Practice
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• 제17권2호
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• pp.218-227
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• 2023

BACKGROUND/OBJECTIVES: Malnutrition during hospitalization is linked to increased morbidity and mortality, but there are insufficient studies observing clinical factors contributing to weight loss during hospitalization in Indonesia. This study was therefore undertaken to determine the rate of weight loss during hospitalization and the contributing factors. SUBJECTS/METHODS: This was a prospective study involving hospitalized adult patients aged 18-59 yrs, conducted between July and September 2019. Body weight measurement was taken at the time of admission and on the last day of hospitalization. The factors studied were malnutrition at admission (body mass index < 18.5 kg/m²), immobilization, depression (Beck Depression Inventory-II Indonesia), polypharmacy, inflammatory status (neutrophil-lymphocytes ratio; NLR), comorbidity status (Charlson Comorbidity Index; CCI), and length of stay. RESULTS: Totally, 55 patients were included in the final analysis, with a median age of 39 (18-59 yrs) yrs. Of these, 27% had malnutrition at admission, 31% had a CCI score > 2, and 26% had an NLR value of ≥ 9. In all, 62% presented with gastrointestinal symptoms, and depression was documented in one-third of the subjects at admission. Overall, we recorded a mean weight loss of 0.41 kg (P = 0.038) during hospitalization, with significant weight loss observed among patients hospitalized for 7 days or more (P = 0.009). The bivariate analysis revealed that inflammatory status (P = 0.016) was associated with in-hospital weight loss, while the multivariate analysis determined that the contributing factors were length of stay (P < 0.001) and depression (P = 0.019). CONCLUSIONS: We found that inflammatory status of the patient might influence the incidence of weight loss during hospitalization, while depression and length of stay were independent predictors of weight loss during hospitalization.

• 보건행정학회지
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• 제31권2호
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• pp.173-179
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• 2021

Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients. Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals. Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001). Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.

• Archives of Plastic Surgery
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• 제34권6호
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• pp.713-718
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• 2007

Purpose: The aim of this study is to develop and apply the critical pathway to the orbital wall fracture patients and to elucidate its effect. Methods: Critical pathway(CP) sheet and questionnaire were developed by a team approach. Critical pathway was applied to 7 orbital wall fracture patients (CP group) from April 2006 to September 2006. Length of hospitalization and cost for hospitalization of CP group were compared to those of the 10 patients who had same disease entities and treated by conventional regimen(control group). Results: Length of hospitalization in the CP group (7.20 day) were insignificantly shorter than that of control group(8.71 day). Mean cost for hospitalization of the CP group(776,398 won) were insignificantly lower than that of control group(1,028,531 won). The patients satisfaction for the explanation regarding operation procedure, therapeutic operation fee, length of hospitalization and medical personnel were all affirmative. Conclusion: Critical pathway that we developed for orbital wall fracture definitely improved the quality of treatment. Furthermore, other critical pathways should be developed for another facial trauma patients.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4421-4426
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• 2016

Background: Smoking is recognized as a main leading preventable cause of mortality and morbidity worldwide. It is responsible for a considerable financial burden both on the health system and in society. This study aimed to examine the effect of smoking on cost of hospitalization and length of stay (LoS) among patients with lung cancer in Iran in 2014. Materials and Methods: A total of 415 patients were included in the study. Data on age, sex, insurance status, type of hospitals, type of insurance, geographic local, length of stay and cost of hospitalization was extracted by medical records and smoking status was obtained from a telephone survey. To compare cost of hospitalization and LoS for different smoking groups, current smokers, former smokers, and never smokers, a gamma regression model and zero-truncated poisson regression were used, respectively. Results: Compared with never smokers, current and former smokers showed a 48% and 35% increase in hospitalization costs, respectively. Also, hospital LoS for current and former smokers was 72% and 31% higher than for never smokers, respectively. Conclusions: Our study indicated that cigarette smoking imposes a significant financial burden on hospitals in Iran. It is, however, recommended that more research should be done to implement and evaluate hospital based smoking cessation interventions to better increase cessation rates in these settings.

• 한국콘텐츠학회논문지
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• 제16권3호
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• pp.563-574
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• 2016

본 연구의 목적은 정신요양시설 입소 정신장애인의 정신건강자신감 영향요인을 살펴보고 영향요인 및 메카니즘이 입소기간에 따라서 차이가 있는지를 탐색적으로 고찰하는 것이다. 분석대상은 정신요양시설 실태조사에 참여한 정신요양시설 입소 정신장애인 1,742명으로 구조방정식을 이용하여 분석하였다. 입소기간에 따른 차이를 탐색하기 위해 평균입소기간이 10년 미만 입소 정신장애인(n=962)와 10년 이상 입소 정신장애인(n=780)간 다중집단분석을 실시하였다. 주요 결과는 다음과 같다. (1) 학력, 유병기간, 정신과적 증상, 및 인지된 스티그마는 직 간접적으로 정신건강자신감에 영향이 있는 것으로 나타났다. (2) 영향력의 효과분해 결과 유일하게 유병기간만 인지된 스티그마를 통한 유의한 간접효과를 나타내었다. (3) 다중집단분석 결과는 입소기간에 따른 영향요인 및 메카니즘에 차이가 있는 것으로 나타났다. 이러한 결과를 바탕으로 연구의 의의 및 한계를 논의하였다.

• Journal of Preventive Medicine and Public Health
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• 제42권6호
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• pp.416-423
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• 2009

Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

• 한국의료질향상학회지
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• 제10권2호
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• pp.154-163
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• 2003

Purpose: The aim of this study is to develop and apply the critical pathway to the nasal bone fracture patients and to elucidate its effect. Methods: Critical pathway (CP) sheet and questionnaire were developed by a team approach. Critical pathway were applied to 30 nasal bone fracture patients (CP group) from June 2001 to November 2001. Length of hospitalization, cost for hospitalization and bed turnover rate of CP group were compared to those of the 30 patients who had same disease entities and treated by conventional regimen (control group). Results: Length of hospitalization in the CP group (4.20 day) were significantly shorter than that of control group (6.21 day). Mean cost for hospitalization of the CP group (492,106 won) were significantly lower than that of control group (678,376 won). Bed turnover rate in CP group (2.5) were higher than that of control group. The patients satisfaction for the medical personnel, explanation regarding operation procedure, therapeutic operation fee, and length of hospitalization were all affirmative. Conclusion: Critical pathway that we developed for nasal bone fracture definitely improved the quality of treatment and lowered cost of medical service. Furthermore, other critical pathways should be developed for another facial trauma patients.

• 디지털융복합연구
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• 제10권3호
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• pp.233-240
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• 2012

본 연구는 뇌졸중 환자의 입원 및 재원적절성에 영향을 미치는 요인을 파악함으로써 효율적인 병상이용과 질적인 의료서비스를 제공하고 불필요한 병상 이용을 줄여 급성기 치료가 꼭 필요한 대상자들이 즉시 병원을 이용할 수 있도록 도움을 주고자 하였다. 연구대상자는 일개 종합병원의 신경과에서 퇴원한 뇌졸중 환자로 의료보장별 의료 적절성을 파악하기 위해 최근 약 4년 동안인 2006년 3월 l일부터 2010년 10월 31일까지 총 154명의 대상자를 선정하였다. 연구방법은 입원 및 재원적절성을 평가하기 위해 적절성 평가지침(AEP)을 이용하여 의무기록을 분석하였고, 수집된 자료는 SPSS 12.0을 이용하여 전산처리하였다. 이상의 결과를 근거로 입원적절성을 높이고 재원기간을 단축시킨다면 재원적절성도 높아질 것이라는 결론을 얻게 된다. 또한 재원기간이 재원적절성에 영향을 미치는 것으로 조사되었기에 재원기간이 길어질수록 병상 회전율을 감소시키는 요인으로 영향을 미치게 되므로 적절한 시기에 퇴원이 이루어질 수 있도록 의료기관 내에서의 질 향상 전담팀을 구성하여 각 질환군에 따른 재원기간에 대한 적절성 평가 및 관리가 이루어져야 한다. 궁극적으로 뇌졸중 환자의 급성치료가 끝나면 즉시 재활치료 및 장기요양관리가 이루어질 수 있도록 장기요양시설 확충과 같은 정부의 뒷받침으로 불필요한 재원기간을 줄여갈 수 있는 것이다.

• 대한간호학회지
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• 제5권2호
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• pp.1-10
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• 1975

Every patient, who enters the hospital has a potential for becoming anxious. The control of hospitalization anxiety experienced by hospital patients is considered to be an important factor in the process of recovery from illness. This study was conducted to investigate the relationship between informativeness and hospitalization anxiety in order to give basic data for psycho-social aspect of nursing care for hospitalized patients. One hundred patients admitted to Kyungpook National University Hospital during the period of Jan. to June 1975 were sampled and divided into two groups; fifty of experimental and fifty of control group. The set of informations prepared by the investigator were given additionally to experimental group while the control group only received routine informations. Both groups were rated according to the Hospitalization Informativeness Scale which consisted of 24 questionaries and 4 categories and Hospitalization Anxiety Scale one or two days prior to discharge from the hospital. The results of the study were as follows; 1 . Mean values of Hospitalization Informativeness Scale revealed significant differences at 0.01 level with experimental group showing higher mean value. Age, sex ana educational states aid not influence the mean values of Hospitalization Informativeness Scale in both groups. 2 . The length of hospitalization did not influence significantly on the mean value of Hospitalization Informativeness Scale in both groups. 3. Rank difference correlation coefficiently between mean value of Hospitalization Informativeness Scale and the importance of information the patient's perceived were revealed significant at 0.01 level in all 4 categories such as admission discharge, treatment and nursing activities, diagnostic test, diagnosis and prognosis, health teaching for the patient and family in experimental group. While, only two categories such as treatment and nursing activities and health teaching for the patient and family in control group were revealed significant correlation. 4. Mean value of Hospitalization Anxiety Scale revealed significant difference at 0.05 level with the experimental group showing lower Hospitalization Anxiety Scale. 5. Correlation coefficiently between Hospitalization Informativeness Scale and Hospitalization Anxiety Scale were revealed significant at 0.01 level in experimental group but there was no significant correlation in control group.

• 생명과학회지
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• 제18권11호
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• pp.1493-1498
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• 2008

본 연구는 심폐바이패스를 이용한 성인 심장수술 시 수술 후 환자의 회복 결과에 영향을 미치는 인자들을 규명하기 위해 시행하였다. 성인 심장수술 환자 32명을 대상으로 하여 연구하였다. 심장수술 시 밸혈구 수, GOT, troponin-I (cTNI), interleukin-6 (IL-6), endothelin-1 (ET-1), D-dimer, neuron-specific enolase (NSE) 등의 혈장농도는 유의하게 증가한데 비해 혈소판 수는 감소하였다. 수술 직후 GOT 및 D-dimer 농도와 24 시간 및 총출혈량, 기계호흡보조 시간, 중환자실 치료기간, 재원일수와 각각 양의 상관성이 있었다. 혈소판 수와 기계호흡보조 시간, 중환자실 치료기간, 재원일수와 각각 음의 상관관계가 있었다. Creatinine 농도와 기계호흡보조 시간, 중환자실 치료기간 사이에 양의 상관성이 있었다. NSE 농도와 24 시간 출혈량 사이에 양의 상관관계를 보였다. cTNI 농도와 재원일수 간에 양의 상관성이 있었다. 대동맥 교차차단 및 총심폐바이패스 실시 시간과 24 시간 및 총 출혈량, 재원일수 사이에 양의 상관관계를 나타내었다. 결론적으로 본 연구의 결과들은 심폐바이패스를 적용한 성인 심장수술 시 수술 후 환자의 결과와 회복에 영향을 미치는 가장 중요한 변수는 수술 종료 직후(CPB-off)의 GOT, BUN, creatinine, D-dimer 등의 농도와 혈소판 수임을 시사하고 있다.