• 한국콘텐츠학회논문지
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• 제11권9호
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• pp.372-383
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• 2011

본 연구의 목적은 관상동맥중재술 입원 환자의 재원일수의 변이를 규명하기 위해 중증도 보정 모형을 개발하였다. 2004~2006년 퇴원손상환자 조사자료 중 관상동맥중재술 입원 환자 1,011건을 연구대상으로 하였으며, 재원일수의 변이분석은 t검정, 분산분석을 실시하였고, 중증도 보정 재원일수 모형은 데이터마이닝 기법을 이용하였다. 개발된 다중회귀분석 모형을 이용하여 예측 재원일수를 산출하고 이를 실제 재원일수와 비교한 결과 병상규모별, 보험유형과 지역별로 재원일수의 변이가 존재하는 것으로 나타났다. 환자 특성과 중증도를 통제하고 나타난 재원일수의 변이는 공급자 요인으로 설명될 수 있는데, 진료행태나 의료자원에 대한 후속 연구가 필요한 것으로 보인다. 본 연구는 행정 데이터를 이용하여 중증도 모형을 개발하고 변이를 확인하였다는 점에서 활용의 효용성을 높이는 데 기여할 것으로 사료된다.

• 기본간호학회지
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• 제4권2호
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• pp.245-265
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• 1997

The purpose of this study was to promote the effectiveness in managing disease or injury, by examining the length of stay in hospital according to characteristics concerned before and after operation, and by serving as a basis for reducing that length. As a result of investigating the length of stay in hospital according to inpatient's personal characteristics, clinical features and other characteristics concerned, the following characteristics appeared significant. The characteristics that showed a significant difference about the length of stay in hospital before and after operation were the age and the fact whether one was married or not among inpatient's personal characteristics. The significant ones among clinical features were the route to be taken to hospital, the form of insurance, the experience of re-hospitalization, whether another disease coexisted, the experiment of changing department, whether a diagnosis was determined by consultation, whether an intensive care unit was used, whether re-operation was performed, the total number of case of the experience of re-hospitalization, inpatient who were again sent to hospital under the same diagnosis was not included in the investigation, which was pointed out as a limit in this study. The significant ones among other characteristics concerned were the date and season when the patients were taken to hospital and the doctor in attendance. The doctor in attendance appeared to give a significant impact on the length of stay in hospital before operation, but no significant difference was noted in the mean among the doctors in attendance. And those characteristics were not found regularly among the selected departments. As stated above, one way to reduce the length of stay In hospital was to diminish the length of stay in hospital before operation. The term of hospitalization before operation shall be reduced by grasping the factors that affected that length before operation and by conducting examination as many as possible in the out-patient department. Also, the efforts should be put on that length after operation. The management of hospital seemed to be successfully carried out if those factors affected that length were effectively controlled.

• 한국병원경영학회지
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• 제3권1호
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• pp.100-120
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• 1998

Tertiary been increasing rapidly. There has been shortage of beds in hospitals and effective management of beds had to b considered. For the efficient utilization of the exsisting hospital beds, bed turnover rate ha to be high and their length of stay in hospital has to be shortened. The sample of this study was in-patients admitted in 13 clinical departments of a tertiar hospital in Wonju. Daily medical fees through length of stay in hospital were observed an we analyzed the increase of hospital revenues per bed for the shortening of length of stay. The results of the analysis were as follows: 1. The average length of stay by dept. was 11.0 in dept. of internal medicine. 12.4 in dept. of general surgery, 7.1 in dept. of gynecoloty, 6.8 in dept. of pediatrics, 26.1 in dept. of nervous surgery, 21.6 in dept. of orthopedic surgery, 25.5 in dept. of plastic sersury, 7.6 in dept. of ophthalmology, 7.1 in dept. of E.N.T, 8.1 in dept. dermatoloty, 9.0 in dept. urology. 2. The trend of daily medical fees of in-patients was the highest from the first day to the third day. Because most necessary examination and various treatment or operation took place in these period. 3. The estimative model for medical fees by the length of stay at each clinical department was inferred. 4. The increased revenue per bed by shortening the length of stay was calculated by the estimative model. Shortening one day would increase 305,999 thousand won in dept. of internal medicine 232,138 thousand won in dept. of general surgery., 177,795 thousand won in dept. of gynecology medicine, 69,031 thousand won in dept. of pediatrics 360,381 thousand won in dept. of nervous surgery 211.339 thousand won in dept. of orthopedic surgery, 100,249 thousand won in dept of plastic surgery, 10,569 thousand won in dept. of ophthalmology -814,122 thousand won in dept. of E.N.T, 1,582 thousand won in dept. of dermatology, -5,821 thousand won in dept. of urology. It is expected that they can improve their profitability by shortening the length of stay of the in-patients.

• 한국병원경영학회지
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• 제23권3호
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• pp.52-62
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• 2018

This study aims to analyze the factors affecting in-hospital complication and length of stay in elderly patients with total knee arthroplasty. A total of 8,224 inpatients over 65 years old were selected from the national old inpatient sample data which was produced by Health Insurance Review and Assessment Service in 2016. STATA 12.0 was performed using frequency, chi-square test, t-test, ANOVA and multiple linear and logistic regression analysis. Analysis results show that ages(over 85), Charlson Comorbidity Index, district(metropolitan) for general hospitals and gender, district, beds(100-199) for hospitals are significantly influenced in-hospital complication. Statistically significant factors affecting the length of stay are gender, insurance type, depression, district, bed(300 over) for general hospitals and gender, type of insurance, Charlson Comorbidity Index, depression, district, beds(200-299) for hospitals. Based on these findings, the factors affecting in-hospital complication and length of stay were different depending on the type of medical institution. Accordingly, policymakers should analyze the differences in care behavior depending on the type of medical institution and expand policy and financial support to resolve them.

• 사물인터넷융복합논문지
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• 제3권2호
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• pp.21-32
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• 2017

본 연구는 노인 전신마취 환자의 회복실 체류시간에 영향을 미치는 융합적 요인들을 파악하기 위한 서술적 조사연구이다. 경기도 소재 C대학병원에서 2014년 1월 1일부터 2014년 12월 31일까지 전신마취하에 수술을 받고 회복실에 입실하였던 환자 중 65세 이상인 환자 300명을 대상으로 후향적으로 자료 수집을 하였다. 회복실 체류시간은 평균 48.4분으로 나타났으며, 회복실 체류시간 30-59분이 58.0%로 가장 많았다. 수술중 요인에 따른 회복실 체류시간 정도는 근이완제, 수혈, 동맥혈가스 검사, 체온 그리고 총 마취시간에 따라 유의한 차이가 있는 것으로 나타났다. 수술후 요인에 따른 회복실 체류시간 정도는 합병증, 자가 통증 조절기, 순환기계 약물사용에 따라 유의한 차이가 있는 것으로 나타났다. 회복실 체류시간에 영향을 미치는 요인을 알아보기 위해 다중 회귀분석을 실시한 결과 수술 후 '순환기계 약물사용', '수술 중 저체온'이 회복실 체류시간에 영향을 미치는 것으로 확인되었고 설명력은 13%로 나타났다. 이러한 결과를 토대로 회복실 체류시간 관련요인들을 모니터링하고 신속하게 처치하여 교정하는 것이 노인 전신마취 환자의 회복실 체류시간의 단축에 기여할 것으로 사려된다.

• 보건행정학회지
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• 제5권2호
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• pp.18-34
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• 1995

To clarify the relationship between the medical supply(medical persons and goods) and the use of bed, the author has made comparison among OECD 24 countries. Per Capita Bed-days can be divided into Average Length of Stay and Admission Rate, and these three variables were regressed upon both In-patient Care Beds of all medical institutions including acute somatic, psychiatric, special, nursing homes and other long-term care and Share of Total Health Employment in Total Employment. The result of regression analysis shows a statistically significant positive relationship between In-patient Care Beds and Average Length of Stay, and negative relationship between Share of Total Health Employment and Admission Rate. In addition to Ordinary Least Square(OLS) estimation, amended Bounded Influence Estimation(BIE) was also made to adjust the influence of outliers. Japan shows a very large number of In-patient Care Beds and a very low Share of Total Health Employment, and this medical situation is judged to have close relation to her long Average Length of Stay and low Admission Rate.

• Journal of Preventive Medicine and Public Health
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• 제44권1호
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• pp.48-55
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• 2011

Objectives: The purpose of this study was to examine the impact of Diagnosis-Related Group (DRG)-based payment on the length of stay and the number of outpatient visits after discharge in for patients who had undergone caesarean section. Methods: This study used the health insurance data of the patients in health care facilities that were paid by the Fee-For-Service (FFS) in 2001-2004, but they participated in the DRG payment system in 2005-2007. In order to examine the net effects of DRG payment, the Difference-In-Differences (DID) method was adopted to observe the difference in health care utilization before and after the participation in the DRG payment system. The dependent variables of the regression model were the length of stay and number of outpatient visits after discharge, and the explanatory variables included the characteristics of the patients and the health care facilities. Results: The length of stay in DRG-paid health care facilities was greater than that in the FFS-paid ones. Yet, DRG payment has no statistically significant effect on the number of outpatient visits after discharge. Conclusions: The results of this study that DRG payment was not effective in reducing the length of stay can be related to the nature of voluntary participation in the DRG system. Only those health care facilities that are already efficient in terms of the length of stay or that can benefit from the DRG payment may decide to participate in the program.

• 한국간호교육학회지
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• 제24권4호
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• pp.433-442
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• 2018

Purpose: This study was performed to investigate the factors affecting postoperative pain and length of hospital stay of liver transplantation donors. Methods: This is a retrospective study using the Electronic Medical Records (EMR) of 91 patients operated on at a tertiary hospital in Seoul, Korea in 2016. The collected data were analyzed using descriptive statistics, t-test, Mann-Whitney U test and Kruskal-Wallis test, Spearman's rank correlation, and multiple regression analysis. Results: The average age of the donors was $35.7{\pm}12.2$ years, and all donors were family members. PCA was applied for control pain in all patients, and 40.7% of PCA-related side effects were observed. The average length of hospital stay was $9.24{\pm}2.52$ days. The factors influencing the length of hospital stay were operative methods, pain control methods, and postoperative complications. The length of hospital stay was 1.29 days shorter if donors had no complication, 1.43 days shorter when only PCA was used, and 1.19 days shorter when laparoscopic resection was performed (Adjusted $R^2=0.17$, F=4.67, p<.05). Conclusion: The results of this study can be used as basic data for practical and effective postoperative nursing education and intervention of living liver donors.

• 한국전자통신학회논문지
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• 제9권2호
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• pp.203-209
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• 2014

본연구의 목적은 유비쿼터스 의료환경에서 경요추부 염좌 환자의 민영의료보험 가입이 재원기간에 미치는 영향을 조사하기 위하여 시행되었다. 연구의 대상자들은 2010년 7월1일 부터 2012년 2월 29일까지 신경학적 증상이 없는 경요추 염좌 진단받은 환자이다. 분석방법은 t-분석, 분산분석 그리고 다중회귀분석을 이용하였다. 재원기간과 관련된 요인을 통제한 후에 민영의료보험 관련 특성인 민영의료보험 개수를 독립변수로 투입하였을 때, 민영의료보험 개수가 '없음' 보다 1-2개(${\beta}$=2.731, P=0.013), 3개 이상(${\beta}$=4.991, P=0.000)에서 유의하게 입원기간이 길었다. 민영의료보험의 다수 가입이 도덕적 해이의 존재와 정도를 일정 부분 규명하였다.

• Journal of Preventive Medicine and Public Health
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• 제27권4호
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• pp.793-805
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• 1994

Investigating the existence of volume-outcome relationships for specific disease groups relates directly to the policy issue of whether, and how, specific inpatient services should be regionalized. This study examined whether medical costs and lengths of stay as outcomes were affected by changes in volume within hospitals. Based on the claims data obtained from National Federation of Medical Associations, each six disease categories from medical and surgical conditions were selected and 29,720 cases from 1,266 hospitals were analyzed. Main findings of the research can be summarized as follows: 1. Analyzing volume and cost per case relationship, tonsillectomy class 1, hernia procedure class 0, appendectomy and cesarean section class 0,1 in surgical conditions showed negative relationship significantly. In cases of medical conditions, costs per case in respiratory neoplasm class 2, COPD class 1, 2, digestive malignancy were also related to volume negtively. 2. Comparing volume with length of stay per case, lens procedure class 0, hernia procedure class 0, appendectomy class 0,1, cesarean section class 1 in surgical conditions showed negative relationships significantly. In medical conditions, volume of respiratory neoplasm class 2, COPD class 1,2, digestive malignancy class 0 were associated with negatively. 3. Within same disease categories, changes in cost and length of stay per case to volume were more remarkable in severe cases. These results suggested a significant inverse relationship between disease cases and cost, length of stay per case as outcome variables.