• Journal of The Korean Society of Clinical Toxicology
• /
• v.20 no.2
• /
• pp.66-74
• /
• 2022

Purpose: This study investigates the characteristics and prognosis of acute poisoning patients visiting nationwide emergency departments before and after the Coronavirus disease 2019 (COVID-19) pandemic. Data were obtained from the National Emergency Department Information System (NEDIS). Methods: This nationwide retrospective observational study included acute poisoning patients who visited the emergency departments between February 1 to December 31, 2020, which has been determined as the pandemic period. The same periods in 2018 and 2019 were designated as the control periods. The primary outcome assessed was the length of stay in emergency departments (EDLOS). The secondary outcomes examined were intensive care unit admission rate and in-hospital mortality rate before and after the pandemic. A subgroup analysis was performed for inpatients and intentional poisoning patients. Results: A total of 163,560 patients were included in the study. During the pandemic, the proportion of women increased from 50.0% in 2018 and 50.3% in 2019 to 52.5% in 2020. Patients aged 20-29 years increased from 13.4% in 2018 and 13.9% in 2019 to 16.6% in 2020. A rise in cases of intentional poisoning was also noted - from 33.9% in 2018 and 34.0% in 2019 to 38.4% in 2020. Evaluating the hospitalized poisoned patients revealed that the EDLOS increased from 3.8 hours in 2018 and 3.7 hours in 2019 to 4.2 hours in 2020. ICU admissions were also markedly increased (2018, 48.2%; 2019, 51.8%; 2020, 53.2%) among hospitalized patients. Conclusion: The COVID-19 pandemic has changed the epidemiology, clinical characteristics, and prognosis of acute poisoning patients visiting nationwide emergency departments in Korea. The proportion of young adults, women, and intentional poisoning patients has increased after the COVID-19 pandemic. Prolonged length of stay at the emergency department and an increased rate of intensive care unit admissions were determined in hospitalized acute poisoning patients.

• Archives of Plastic Surgery
• /
• v.44 no.6
• /
• pp.539-544
• /
• 2017

Background We conducted this study to identify factors that may prolong the length of the hospital stay (LHS) in patients with diabetic foot (DF) in a single-institution setting. Methods In this single-center retrospective study, we evaluated a total of 164 patients with DF, and conducted an intergroup comparison of their baseline demographic and clinical characteristics, including sex, age, duration of diabetes, smoking status, body mass index, underlying comorbidities (e.g., hypertension or diabetic nephropathy), wound characteristics, type of surgery, the total medical cost, white blood cell (WBC) count, C-reactive protein (CRP) levels, erythrocyte sedimentation rate, and albumin, protein, glycated hemoglobin, and 7-day mean blood glucose (BG) levels. Results Pearson correlation analysis showed that an LHS of >5 weeks had a significant positive correlation with the severity of the wound (r=0.647), WBC count (r=0.571), CRP levels (r=0.390), DN (r=0.020), and 7-day mean BG levels (r=0.120) (P<0.05). In multiple regression analysis, an LHS of >5 weeks had a significant positive correlation with the severity of the wound (odds ratio [OR]=3.297; 95% confidence interval [CI], 1.324-10.483; P=0.020), WBC count (OR=1.423; 95% CI, 0.046.0-356; P=0.000), CRP levels (OR=1.079; 95% CI, 1.015-1.147; P=0.014), albumin levels (OR=0.263; 95% CI, 0.113.3-673; P=0.007), and 7-day mean BG levels (OR=1.018; 95% CI, 1.001-1.035; P=0.020). Conclusions Surgeons should consider the factors associated with a prolonged LHS in the early management of patients with DF. Moreover, this should also be accompanied by a multidisciplinary approach to reducing the LHS.

• Journal of Preventive Medicine and Public Health
• /
• v.42 no.1
• /
• pp.49-58
• /
• 2009

Objectives : The purpose of the current study was to evaluate the usefulness of the following four comorbidity indices in gastric cancer patients who underwent surgery: Charlson Comorbidity Index(CCI), Cumulative Illness rating scale(CIRS), Index of Co-existent Disease(ICED), and Kaplan-Feinstein Scale(KFS). Methods : The study subjects were 614 adults who underwent surgery for gastric cancer at K hospital between 2005 and 2007. We examined the test-retest and inter-rater reliability of 4 comorbidity indices for 50 patients. Reliability was evaluated with Spearman rho coefficients for CCI and CIRS, while Kappa values were used for the ICED and KFS indices. Logistic regression was used to determine how these comorbidity indices affected unplanned readmission and death. Multiple regression was used for determining if the comorbidity indices affected length of stay and hospital costs. Results : The test-retest reliability of CCI and CIRS was substantial(Spearman rho=0.746 and 0.775, respectively), while for ICED and KFS was moderate(Kappa=0.476 and 0.504, respectively). The inter-rater reliability of the CCI, CIRS, and ICED was moderate(Spearman rho=0.580 and 0.668, and Kappa=0.433, respectively), but for KFS was fair(Kappa=0.383). According to the results from logistic regression, unplanned readmissions and deaths were not significantly different between the comorbidity index scores. But, according to the results from multiple linear regression, the CIRS group showed a significantly increased length of hospital stay(p<0.01). Additionally, CCI showed a significant association with increased hospital costs (p<0.01). Conclusions : This study suggests that the CCI index may be useful in the estimation of comorbidities associated with hospital costs, while the CIRS index may be useful where estimatation of comorbiditie associated with the length of hospital stay are concerned.

• Journal of Preventive Medicine and Public Health
• /
• v.42 no.6
• /
• pp.416-423
• /
• 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.

• Journal of Korean Academy of Nursing Administration
• /
• v.3 no.2
• /
• pp.151-165
• /
• 1997

A cost analysis for hospitalized patients was performed based on the KDRG classification in order to determine an appropriate nursing fee under the PPS(Prospective Payment System). The data was collected from 20 nursing units of three tertiary hospitals and two secondary hospitals from August 26 to September 15, 1996. The study consisted of 148 inpatients diagnosed for lens procedures(KDRG 03900), tonsillectomy &/or adenoidectomy(KDRG 16100), Cesarean section(KDRG 37000), or vaginal delivery(KDRG 37300) without any complications. The direct or indirect nursing hours of each patients were measured. Then, direct or indirect nursing expenditures of four nursing units, operating room and delivery room were computed. Finally, the resources used including average total nursing hours, average length of stay and average nursing cost of each KDRG were estimated as follows; 1) The average total nursing hours were 640 minutes for lens procedures, 403 minutes for tonsillectomy &/or adenoidectomy, 934 minutes for appendectomy with complicated principal diagnosis, 1,094 minutes for Cesarean section and 631 minutes for vaginal delivery. Significant differences were found in average total nursing hours among hospitals. 2) The average length of stay in lens procedures were 5 days, 4 days for tonsillectomy &/or adenoidectomy, 6 days for appendectomy with complicated principal diagnosis, 8 days for Cesarean section and 3 days for vaginal delivery. All results were within normal determined by the Ministry of Health and Welfare although significant differences existed among hospitals, especially with average length of stay for leng procedures between tertiary hospitals and secondary hospitals which was greater than for those of others. 3) The average nursing cost were 87,146 Won for lens procedures, 69,600 Won for tonsillectomy &/or adenoidectomy, 128,337 Won for appendectomy with complicated principal diagnosis, 151,769 Won for Cesarean section and 85,403 Won for vaginal delivery. These costs were 7.6%, 13.0%, 13.0%, 16.0% and 22.0%, respectively, of the official price fixed by the Ministry of Health and Welfare under the prospective payment system. Research for the analysis of nursing costs according to the severity of illness for those KDRGs shoud be carried out within the period of the PPS pilot project. In addition, a proper nursing fee schedule for a new reimbursement system based upon the result of the above research should be prepared in the near future.

• Culinary science and hospitality research
• /
• v.20 no.2
• /
• pp.214-231
• /
• 2014

This study was intended to investigate the alcohol drinking characteristics, Makgeolli drinking behavior, and perception of Makgeolli focusing on the Chinese students studying in Korea. 550 copies of self-administrated questionnaire for a survey were distributed from May 2nd to June 30th, 2012, and then 461 copies were adopted for the analyses. The drinking frequency and drinking amount at a time increased as the length of stay in Korea and monthly pocket money increased, and Makgeolli was second preferred, following beer. 97.5% of the students experienced drinking Makgeolli, the drinking rate and drinking amount of Makgeolli increased with the length of stay in Korea, and they mostly drank at restaurants and bars. Common motivations for drinking Makgeolli were taste and atmosphere while drinking it, and bad taste and headache were the most common reasons for disliking Makgeolli. The awareness of commercial Makgeolli types was low, and for the price and health promoting effects of Makgeolli, 92.4% and 85.8% of the students replied positively, respectively. These results suggest that the development of high quality Makgeolli adapted to the tastes of Chinese and relieving hangover, and advertising the health benefits would promote Makgeolli consumption in Chinese market.

• The Korean Nurse
• /
• v.35 no.3
• /
• pp.61-76
• /
• 1996

The purpose of this study was to develop a nursing care delivery system which can provide patient focused care and increase satisfaction for both patients and nurses. This study was a quasi-experimental study to test the effectiveness of direct / indirect nursing care hours, patient satisfaction, nurse's job satisfaction, and the difference of the length of stay between model and control group. Control group data were collected from 100 patients who had lumbar disease in the neuro-surgical unit and model group data were from 66 patients who didn't have family residents from August 21, 1995 to February 29, 1996. Model unit was operated by modified PPM(Professional Practical Model) system for 3 months from December 1, 1995 to February 29, 1996. Working committee empowered nurses to make a decision to provide increased opportunities for autonomy, accountability, and control over the environment in which they deliver care. Satisfaction survey was done twice and analyzed by the SPSS program. The results of the study were as follows; 1. Mean direct nursing care hours of the model group was 90.47 minutes as it was 28.04 in the control group which shows significant statistical difference (t=-18.0, P=0.000). 2. Patient satisfaction to nursing care of in the model group was significantly higher than the control group (t=-6. 77, P=0.000) and it apples to the all subcategories, too. 3. Nurse's job satisfaction shows the significant increase in the model group than the control group(Z=-3.0405, p=0.0024). 4. There was no statistical difference between 2 groups in average length of stay except for the post-op patient which shows 5.4 days less in the model group. This study shows that patient satisfaction and nurse's job satisfaction were increased and length of stay was decreased in the model group. Even though this new developed Patient - Nurse Oriented Model can provide nursing with the opportunity to improve patient care to increase productivity and highly valued, it is very difficult to practice due to the limited nursing resources, higher acuity levels and nursing care cost. It is strongly recommended that the government needs to look at the unreasonable reimbursement system and recognize the nursing care costs to the high acuity level patients. Otherwise, make the patient responsible for the nursing care cost so that we can provide more efficient and patient focused care.

• Journal of Digital Convergence
• /
• v.11 no.10
• /
• pp.619-627
• /
• 2013

This study reviews the time while the homeless patients Length of Stay emergency medical institution according to their medical treatment when they visit a hospital and characteristics of pathogenesis to understand the related factors affecting the case. Such review aims at providing basic data and information on how to improve medical care services of our society. 691 homeless patients visited an emergency medical care institution in Chungnam-si for one year from January 1, 2012 until December 31, of the same year were surveyed. Methods adopted were the analysis of frequency, ANOVA, correlation analysis and multiple regression analysis was conducted by making an independent variable as a dummy. This study came to a conclusion that first of all a medical care institution is required to avoid negative awareness and it should provide the homeless patients with medical care of better quality, having emergency care support system. Second, as most of the homeless patients are in their 40 or 50's, they are still in the age of high productivity of our society. Therefore, proper policy should be established and managed by the government on the program for their returning to the society as well as providing them with better medical care and support.

• Tuberculosis and Respiratory Diseases
• /
• v.65 no.2
• /
• pp.99-104
• /
• 2008

Background: Acute respiratory distress syndrome (ARDS) is ultimately an inflammatory state. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level are inflammatory markers. The aim of this study was to evaluate the value of the ESR, CRP and APACHE II score as prognostic factors for patient with ARDS. Methods: We retrospectively analyzed the medical records of 87 ARDS patients. The predictors (APACHE II score, ESR and CRP) and outcomes (mortality and length of the total hospital stay, the ICU stay and mechanical ventilator care) were obtained from the patients' records. The patients were grouped according to survival as the Survivor and Non survivor groups. We compared the APACHE II score, the ESR and the CRP level between the survivor group and the nonsurvivor group. We evaluated the correlation between the predictors and the outcomes. The initial ESR, CRP level and APACHE II score were checked at the time of ICU admission and the second ESR and CRP level were checked $3.3{\pm}1.2$ days after ICU admission. Results: Thirty-eight (43.7%) patients remained alive and 49 (56.3%) patients died. The APACHE II score was significantly lower for the survivor group than that for the non survivor group ($14.7{\pm}7.6$ vs $19.6{\pm}9.1$, respectively, p=0.006). The initial ESR and CRP level were not different between the survivor and non-survivor groups (ESR $64.0{\pm}37.8mm/hr$ vs $63.3{\pm}36.7mm/hr$, respectively, p=0.93, CRP $15.5{\pm}9.6mg/dl$ vs $16.3{\pm}8.5mg/dl$, respectively, p=0.68). The decrement of the CRP level for the survivor group was greater than that for the non survivor group ($-8.23{\pm}10.0mg/dl$ vs $-1.46{\pm}10.1mg/dl$, respectively, p=0.003). Correlation analysis revealed the initial ESR was positively correlated with the length of the total hospital stay and the ICU stay (correlation coefficient of the total hospital days: R=0.43, p=0.001, correlation coefficient of the ICU stay: R=0.39, p=0.014). Conclusion: The initial APACHE II score can predict the mortality of ARDS patients, and the degree of the early CRP change can be a predictor of mortality for ARDS patients. The initial ESR has positive correlation with the ARDS patients' duration of the total hospital stay and the ICU stay.

• Korea Journal of Hospital Management
• /
• v.5 no.1
• /
• pp.84-104
• /
• 2000

This paper analyzes the technical efficiency of thirty two hospitals in Korea using DEA(Data Envelopment Analysis). DEA provides an efficiency measure for each hospital compared to the most efficient one. The amount and sources of inefficiency that are identified by the DEA are useful for benchmarking to improve efficiency. The results from multiple regression analysis and Wilcoxon Rank Sum test show that bed turnover, hospital size, and average length of stay are related to hospital efficiency.