• 대한예방한의학회지
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• 제22권2호
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• pp.41-53
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• 2018

Objectives : It was to classify and its affecting factors to the patients of Korean medicine hospital with short term and long term hospitalization. Methods : I focused on long-term hospitalized patients. I was conducted on 344 hospitalized patients among the original data of usage and consumption of Korean medical report in 2014. Among those patients, I have classified them into long term inpatients(131 patients) and short term inpatients(213 patients) based on 16 days of hospitalization. Also multiple regression analysis was conducted to investigate the characteristics of the hospitalization, treatment satisfaction and dissatisfaction, the characteristics of long term hospitalization according to the sociodemographic of the subjects, the top 21 diseases and the distribution of human bodies, side effects and kinds of Korean medicine. Results : There was a statistically significant difference between the short term and long term hospitalized patients due to age, occupation, marital status, all 21 diseases and institutional fees, experience of Korean medical treatment due to traffic accidents. There was no significant difference in gender, education level, residence, income level, type of medical insurance, whether private insurance, type of medical treatment for Korean medicine, medical expenses for car accidents, reason for dissatisfaction with treatment. The number of long term patients at Korean medicine hospitals increased by a statistically significant by age in model 1 where confounding factors were differently controlled. In model 2, the number of long term patients at Korean medicine hospitals increased by a statistically significant by age, among those who earned 5,000,000 Korean won or more, and among those with nerve diseases. The number of long term patients at Korean medicine hospitals decreased by a statistically significant amount among the unemployed and others in model 2. In model 3, the number of long term patients at Korean medicine hospitals increased by a statistically significant by age, among those who earned 5,000,000 Korean won or more, and among those with nerve diseases, while the number decreased by a statistically significant amount among the married. Conclusions : These results suggest that the factors affecting the short term and long term hospitalization of patients with Korean medicine hospital are different from each other. Especially it was significant by age, over 5,000,000won Income per month, nerve disease, but decrease significant married.

• 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.

• 보건행정학회지
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• 제19권2호
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• pp.36-50
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• 2009

Korean Government had performed three pilot programs to introduce the long term care insurance system. Persons aged 65 or older who are dependent on others for daily living could use long term care services in the pilot program. The long-term care insurance covered nursing home services, home care services and cash benefits. The cash benefits are included that for elderly at home and for patients in geriatric hospital. This study investigated whether there had been any change in the medical care utilization according to cash benefits for geriatric hospitalization. This study used National Health Insurance claims and Long term Care Insurance claims 2003 through 2006. Data were composed of subjects who undertook both insurance coverage. The subjects was divided into two groups. Case group included participants with the cash benefits of geriatric hospitalization. Control group included persons without the cash benefits selected by random sampling according to the distribution of case group. This study showed that the amount of medical care utilization of the case group is more significantly increased than the control group after adjusted their health condition and functional condition. This result will be helpful for making decisions on whether the cash benefit of geriatric hospitalization can be introduced into long term care insurance system.

• 보건행정학회지
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• 제23권2호
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• pp.132-144
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• 2013

Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing longterm care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple regression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were demographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91.63% and the drug expenses have increased by 31.85%. Multiple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.6%. And outpatient expenses have increased by 10.4%, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.

• 한국병원경영학회지
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• 제12권2호
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• pp.25-42
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• 2007

To identify characteristics of elderly inpatients who had long term hospitalization in a general hospital, this study categorized into two groups who were hospitalized for less than 30 days and a group hospitalized for more than 30 days. To compare the groups the independent variables were the sociodemographical characteristics, the medical care utility characteristics, and the disease characteristics and finally analyzed factors affecting the hospitalization period. The data of 18,727 inpatients who were older than 65 years of age by the year 2005 were used and the data were analyzed using SPSS for Windows 12.0. With the results, it is necessary to provide intensive and positive management to elderly inpatients who belong to the more than 30 days group and also necessary to share roles and functions of hospital by medical network with local hospitals and clinics in order to manage long-term elderly inpatients and offer continuous post-management to discharged patients by encouraging them to use a long-term care center or by implementing an early discharge program. This study should provide many studies on how to manage the period of hospitalization efficiently on long-stay elderly inpatients in the future.

• 한국산학기술학회논문지
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• 제18권4호
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• pp.267-274
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• 2017

본 연구는 장기 요양이 환자의 체질량지수(Body Mass Index, BMI )와 지질대사(Lipid metabolism)에 미치는 영향을 확인하기 위한 비실험적, 후향적 조사연구이다. 연구 대상자는 경기도내 2개 요양병원에 3개월 이상 입원한 만 40- 65세 미만의 환자 120명을 대상으로 하였다. 연구 방법은 입원시와 입원 3개월 경과 후의 BMI와 총콜레스테롤 (Total cholesterol), 중성지방 (Tryglycerides, TG), 고밀도지단백 콜레스테롤 (High Density Lipoprotein, HDL) 저밀도지단백 콜레스테롤 (Low Density Lipoprotein, LDL) 수치를 비교 분석하고, 시간 경과에 따른 변화를 추적관찰하였다. 대상자의 일반적 특성은 기술통계, 빈도분석을 하였다. 또한 일반적 특성이 BMI 미치는 영향은 로지스틱 회귀분석을 실시하였다. 입원시과 입원 3개월 후의 BMI와 혈중지질농도의 변화는 paired t-test를 이용하여 분석하였다. 연구 결과, 혈중지질농도의 변화가 입원 3개월 후에 중성지방 (Triglycerides)이 유의하게 증가하였다(p<.05). 이는 급성기 치료 후 요양 및 재활을 위하여 장기 입원하는 환자는 잠재적으로 이상지질 혈증의 위험성이 높다는 것을 고려하고 이상지질혈증 예방 및 개선을 위한 운동, 식이교육을 포함한 건강교육이 필요하다는 것을 의미한다.

• 보건행정학회지
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• 제19권1호
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• pp.81-96
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• 2009

The expansion of long-term care hospitals (LTCHs) is expected to contribute to meeting the long-term care needs of the elderly with chronic diseases in a rapidly aging society. It is also expected to increase efficiency of health resource use and decrease elderly health expenditures by transferring patients from acute care hospitals (ACHs) to LTCHs. This study aimed to empirically examine how the expansion of LTCHs had influences on the length of hospitalization of the elderly in ACHs. Panel regression analysis was employed as an analytic tool using data of the National Health Insurance and the National Statistical Office from 2002 to 2006. The expansion of LTCHs was measured as location quotient (LQ) of LTCHs, denoting the share of LTCHs in a large city or province relative to the share of LTCHs at the national level. In addition, per capita GRDP (gross regional domestic product) and the proportion of population over 65 were included as control variables. The main findings are as follows. First, it was observed that LQ of LTCHs showed a statistically significant negative association with the length of hospitalization of the elderly in ACHs. Second, the negative correlation was evident among general hospitals with over 100 beds while it was not among hospitals with less than 100 beds. Third, LQ of LTCHs had more influences among the elderly over 85. In conclusion, the expansion of LTCHs seems to contribute to decrease in the inpatient cost of the elderly in ACHs and to increase efficiency in the utilization of health resources.

• 한국산업정보학회논문지
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• 제28권6호
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• pp.11-20
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• 2023

자동차보험 교통사고 진료비는 매년 증가하고 있다. 본 연구는 교통사고 진료비용 상승의 주요 항목인 경상환자 중 장기입원환자(18일 이상)를 예측하는 모델을 decision tree 등 5개 알고리즘을 이용하여 생성하고, 장기입원에 영향을 미치는 요인을 분석했다. 그 결과, 예측 모델의 정확도는 91.377 ~ 91.451이며 각 모델 사이에 큰 차이점은 없었으나 random forest와 XGBoost 모델이 91.451로 가장 높았다. 설명변수 중요도에 있어서 병원 소재지, 상병명, 병원 종류 등 장기환자군과 비 장기입원 환자군 사이에 모델마다 상당한 차이가 있었다. 모델 평가는 훈련 데이터의 교차검증(10회)한 모델별 평균 정확도와 실험 데이터의 정확도를 상호 비교한 결과로 검정했다. 설명변수 유의성 검증을 위해 범주형 변수는 카이제곱 테스트를 실시하였다. 본 논문의 연구 결과는 경상 환자들의 과잉진료 및 사회적 보험료 비용을 줄이는 진료행태 분석에 도움이 될 것이다.

• 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.

• 가정간호학회지
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• 제31권1호
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• pp.56-65
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• 2024

Purpose: This study aimed to explore the association between demographic characteristics, hospitalization-related characteristics, and the severity of long-term hospitalization in a high-level general hospital, and to analyze the factors influencing decisions of all patients. Methods: General and clinical characteristics of the participants were analyzed using frequency, percentage, mean, and standard deviation. Differences in these characteristics, contingent upon whether a power source was requested, were analyzed using independent t-Test and Chi-squared tests. Logistic regression analysis was used to identify the factors related to the presence or absence of power requests. Results: The factors impacting the decision to refer a dependent variable include medical treatment (neurosurgery) (B=2.118, SE=0.960, p-value=.027, OR=8.314, 95% CI=1.267-54.551), infection isolation (CRE) (B=1.336, SE=0.666, p-value=.045, OR=3.804, 95% CI=1.032-14.021), and the utilization of tertiary antibiotics (B=3.076, SE=1.362, p-value= .024, OR=21.663, 95% CI=1.502-312.530). Conclusion: This study found a significant association between medical treatment (neurosurgery), infection isolation (CRE), and the use of tertiary antibiotics as dependent variables. These findings indicate that continuous monitoring can contribute to a reduction in long-term financial burdens.