• Title/Summary/Keyword: Length of stay

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Patient Flow Optimization for Outpatient Department Using Discrete-Event Simulation

  • Dieu, Xuan-Manh;Hoang, Huu-Trung;Kim, Jung Eon;Kim, Hoon;Park, Junseok;Hwang, Won-Joo
    • Journal of Korea Multimedia Society
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    • v.22 no.7
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    • pp.804-814
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    • 2019
  • The patient's waiting time and length of stay have been reported as a factor decreasing their satisfaction in the hospital, especially in developing countries. This paper focuses on modeling hospital's outpatient department workflow in a developing country and optimizing the patient waiting time as well as total length of stay. By using discrete-event simulation, many alternative scenarios have raised, such as adding more working time, altering human resources, and adjusting the staff's responsibility, those scenarios will be examined to explore better settings for the hospital. The results show that possible to achieve a 9.6% reduction in patient total length of stay and it could be accomplished without adding more resources to the hospital.

A Convergence Study on the Characteristics of Length of Hospital Stays of Injured and Traumatic Death Patients - Based on the Korea National Hospital Discharge Injury Survey Data (손상 및 외상 사망 환자의 재원일수 특성에 관한 융합 연구 -퇴원손상심층조사자료를 중심으로)

  • Song, Yu-Rim;Lee, Moo-Sik;Kim, Doo-Ree;Kim, Kwang-Hwan
    • Journal of the Korea Convergence Society
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    • v.8 no.5
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    • pp.87-96
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    • 2017
  • This study was carried out to provide basic data for prevention of death from injuries and traumas by analyzing the characteristics of length of hospital stay of patients with injuries and traumas, utilizing in-depth investigation data of discharged injuries. The study subjects were 233 patients discharged from January 1 to December 31 in 2014 whom the final treatment result was 'death' and the main diagnosis were injuries and accidental external causes(S00-T98). According to the research findings, the length of hospital stay of females was longer than that of males. Based on the main diagnosis, the longest length of hospital stay had complication of other internal prosthetic devices, implants and grafts(T85). In conclusion, it is necessary to develop a policy to identify the factors affecting the length of hospital stays of patients and to manage them intensively.

A Comparison of the Effectiveness of Before and After the Regional Trauma Center's Establishment

  • Song, Bo Hyung;Hyun, Sung Youl;Kim, Jin Joo;Cho, Jin Seong;Ma, Dae Sung;Kim, Ha Kyung;Lee, Geun
    • Journal of Trauma and Injury
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    • v.29 no.3
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    • pp.68-75
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    • 2016
  • Purpose: The purpose of this study was to analyze the effectiveness of regional trauma center's management. Methods: Data collected between January 2013 and December 2015 from a regional trauma center registry was retrospectively reviewed. The patients who had injury severity score (ISS) greater than 15 and over the age of 18 were included. We compared annual general characteristics, the injury mechanism, the pathway of transportation, the injury severity score, the length of stay in emergency department (ED) and hospital, the in-hospital mortality. Results: The annual numbers of enrolled patients were 337, 334 and 278, respectively. No significant differences were found in the annual patient's median ages, injury mechanism, ISS and in-hospital mortality. The annual proportions of coming from other hospital and the median length of stay in hospital were increased after establishment of regional trauma center. The annual median lengths of stay in ED were decreased remarkably. Conclusion: Through the establishment of regional trauma center, the length of stay in ED can be reduced but not in-hospital mortality. More multidisciplinary cooperation and well-organized study is needed to reduce mortality of major trauma patients and maximize effect of regional trauma center.

A Study on the Relationships among Experience, Perceived Value, and Satisfaction of Rural Tourism - The Moderating Effect of Length of Stay - (농촌체험의 체험요인이 지각된 가치와 만족에 미치는 영향 - 체류기간의 조절효과 -)

  • Kim, Kyung-Hee;Lee, Sun-Min
    • Journal of Agricultural Extension & Community Development
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    • v.23 no.1
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    • pp.1-14
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    • 2016
  • The purpose of this study was to examine the relationships among experience, perceived value, and satisfaction of rural tourists based on the experience economy(Pine, & Gilmore, 1998; 1999). In addition, this study included the moderating effect of length of stay on the proposed relationships. This study was attempt to develop measurement scales based on the theory of experience economy(Pine, & Gilmore, 1998). Data were collected from 481 visitors by field survey from the 10 rural tourism communities. SPSS 20.0 and Amos 18.0 statistical package were used for frequency, reliability, confirmatory factor, and structural equation modelling analysis. The results of a confirmatory factor analysis yielded four dimensions of experience(esthetics, education, escape, and entertainment). The results of structural equation modeling indicated that entertainment, esthetics, and education had positive effects on perceived value, which in turn had a positive effect on satisfaction. In addition, length of stay moderated the relationships among experience, perceived value, and satisfaction. The entertainment and esthetics among experience factor had an effects on perceived value in the group of day visit group, and the entertainment, education, and esthetics among experience factor had an effects on perceived value in the group of stay night group. And the perceived value had a positive effect on satisfaction in the all group. Therefore, in order to increase rural tourists' satisfaction effectively, practitioners needs to develop rural tourism products by considering area of experience economy including tourists' length of stay.

The Influence of the Sense of Place on Regeneration Space using Idle Industrial Facilities on Visitors' Satisfaction and Length of Stay - Focused on Visitors of Mullae Art Village - (유휴산업시설 재생공간의 장소성이 방문만족도와 체류시간에 미치는 영향 - 문래예술창작촌의 방문자들을 대상으로 -)

  • Yoon, Han;Yun, Hee Jeong
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.4
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    • pp.1-10
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    • 2018
  • The purpose of this study is to analyze the influence of visitors' sense of place on regeneration space using idle industrial facilities on visitors' satisfaction and length of stay. For this purpose, this study selected Mullae Art Village in Seoul as a study site and conducted a questionnaire survey focused on visitors. The results of an exploratory factor analysis (EFA), reliability analysis and multiple regression analysis show that among the sense of place factors of Mullae Art Village 'Attractiveness' and 'Meaningfulness' have a positive influence on visitor satisfaction and length of stay. 'Attractiveness' was found to be the most influential factor. 'Historicity' was found to have no effects on visitor satisfaction and length of stay. In addition, visitor satisfaction has a positive influence on duration of stay. These results suggest that it is important to analyze the sense of place of idle industrial facilities. It will be a useful guide for urban space planners in revitalizing and establishing a marketing strategy for these spaces.

Length of Stay, Health Care Cost, Postpartum Discomfort, and Satisfaction with Medical Service in Puerperas Giving Birth in Midwifery Clinic and Hospitals (조산원과 병원 분만 산모의 재원일 수, 의료비용, 산후불편감과 의료서비스 만족도 비교)

  • Park, Mi-Ran;Lee, Ju-Young
    • Women's Health Nursing
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    • v.24 no.1
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    • pp.24-32
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    • 2018
  • Purpose: To determine traits related to pregnancy and delivery, length of stay, health care cost, postpartum discomfort, and satisfaction with medical service of puerperas giving birth in midwifery clinic and hospitals. Methods: This study used a comparative survey design. Data were collected from a total of 140 postpartum mothers composed of 70 mothers who gave births in two hospitals and another 70 mothers who delivered in one midwifery clinic. Results: Delivery in midwifery clinic had higher Apgar score at 1 minute and 5 minutes after birth than hospital. Those who delivered in midwifery clinic had shorter stay in the clinic, fewer health care cost, less postpartum discomfort in physical, environmental, social, and cultural areas, higher satisfaction with medical services than those who delivered in hospitals. Conclusion: Results of this study can be used as a basis for studies on giving birth in midwifery clinic and hospitals. They might increase the autonomy of women in giving birth with positive effect on the delivery experience of the mother and her spouse.

Changes in Medical Practice Pattern before and after Covering Intraocular Lens in the Health Insurance (인공수정체 보험급여 전.후 진료양상의 변화)

  • Choi, No-Ah;Yu, Seung-Hum;Min, Hey-Young;Chung, Eun-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.4 s.48
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    • pp.807-814
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    • 1994
  • This study is to find out changes in medical practice at a university hospital before and after covering intraocular lens (IOL) from the health insurance benefit. The coverage started on March 1, 1993 and a total of 596 cases who were discharged from July 1 to December 31, 1992 and 580 cases who were discharged from July 1 to December 31, 1993 were analyzed. Since the standard reimbursement scheme was changed from March 1, 1993, the charges for 1992 were transformed into 1993 scheme. Major findings are as follows: Average length of stay was statistically significantly decreased from 8.24 days in 1992 to 6.86 days in 1993. Charges except IOL has been statistically significantly decreased from 501,000 Won in 1992 to 444,000 Won in 1993. Charges for drugs and injection have been reduced. However, charge per day for them was not much different. This is due to decrease in length of stay. Charges for laboratory tests and radiologic examination were quite the same. Charges which are not covered by the insurance remained the same. The revenue of the hospital was reduced as expected. However, the hospital reduced the length of stay and increase the turnover rate In order to compensate the potential loss of revenue due to the difference of reimbursement between the out-of-pocket expense and the insurance coverage. By introducing the IOL benefit in the insurance, the insured pays less, hospital generates more revenue through shortening the hospital stay, and the total medical care cost becomes less nationwidely.

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Evaluation of Shortening the Stay Time of Patients in an Emergency Medical Center (EMC) (응급실 환자의 응급의료센터 체류시간 단축프로그램 개발 및 효과)

  • Kim, Eun-Joo;Lim, Ji-Young
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.17 no.1
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    • pp.21-27
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    • 2010
  • Purpose: The study evaluated a program to shorten EMC stay time. Methods: The subjects were EMC patients, and comprised a control group of 8,477 and an experimental group of 8,378. Data were collected from June 2006 to August 2007, and analyzed concerning stay time for doctor visit, decision making, and discharge. The data were analyzed by $X^2$-test and ANCOVA using SPSS14.0. Result: The stay time of doctor visit, decision making and discharge of the experimental group was significantly less compared to the control group. Using second and third grade triage criteria, the stay time of experimental group was statistically reduced from the control. Conclusion: The implemented shortening program was effective in reducing EMC stay time and increasing EMC effectiveness.

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Prognostic Impact of Charlson Comorbidity Index Obtained from Medical Records and Claims Data on 1-year Mortality and Length of Stay in Gastric Cancer Patients (위암환자에서 의무기록과 행정자료를 활용한 Charlson Comorbidity Index의 1년 이내 사망 및 재원일수 예측력 연구)

  • Kyung, Min-Ho;Yoon, Seok-Jun;Ahn, Hyeong-Sik;Hwang, Se-Min;Seo, Hyun-Ju;Kim, Kyoung-Hoon;Park, Hyeung-Keun
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.2
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    • pp.117-122
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    • 2009
  • Objectives : We tried to evaluate the agreement of the Charlson comorbidity index values(CCI) obtained from different sources(medical records and National Health Insurance claims data) for gastric cancer patients. We also attempted to assess the prognostic value of these data for predicting 1-year mortality and length of the hospital stay(length of stay). Methods : Medical records of 284 gastric cancer patients were reviewed, and their National Health Insurance claims data and death certificates were also investigated. To evaluate agreement, the kappa coefficient was tested. Multiple logistic regression analysis and multiple linear regression analysis were performed to evaluate and compare the prognostic power for predicting 1 year mortality and length of stay. Results : The CCI values for each comorbid condition obtained from 2 different data sources appeared to poorly agree(kappa: 0.00-0.59). It was appeared that the CCI values based on both sources were not valid prognostic indicators of 1-year mortality. Only medical record-based CCI was a valid prognostic indicator of length of stay, even after adjustment of covariables($\beta$ = 0.112, 95% CI = [0.017-1.267]). Conclusions : There was a discrepancy between the data sources with regard to the value of CCI both for the prognostic power and its direction. Therefore, assuming that medical records are the gold standard for the source for CCI measurement, claims data is not an appropriate source for determining the CCI, at least for gastric cancer.

Comparative Analysis of Medical Use of Spine Specialty Hospitals and Nonspecialty Hospitals (척추전문병원과 비전문병원의 의료이용 비교분석)

  • Young-Noh Lee;Yun-Ji Jeong;Kwang-Soo Lee
    • Health Policy and Management
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    • v.34 no.1
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    • pp.26-37
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    • 2024
  • Background: The purpose of this study was to compare and analyze the differences in charges and length of stay per case between spine specialty hospitals and non-specialty hospitals, and to identify the factors that influenced them. Methods: This study used claims data from the Health Insurance Review and Assessment Service, including inpatient visits from January 2021 to December 2022. The healthcare facility status data was used to identify the characteristics of study hospitals. Multilevel analysis was conducted to identify factors associated with the charges and Poisson regression analysis was conducted to analyze the length of stay between spine specialty hospitals and non-specialty hospitals. There were 32,015 cases of spine specialty hospitals and 17,555 cases of non-specialty hospitals. Results: For four of five common spinal surgeries, specialty hospitals shaped longer length of stay than those of non-specialty hospitals. Multilevel and Poisson regression analysis revealed that regardless of the type of surgery, higher age and higher Charlson comorbidity index scores were significantly associated with an increase in both the charges per case and length of stay (p<0.05). However, when hospitals were located in metropolitan areas, there was a significant decrease (p<0.05). Conclusion: This study found that specialty hospital had higher inpatient charges and loner length of stay contrary to the previous study results. Further studies will be needed to find which contribute to the differences.