• Title/Summary/Keyword: Length of stay

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Development of severity-adjusted length of stay in knee replacement surgery (무릎관절치환술 환자의 중증도 보정 재원일수 모형 개발)

  • Hong, Sung-Ok;Kim, Young-Teak;Choi, Youn-Hee;Park, Jong-Ho;Kang, Sung-Hong
    • Journal of Digital Convergence
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    • v.13 no.2
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    • pp.215-225
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    • 2015
  • This study was conducted to develop a severity-adjusted LOS(Length of Stay) model for knee replacement patients and identify factors that can influence the LOS by using the Korean National Hospital Discharge in-depth Injury Survey data. The comorbidity scoring systems and data-mining methods were used to design a severity-adjusted LOS model which covered 4,102 knee replacement patients. In this study, a decision tree model using CCS comorbidity scoring index was chosen for the final model that produced superior results. Factors such as presence of arthritis, patient sex and admission route etc. influenced patient length of stay. And there was a statistically significant difference between real LOS and adjusted LOS resulted from health-insurance type, bed size, and hospital location. Therefore the policy alternative on excessive medical utilization is needed to reduce variation in length of hospital stay in patients who undergo knee replacement.

Appropriateness of Bed Utilization in One University Hospital (병상 이용의 적절성에 영향을 미치는 요인에 관한 연구 -한 대학병원 자료를 중심으로-)

  • 이상일;김용익;신영수
    • Health Policy and Management
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    • v.3 no.1
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    • pp.1-24
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    • 1993
  • This study is designed to find clues to make a plan for efficient hospital bed utilization. Author has tried to estimate the level of appropriateness and to find out factors affecting intra-hospital variation of inappropriate bed utilization using modified Appropriateness Evaluation Protocol of which criteria are based on service intensity and patients' conditions. Systematic random sampling was done from the population of inpatients during one month in on university hospital. Data were collected by concurrent and retrospective medical record review and analysed by multiple logistic regression. In medical services, 83.5% of admission reveals appropriate and the level of inappropriate admission shows significant differences by patients' residence, type of department admitted to, admission 개\ulcorner, and length of stay. In surgical services, 97.3% and 34.7% are appropriate in location and timing of surgery respectively. Inappropriate timing of surgery differs significantly depending on patients' age, type of department admitted to, admission route, and length of stay. Sixty two percent of hospital days shows appropriate and the level of inappropriateness show marked differences by patients'age, type of services, admission routes, part of the month, part of the stay, and length of stay. Inappropriate hospital days are due to inappropriate level of care, premature admission, improper scheduling of diagnostic or therapeutic procedures, and problems in scheduling surgery in sequence. In conclusion, substantially high proportion of inappropriate hospital bed utilization was confirmed. To reduce it, it is necessary to develop alternative services with which can replace inpatient services, and to introduce utilization management system which may include internal peer review.

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Risk Factors for Surgical Site Infections in Patients Undergoing Craniotomy (개두술을 받은 환자의 수술부위감염 관련요인 분석)

  • Cha, Kyeong-Sook;Cho, Ok-Hee;Yoo, So-Yeon
    • Journal of Korean Academy of Nursing
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    • v.40 no.2
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    • pp.298-305
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    • 2010
  • Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative surgical site infections (SSIs) after craniotomy. Methods: This study was a retrospective case-control study of 103 patients who had craniotomies between March 2007 and December 2008. A retrospective review of prospectively collected databases of consecutive patients who underwent craniotomy was done. SSIs were defined by using the Centers for Disease Control criteria. Twenty-six cases (infection) and 77 controls (no infection) were matched for age, gender and time of surgery. Descriptive analysis, t-test, $\chi^2$-test and logistic regression analyses were used for data analysis. Results: The statistical difference between cases and controls was significant for hospital length of stay (>14 days), intensive care unit stay more than 15 days, Glasgrow Coma Scale (GCS) score (${\leq}7$ days), extra-ventricular drainage and coexistent infection. Risk factors were identified by logistic regression and included hospital length of stay of more than 14 days (odds ratio [OR]=23.39, 95% confidence interval [CI]=2.53-216.11) and GCS score (${\leq}7$ scores) (OR=4.71, 95% CI=1.64-13.50). Conclusion: The results of this study show that patients are at high risk for infection when they have a low level of consciousness or their length hospital stay is long term. Nurses have to take an active and continuous approach to infection control to help with patients having these risk factors.

Length of stay in PACU among surgical patients using data mining technique (데이터 마이닝을 활용한 외과수술환자의 회복실 체류시간 분석)

  • Yoo, Je-Bog;Jang, Hee Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.7
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    • pp.3400-3411
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    • 2013
  • The data mining is a new approach to extract useful information through effective analysis of huge data in numerous fields. This study was analyzed by decision making tree model using Clementine C&RT(Classification & Regression Tree, CART) as data mining technique. We utilized this data mining technique to analyze medical record of 1,500 people. Whole data were assorted by length of stay in PACU and divided into 3 groups. The result extracted by C5.0 decision tree method showed that important related factors for lengh of stay in PACU are type of operation, preoperative EKG abnormality, anesthetics, operative duration, age.

The comparative study of predictive factors for prolonged length of stays that adult patients with acute appendicitis in emergency department (응급의료센터를 방문한 성인 급성 충수염 환자에서 재실 기간의 연장을 예측하는 인자에 대한 비교연구)

  • Jang, Young Jae;Kim, Sin Young;Hong, Dae Young;Baek, Kwang Je;Park, Sang O;Kim, Jong Won;Kim, Jin Yong;Lee, Kyeong Ryong
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.671-678
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    • 2018
  • Objective: This study examined the predictive factors for prolonged length of stays of adult patients with acute appendicitis (AA) in an emergency department (ED). Methods: This was a retrospectively clinical study including patients in an ED. All patients were diagnosed from the clinical symptoms and a typical physical examination, and had undergone a computed tomography (CT) evaluation on the ED visiting date. All data were collected from the electrical medical records. The clinical parameters analyzed were the laboratory data, including the white blood cell count with differential values, C-reactive protein (CRP) level, initial vital signs, duration of admission, coexisting perforation of the appendix in the CT findings. The relationship between the clinical parameters and length of stay was assessed. Results: A total of 547 patients with AA were enrolled in this study. Among them, there were 270 male patients with a mean age of $40.7{\pm}15.8years$. The baseline characteristics, initial clinical features, laboratory, and imaging studies results of 129 patients in the prolonged length of stay (pLOS) group, and 418 patients of the non-pLOS group in AA were compared. Multivariable logistic regression analysis revealed the predictive factors related to pLOS in AA to be as follows: age 40 years or older, body temperature over $37.3^{\circ}C$, CRP level greater than 5.0 mg/dL, and evidence of perforation in CT findings (P<0.001). Conclusion: If we check age, fever, CRP level and find evidence of perforation, it might be helpful for predicting the increasing period of length of hospital stay for patients with AA in ED.

Factors Influencing Intensive Care Unit Length of Stay of Patients with Critical Illness (성인 중환자실에 입실한 환자의 중환자실 체류기간에 영향을 미치는 요인 탐색)

  • Son, Youn-Jung;Song, Hyo-Suk;Won, Mi Hwa;Yang, Sun Hee
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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    • v.7 no.11
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    • pp.525-536
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    • 2017
  • Purpose: The aim of this study was to identify the factors influencing ICU (intensive care units) length of stay of adult patients with critical illness. Methods: This study was adopted descriptive design. 270 patients who were admitted to ICU in general hospital, Seoul were analyzed. Results: A total of 270 patients, 116 (43%) patients had stayed more than 5 days. The length of stay of intensive care unit was significant positive correlation with the FCI(Functional Comobidity Index) score(r=0.33, p<.001) and APACHE(Aacute Physiology and Chronic Health Evlauaion) II(r=0.19, p=.001). In multiple logistic regression, the predictors of ICU length of stay were admission route (p=0.013), FCI score (p<0.001), APACHE II(p=0.012). Conclusions: Heatlh care providers in ICU should be aware that patients who admit to emergency departments and have higher disease severity are more considered to reduce their ICU length of stays.

Evaluation of lung injury score as a prognostic factor of critical care management in multiple trauma patients with chest injury (흉부외상이 동반된 다발성 외상환자에서 폐손상 점수가 중환자실 치료에 미치는 영향)

  • Han, Kook-Nam;Choi, Seok-Ho;Kim, Yeong-Cheol;Lee, Kyoung-Hak;Lee, Soo-Eon;Jeong, Ki-Young;Suh, Gil-Joon
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.105-110
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    • 2011
  • Purpose: Chest injuries in multiple trauma patients are major predisposing factor for increased length of stay in intensive care unit, prolonged mechanical ventilator, and respiratory complications such as pneumonia. The aim of this study is the evaluation of lung injury score as a risk factor for prolonged management in intensive care unit (ICU). Methods: Between June to August in 2011, 46 patients admitted to shock and trauma center in our hospital and 24 patients had associated chest damage without traumatic brain injury. Retrospectively, we calculated injury severity score (ISS), lung injury score, and the number of fractured ribs and performed nonparametric correlation analysis with length of stay in ICU and mechanical ventilator support. Results: Calculated lung injury score(<48 hours) was median 1(0-3) and ISS was median 30(8-38) in study population. They had median 2(0-14) fractured ribs. There were 2 bilateral fractures and 2 flail chest. Ventilator support was needed in 11(45.8%) of them for median 39 hours(6-166). The ISS of ventilator support group was median 34(24-34) and lung injury score was median 1.7(1.3-2.5). Tracheostomy was performed in one patient and it was only complicated case and ICU stay days was median 9(4-16). In correlation analysis, Lung injury score and ISS were significant with the length of stay in ICU but the number of fractured ribs and lung injury score were predicting factors for prolonged mechanical ventilator support. Conclusion: Lung injury score could be a possible prognostic factor for the prediction of increased length of stay in ICU and need for mechanical ventilator support.

Analysis of the Quality of Foreign Tourists to Indonesia

  • DIRGANTARA, Satria;AGUSTINA, Neli
    • Asian Journal of Business Environment
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    • v.12 no.3
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    • pp.31-39
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    • 2022
  • Purpose: This research aims to analyze the quality and characteristics of foreign tourists to Indonesia. Research design, data and methodology: The indicator used to see the quality of foreign tourists is their expenditure while in Indonesia. The data used is secondary data and the statistical analysis used is panel data regression to see the effect of Economic Distance, GDP per capita, Average Length of Stay and Exchange Rate on the quality of Foreign Tourists from 2010 to 2019. Results: Foreign tourists to Indonesia are dominated by young tourists, male and stay about 8.87 days. Their expenditure is relatively low, mostly spent on accommodation, food and beverage. The variables of average length of stay, exchange rate, economic distance, and GDP per capita have a significant and positive effect on the quality of foreign tourists to Indonesia. Conclusions: The number of foreign tourists visiting Indonesia in 2010-2019 tends to increase where the majority of tourists come from countries that are geographically close to Indonesia, young tourists, and male. The quality of tourists in terms of spending is still relatively low. The characteristics of foreign tourists and economic indicators used in the study have a positive effect on improving the quality of tourists.

Patient Outcomes according to Blood Glucose Level in Neonates with Cardiovascular Surgery (심혈관 수술 신생아의 혈당수준에 따른 환아 결과)

  • Hwang, Jeong-Hye;Park, Hyoung-Sook
    • Child Health Nursing Research
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    • v.18 no.1
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    • pp.43-52
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    • 2012
  • Purpose: The purpose of this study was to provide basic data for suitable neonate blood glucose maintenance by investigating and analyzing the blood glucose level of post cardiovascular surgery neonates in the ICU for the effect of blood glucose levels on the following outcomes; ICU stay, hospital stay, mechanical ventilation time, morbidity, and mortality. Methods: The participants were 143 neonates in the ICU after having had cardiovascular surgery. The design for this study was an investigation of the blood glucose levels of the neonates and retrospective analysis of patient outcomes according to blood glucose level. Results: The results for the neonate groups showed that the factors of hospital stay, ICU stay, mechanical ventilation time and mortality, for the group with a blood glucose level over 140 mg/dL were longer and higher than for the group with blood glucose of less than 100 mg/dL or the group between 100-139 mg/dL. Conclusion: The results of this study indicate that when caring for neonates after cardiovascular surgery, it is important to recognize the influence of blood glucose levels on patient outcomes like hospital days, ICU stay, length of time on mechanical ventilation and mortality. Further, care guidelines for neonates' glucose level management need to be developed.