• Journal of Preventive Medicine and Public Health
• /
• v.43 no.6
• /
• pp.523-534
• /
• 2010

Objectives: We assessed impact of performance reporting information about the readmission rate, length of stay and cost of hip hemiarthroplasty. Methods: The data are from a nationwide claims database, National Quality Improvement Project database, of Health Insurance Review & Assessment Service in Korea. From January 2006 to April 2008, we received information of length of stay, readmission within 30 days, cost of 22 851 hip hemiarthroplasty episodes. Each episodes has retained the diagnoses of comorbidities and demographics. We used time-series analysis to assess the shifting of patients selections, between high volume (over 16 operations in a year) and low volume institutions, after performance reporting (December 2007). The changes of quality (readmission, length of stay) and cost were evaluated by multilevel analysis with adjustment of patient's factors and institutional factors after performance reporting. Results: As compared with the before performance reporting, the proportion of patients who choose the high volume institution, increased 3.45% and the trends continued 4 months at marginal significance (p = 0.059). After performance reporting, national average readmission rate, length of stay were decreased by 0.49 OR (95% CI=0.25 - 0.95) and 10% (${\beta}$=-0.102, p<0.01) and cost was not changed (${\beta}$=-0.01, p=0.27). The high volume institutions were more decreased than low volume in length of stay. Conclusions: After performance reporting, readmission rate, length of stay were decreased and the patient selections were marginally shifted from low volume institutions to high volume institutions.

• Journal of Preventive Medicine and Public Health
• /
• v.21 no.1 s.23
• /
• pp.10-20
• /
• 1988

This study was conducted to compare the maternal charactristics, and birth weight of infants delivered at five different categories of medical facility in Taegu to examine the risk level of pregnant women and children by the medical facility for delivery. The study population included 1,410 pregnant women who delivered a baby at one of nine medical facilities (3 university hospitals, 2 general hospitals, 2 private clinics, 1 midwife clinic, 1 MCH center) in Taegu in April, 1987(April and May, 1987 for K university hospital), Pregnant women were interviewed to ask the age and educational level of woman, payment of medical fee, birth order, delivery method. Birth weight of infant was obtained from medical record. Mean ages of the women delivering at the university hospitals(27.5 years) and at general hospitals(26.7 years) were higher than those at midwife clinic(25.4 years) and at MCH center(26.1 years). Also, mean years of school education were higher in women of university hospitals(12.7 years) and general hospitals (12.2 years) than in women of midwife clinic(9.2 years) and MCH center (9.3 years). The percentages of women covered by the medical insurance were far greater in the university hospitals(78.1%) and general hospitals(82.9%) than in private clinics(44.3%) , midwife clinic(29.1%) and MCH center (5.4%). Infants born at the MCH center were mostly the second birth (47.3%) while 56.0% to 61.7% of infants born at all the other medical facilities were the first birth more women delivering at the university hospitals had history of spontaneous abortion as well as still birth than the women delivering at the other medical facilities. The preform birth rate (11.4%) and low birthweight incidence rates(5.8-13.0%) in university hospitals were significantly higher than those of other medical facilities. Accordingly, c-section rates showed a wide variation among the medical facilities. Study findings revealed that most of women delivering at the university hospitals and general hospitals are in the middle of or upper socio-economic class and obstetrically high risk group regardless of socioeconomic class while the wome delivering at the midwife clinic and MCH center are low risk group of low socioeconomic class. Therefore, the data of a specific medical facility are highly limited in interpretation and can not be generalized.

• Journal of Digital Convergence
• /
• v.13 no.12
• /
• pp.245-257
• /
• 2015

This study was to develop the predictive model for severity-adjusted mortality of inpatients with multiple chronic conditions and analyse the factors on the variation of hospital standardized mortality ratio(HSMR) to propose the plan to reduce the variation. We collect the data "Korean National Hospital Discharge In-depth Injury Survey" from 2008 to 2010 and select the final 110,700 objects of study who have chronic diseases for principal diagnosis and who are over the age of 30 with more than 2 chronic diseases including principal diagnosis. We designed a severity-adjusted mortality predictive model with using data-mining methods (logistic regression analysis, decision tree and neural network method). In this study, we used the predictive model for severity-adjusted mortality ratio by the decision tree using Elixhauser comorbidity index. As the result of the hospital standardized mortality ratio(HSMR) of inpatients with multiple chronic conditions, there were statistically significant differences in HSMR by the insurance type, bed number of hospital, and the location of hospital. We should find the method based on the result of this study to manage mortality ratio of inpatients with multiple chronic conditions efficiently as the national level. So we should make an effort to increase the quality of medical treatment for inpatients with multiple chronic diseases and to reduce growing medical expenses.

• Therapeutic Science for Rehabilitation
• /
• v.9 no.3
• /
• pp.103-120
• /
• 2020

Objective : This study aims to understand the phenomenon of social admission in Korea's rehabilitation system by analyzing the perspectives of occupational therapists. Methods : We developed a written questionnaire based on RSAT and, in August 2019, distributed it to occupational therapists with more than three years of experience at the time. Data were analyzed using the van Kaam's method. Further, high frequency words were analyzed by word cloud in order to extract significant statements. Results : Forty-six written interviews were collected from various areas of Korea. We analyzed the data into 2 categories, 4 themes, 13 sub-themes. The two categories were 'hospital system' and 'external factors of occupational therapy practice'. The themes according to 'hospital system' were 'difficulties in implementing multidisciplinary approach' and 'inadequate discharge planning system'. The themes according to 'internal and external factors of occupational therapy' were analyzed as 'difficulties of occupational therapists' and 'difficulties in occupational therapy practice'. Conclusion : Occupational therapists in rehabilitation hospitals recognize that the reason for social admission is insufficient insurance systems related to occupational therapy services in rehab hospitals. This leads to difficulties in occupational therapy practice. We need to develop the insurance systems that can meet patient needs for social recovery.

• Journal of Preventive Medicine and Public Health
• /
• v.35 no.2
• /
• pp.153-159
• /
• 2002

Objectives : To evaluate the accuracy of the registered cause of death in a county and its related factors. Methods : The data used in this study was based on 504 cases, in a county of Chonnam province, registered between January and December 1998. Study subjects consisted of 388 of the 504 cases, and their causes of death were established by an interview survey of the next of kin or neighbor and medical record surveys. We compared the registered cause of death with the confirmed cause of death, determined by surveys and medical records, and evaluated the factors associated with the accuracy of the registered cause of death. Results : 62.6% of the deaths were concordant with 19 Chapters classification of cause of death. external causes of mortality, endocrine, nutritional and metabolic diseases, neoplasms and diseases of the circulatory system showed the good agreement between the registered cause of death and the confirmed cause of death. The factors relating to the accuracy of the registered cause of death were the doctors' diagnosis for the cause of death (adjusted Odds Ratio: 2.67, 95% Confidence Interval: 1.21-5.89) and the grade of the public officials in charge of the death registry (adjusted Odds Ratio: 0.30, 95% CI=0.12-0.78). Conclusions : The accuracy of the registered cause of death was not high. It could be improved by using the doctors' diagnosis for death and improving the job specification for public officials who deal with death registration.

• Journal of Korean Academy of Nursing Administration
• /
• v.16 no.2
• /
• pp.143-151
• /
• 2010

Purpose: This study was conducted to define nurses' level of self-leadership, self-esteem, and organizational effectiveness, and to examine relationships among above variables. Methods: The subjects of this study were 313 nurses from two general hospitals located in Seoul Metropolitan area in Korea. The data was collected by self-reported instruments: Self-leadership scale, Self-esteem scale, Job satisfaction scale, Organizational commitment scale, and Turnover intention scale, Data was analyzed by descriptive statistics, Pearson correlation coefficient, and stepwise multiple reg res don u dng SPSS-PC program, Results: The average scores of variables were; self-leadership, 3,72/5,00 self-esteem, 3,76/5,00 Job satisfaction, 3,36/5.00 organizational commitment, 3.29/5.00 and turnover intentioncri 2.94/5,00, Self-leadership was dgnificantly correlated to self-esteem, job satisfaction, organizational commitment, and turnover intention. Self-leadership, job satisfaction, and turnover intention explained 52.3% of organizational commitment. Self-leadership and organizational commitment explained 43% of turnover intention. Conclusions: It is recommended to develop standardized self-leadership curriculum in the nursing school to build a foundation of self-leadership from undergraduate nursing students, Educational programs are needed that promote nurses' self-leadership as regular continuing education. Organizational effectiveness would be improved by providing programs to enhance nurses' self-esteem, educational motivation, and organizational commitment, which boost self-leadership.

• Journal of Korean Physical Therapy Science
• /
• v.18 no.4
• /
• pp.47-58
• /
• 2011

The purpose of this study was to analyses the main factors of research papers for related with home physical therapy. This study was retrospective descriptive study, the period of data collection was from 1991 to 2011. The data was collected by the journal related in physical therapy, the dissertation of academic degree, National Assembly Library and the web-site for academic information. In the web-site, searched with the keyword 'home physical therapy' and 'after school voucher'. The results were as follows; 1. In the home physical therapy, visiting physical therapy, school physical therapy, there were different based on laws; home physical therapy was based on medical law, visiting physical therapy was based on law for community health and law for long term health insurance, school physical therapy was based on special education law. 2. The summary of research title/thema from 1991 to 2011 was as follows; for the home and visiting physical therapy 'the needs and necessity of home and visiting physical therapy' was 18 papers, 'the contents of service of home and visiting physical therapy' was 18 papers, 'program and skill development' was 16 papers, 'system developing and induction strategy of home and visiting physical therapy 'was 15 papers, 'costs of nome and visiting physical therapy' was 2 papers, 'perception and information of home and visiting physical therapy' was 9 papers, 'Recoding system and administration management' was 9 papers, 'the others 'was 14 papers, for the school physical therapy 'after school voucher system' was 9 papers, the others was 4 papers. The total papers was 114 papers. 3. Finally suggested 'Model of Educational Program for HomeVisiting and School Physical Therapy'.

• Journal of Korean Public Health Nursing
• /
• v.25 no.2
• /
• pp.221-232
• /
• 2011

Purpose: The study sought to provide basic information for North Korean defectors (Sae-Tu-Min) by studying the quality of life(QoL) based on their general characteristics and health problems. Methods: The targeted subjects were 1400 North Korean settlers who were receiving settlement service by Korean National Red Cross after finishing their training at Hanawon in 2005. The data was collected from August to October in 2007. The QoL was assessed by Medical Outcomes Study Short Form-36. Collected data were analyzed by ANOVA and t-test with SPSS win 15.0 program. Result: The majority of the 466 subjects were female(77.9%). The average age was 36.8 years, 52.8% lived alone, and 64.0% were unemployed. The average QoL score of the group was $62.4{\pm}18.4$, which was markedly lower in terms of social, physical and mental health compared to the scores of immigrants to South Korea from other countries. The score was the highest for physical ability and the lowest for general health. Influential socio-demographic factors to QoL were gender, age, education, religion, annual salary, occupation, and life insurance. Employed in the subject group showed higher level of QoL on eight categories than unemployed. Concerning health problems that detracted from QoL, 18.5% of the subjects were aware they suffered from anemia and 8.8% of them recognized they suffered from attention deficits. Conclusion: The health conditions of the North Korean settlers had improved since they settled in South Korea, but their QoL was lower than other immigrants. Various programs to maintain and promote the health of North Korean settlers would be useful.

• Journal of Preventive Medicine and Public Health
• /
• v.35 no.2
• /
• pp.116-122
• /
• 2002

Objectives : To examine the relationships among health promoting lifestyle, anxiety, and self-esteem for korean immigrants in New York. Methods : The study included 425 adults aged 18 and over, who were chosen from Korean church and social organizations located in New York. The data were collected from April to July, 1996 using self-administered questionnaires. Data analyses were conducted using stepwise multiple regression, Pearson's correlation coefficients, 1-test, and ANOVA. Results : Health promoting lifestyle was significantly different by age, religion, occupation, and the length of residence. Those insured and those with no current medial diagnosis revealed significantly higher score in health promoting lifestyle than their counterparts. As for the level of anxiety, significant differences were found by educational level, marital status, occupation, income, and the length of residence. Self-esteem varied significantly by education, marital status, occupation, income, and the length of residence. Those with no current medical diagnosis and those insured experienced significantly higher level of self-esteem than their counterparts. Negative correlations were observed between health promoting lifestyle and anxiety. Perceived health status at present was positively correlated to perceived health status in the future. Health promoting lifestyle was significantly predicted by anxiety, age, and insurance. Conclusions : The above findings suggested that it is necessary to develop programs improving the perceived health status and lowering the level of anxiety. In this context, further researches on the relation between health promoting lifestyle and anxiety is required.

• Annals of Coloproctology
• /
• v.34 no.6
• /
• pp.299-305
• /
• 2018

Purpose: Inflammatory bowel disease (IBD) in Korea has been increasing in recent years, but accurate statistics about operations for IBD are lacking. The purpose of this study was to investigate the trends and current status of IBD surgeries in Korea. Methods: Using a national database from the Korea Health Insurance Review and Assessment Service, we analyzed data from patients who underwent surgery for Crohn disease and ulcerative colitis from January 2009 to October 2016. Results: The mean number of patients who underwent surgery for Crohn disease was 791.8 per year. Colorectal surgery, small bowel surgery, and anal surgery were performed fairly often (31.2%, 29.4%, 39.4%, respectively), and laparoscopic surgery continued to increase, recently exceeding 30%. About 50% of Crohn patients used biologics before and after surgery, and those patients also underwent a relatively high rate of anal surgeries (44.2%). The mean number of patients who underwent surgery for ulcerative colitis was 247.6 per year. Colorectal surgery accounted for more than half of all operations, and laparoscopic surgery has been increasing rapidly, having been performed in about 60% of patients in recent years. The incidence of colorectal cancer in patients with ulcerative colitis was very high and increased rapidly during the study period, reaching about 80%. Conclusion: The number of patients undergoing laparoscopic surgery for IBD in Korea has increased significantly. Biologics are actively used by patients with Crohn disease, with a high proportion of anal surgeries required. Many of the surgical indications for ulcerative colitis have shifted into colorectal cancer.