• 제목/요약/키워드: Long-term Length of Stay

검색결과 57건 처리시간 0.025초

장기입원 의료급여 환자의 재원일수에 미치는 영향요인: 요양병원 입원유형 중심으로 (Factors Affecting the Length of Stay of Long-Stay Medical Aid Inpatients in Korea: Focused on Hospitalization Types in Long-Term Care Hospitals)

  • 윤은지;이요셉;홍미영;박미숙
    • 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.

요양병원 장기입원 현황과 관련 노인 및 기관 특성 비교 연구 (Patient and Hospital Characteristics of Long-Stay Admissions in Long-Term Care Hospitals in Korea)

  • 전보영;김홍수;권순만
    • 보건행정학회지
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    • 제26권1호
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    • pp.39-50
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    • 2016
  • Background: This study examined patient and hospital factors related to long-stay admissions in long-term care hospitals (LTCHs) among older people in Korea. Methods: We analyzed health insurance claims data, entitlement data, and institutional administrative data from the National Health Insurance Service databases between 2010 and 2012. At the patient level, we compared characteristics of patients staying in LTCHs for over 180 days (the long-stay group) with those staying in LTCHs for less than 90 days during a calendar year. At the hospital level, we examined the general characteristics and staffing levels of the top 10% of hospitals with the highest proportion of patients whose length of stay (LOS) was 180+ days (the hospitals with long-stay patients) and compared them with the top 10% of hospitals with the highest proportions of patients whose LOS was less than 90 days (hospitals with shorter-stay patients). Results: The long-stay group accounted for about 40% of all LTCH patients. People in the group were more likely to be women, aged 80+, living alone, and experiencing more than two health conditions. Compared to the hospitals with shorter-stay patients, those with long-stay patients were more likely to be occupied by patients with behavior problems and/or impaired cognition, owned by corporate or local governments, have more beds and a longer period of operation, and deliver services with lower staffing levels. Conclusion: This study found long-stay older people in LTCHs and those in LTCHs with high proportions of long-stay older patients had several distinct characteristics compared to their counterparts designated in this study. Patient and hospital characteristics need to be considered in policies aiming to resolve long-stay admissions problems in LTCHs.

의료의 공급량과 병상이용량과의 관계에 관한 국제비교연구 (Relationship Between Supply Factors of Medical Care and Use of Bed)

  • 정형선
    • 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.

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고액진료비 환자의 특성 비교분석 - 의료보험과 의료보호환자를 중심으로 - (Comparative Analysis on the Characteristics of High Cost Medical Users between the Health Insurance and Medical Assistance Program)

  • 강선희;문옥륜
    • 한국의료질향상학회지
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    • 제2권2호
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    • pp.112-129
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    • 1996
  • Background : A small number of high cost patients usually spend a larger proportion of scarce health resources. Aged, long-term care and readmitted patients usually belong to these high cost patient group. Among others, long length of stay and readmission can be reduced by checking its cause, and these are the areas needed most of quality improvement activity. Characteristics of high cost medical users between health insurance program and medical assistance program were reviewed. Methods : The inpatient claims of health insurance and medical assistance program were analyzed. Patients were divided by 6 groups; long-term, mid-term, short-term, readmitted, cancer and aged. We defined high cost patients as those who had spent one and half million won and over per 6 months. Characteristics of high cost patients for each group were reviewed. Results : medical assistance patients used much more resources than the insured members in the average hospital cost per case but less in daily hospital cost. The former had a longer length of stay and had much heavier diseases. Major diseases of both group were cancer, diseases of circulatory system and chronic degenerative diseases. Gallstone and schizophrenia were more in the insured program. However, pulmonary tuberculosis, asthma were more common among the medical assistance patients. Early readmission before 2 weeks were 28-30% of the total readmission. Readmission rate in the malignat neoplasm and renal failure were 80% and more. Q.A program should be installed to prevent unnecessary readmissions. Conclusion : Almost 30% of early readmissions and admissions due to complications and long length of stay should be reviewed carefully to keep cost down and to enhance the quality of hospital care.

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Factors Related to Long-term Hospital Length of Stay and Opinions on Discharge-related Community-based Medical and Welfare Service on Elderly Patients with Chronic Diseases in Korean Veterans Hospitals

  • Yoon, Young Mi;Park, Jin Hee;Hwang, Moon Sook
    • 지역사회간호학회지
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    • 제33권4호
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    • pp.357-371
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    • 2022
  • Purpose: This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. Methods: The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion. These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). Conclusion: In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.

요양병원 장기입원에 대한 본인부담상한제 개편 영향 분석 (Impact of Adjusted Out-of-Pocket Maximum Rules of Long-stay Admissions in Long-Term Care Hospitals)

  • 구여정;임승지
    • 한국병원경영학회지
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    • 제29권2호
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    • pp.37-47
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    • 2024
  • Purpose: This study aimed to determine the effect of adjusted out-of-pocket maximum rules in the 'differential co-payment ceiling', which means having a higher burden of co-payment, that expanded to the entire ceiling level in long-stay admission patients in long-term care hospitals(LTCH). Methodology: We used health insurance claim data between January 1, 2022, and December 31, 2022 received from the National Health Insurance Service. The study populations were inpatients in long-term care hospitals more than 1 days during the study period. We performed the difference in characteristics of the LTCH patient of the differential and general ceiling by the chi-square test. We estimated the change of the population, cost, and co-payments per person under the assumption of restructuring. Finding: Based on adjusted out-of-pocket maximum rules in 2023, it was expected that the number of benefits decreases at the high-income level while increasing at the low-income level. The burden of health expenditure after reimbursement of co-payment ceiling, is expected to increase by 65.1% in the highest medical necessity, whereas the low medical necessity would decreases compared to 2022. Practical Implications: The results demonstrate that the current out-of-pocket maximum rules do not reflect the needs of medical necessity. This study suggested the need to reflect the medical necessity in LTCH on the out-of-pocket maximum rules in the future.

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현 입원의료이용량의 급성기진료 및 장기요양 서비스 재분류 (Reclassification of healthcare utilization of inpatients to estimate the demand for long-term care services)

  • 장혜정;김창엽;윤석준
    • 보건행정학회지
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    • 제11권3호
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    • pp.31-45
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    • 2001
  • With an economic development and epidemiologic transition, the burden of disease due to chronic diseases and accidents is increasing. However, in most of developing countries, long-term care facilities are not available, therefore acute care facilities should provide both acute and long-term care services. It is also true in Korea. The demand for long-term care services needs to be estimated to establish the adequate supply system of health resources. This article introduces the reclassification methodology of inpatients' healthcare utilization to acute and long-term care services. All discharged patients from hospitals for one month were analyzed. The distribution of inpatients' hospital days were fitted to Chi-squared distribution by ICD disease categories, and they were grouped in five clusters. For each cluster, the lower and upper limit of classification criteria to acute and long-term care services were chosen. Summarizing all hospital days corresponding to acute and long-term care respectively, 24 to 28 percent of inpatient services fumed out to be long-term care services. The study results are consistent with those of the existing studies. They can be used practically in the allocation of long-term care resources.

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융복합 맞춤형 재원일수 관리 시스템 개발 (The Development of Convergence Optimized LOS Management System)

  • 최연희;김윤진
    • 디지털융복합연구
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    • 제15권2호
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    • pp.273-283
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    • 2017
  • 본 연구는 의료기관이 자체적으로 재원일수관리 활동을 하도록 유도하기 위해 외래정보로 재원일수를 예측하여 입원환자 재원일수를 예측하고 재원일수관리의 효율성을 제공할 수 있는 융복합 맞춤형 재원일수 관리 시스템을 개발 방안을 제시하고자 하였다. 외래정보 자료를 기반으로 개발된 재원일수 예측 모형을 이용한 융복합의 맞춤형 재원일수 관리 웹 프로그램은 실시간 예측 재원일수 산출되도록 구현되었다. 예측 모형을 기반으로 장기재원예측 환자군, 집중 관리 환자군 등 재원일수관리 서비스 대상이 도출되었다. 장기재원예측 환자군, 집중관리 환자군에 장기 재원 예상 알림 서비스, 재원일수 초과 알림 서비스 등을 제공할 수 있어 맞춤형 재원일수 관리 시스템이 맞춤형 재원일수 관리에 효율적인 시스템인 것이 확인되었다. 이에 융복합 맞춤형 재원일수 관리 시스템 웹 활용을 위해서는 재원일수 예측 질환의 확대와 국가 차원의 시범운영 정책 추진 방안이 필요하다.

서울소재 3차 의료기관에 재원 중인 노인 환자의 재원기간에 영향을 미치는 관련 요인 (Factors Associated with Length of Stay in Elderly Inpatients in a General Hospital in Seoul)

  • 김선자;유승흠;오현주
    • 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.

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노인요양 시설 노인의 삶의 질과 시설 서비스, 가족 지지의 관계 (The Relationship between the Quality of Life, Care Services, and Family Support of Elderly Residents in Long-Term Care Facilities)

  • 신승호;신소홍
    • 문화기술의 융합
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    • 제7권2호
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    • pp.227-237
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    • 2021
  • 이 연구의 목적은 노인요양 시설 입소 노인의 삶의 질에 시설 서비스가 영향을 미치는지 파악하고, 가족 지지의 매개효과를 알아보는 것이다. 연구 대상은 대구·경북 지역의 노인요양 시설에 입소하여 생활하는 노인 192명이다. SPSS 22.0 program을 활용하여 기술통계, t-test와 ANOVA, Pearson의 상관관계 분석, 회귀분석을 실시하였다. 연구 결과 연령, 학력, 자녀의 경제 수준, 입소 계기, 입소 기간에 따라 삶의 질에 차이가 있었다. 삶의 질에 영향을 미치는 요인은 연령, 학력, 자녀의 경제 수준, 입소 계기, 입소 기간 그리고 시설 서비스로 나타났으며, 가족 지지는 시설 서비스와 삶의 질의 관계에서 매개 요인으로 밝혀졌다. 요양 시설 입소 노인들의 삶의 질 개선을 위한 간호 중재 계획 수립의 정보가 될 것이다.