• 제목/요약/키워드: Outpatient Department

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Overnight hospital stay and/or extended recovery period may allow long-duration oral and maxillofacial surgeries in the operating room of a dental hospital in an outpatient setting: a single-center experience

  • Uzumcugil, Filiz;Yilbas, Aysun Ankay;Akca, Basak;Ozkaragoz, Demet Basak;Adiloglu, Selen;Tuz, Hifzi Hakan;Kanbak, Meral
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.2
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    • pp.125-132
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    • 2020
  • Objectives: The requirement for overnight hospital stay should be considered preoperatively according to patient-related factors, type of surgery, and anesthetic management plan. In this study, we aimed to define the major factors that influence consideration of overnight hospital stay in patients undergoing oral and maxillofacial (OMF) surgery in an operating room (OR) of a dental hospital in an outpatient setting. Materials and Methods: The records of patients who underwent oral procedures under general anesthesia between 2014-2017 were reviewed. Results: A total of 821 patients underwent oral procedures under general anesthesia; 631 of them underwent OMF surgery in the OR of a dental hospital, and 174 of these patients were hospitalized for overnight stay. There was no significant difference in the number of patients with comorbidities between the outpatient and hospitalized patient groups (P=0.389). The duration of surgery was longer in the hospitalized patient group (105.25±57.48 vs 189.62±82.03 minutes; P<0.001). Double-jaw (n=15; 310.00±54.21 minutes) and iliac crest grafting surgeries (n=59; 211.86±61.02 minutes) had the longest durations. Patients who underwent iliac crest grafting had the highest rates of hospitalization (79%). The overall recovery period was longer in outpatients (119.40±41.60 vs 149.83±52.04; P<0.001). Conclusion: Duration of surgery was the main determinant in considering whether a patient required overnight hospital stay. However, patients with an American Society of Anesthesiology physical status score <3 may be scheduled for OMF surgery in the OR of a dental hospital in an outpatient setting regardless of duration of surgery if overnight hospital stay is planned or an extended recovery period is provided until patients meet the discharge criteria.

A Study on the Characteristics of Spatial Configuration for Wayfinding in General Hospital O. P. D. (종합병원 외래진료부의 진로인지를 위한 공간구조 특성에 관한 연구)

  • Han, Gi-Jeung;Lee, Teuk-Koo
    • Korean Institute of Interior Design Journal
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    • v.15 no.5 s.58
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    • pp.183-192
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    • 2006
  • This study analyzes the characteristics of special configuration for wayfinding in general hospitals. To that end, the study categorizes four different hospitals, according to the type of their wayfinding systems. It aims at utilizing the result of the analysis for wayfinding system in general hospitals by applying three elements of analysis methods', perpetual access, depth, and intelligibility. The study result shows as follows: First, there is no difference in special hierarchy when hospitals are analyzed and divided by halls and streets. It means that outpatient departments are located by spatial function and characteristics rather than form of spatial configuration. Second, we found that fewer direction changes are conducive to easier circulation in terms of wayfinding, when we analyzed spatial depth from the main entrances to the outpatient departments. Third, regarding intelligibility, intelligibility of Chungang University Hospital ranked highest. Kunkook University Hospital, Dongkook University Hospital and Seoul National University Hospital ranked 2nd, 3rd, and 4th respectively. It means that difficulty level of wayfinding is not decided by the characteristics of special configuration such as hospital hall and hospital streets but depends on location planning. The difficulty level of wayfinding mainly relies on location planning.

Status of Tuberculosis Infection Control in Hospitals (의료기관의 결핵감염관리 현황)

  • Lee, Na Young;Kim, Kyung Hee;Kang, Hee Sun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.20 no.4
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    • pp.359-371
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    • 2013
  • Purpose: The purpose of this study was to determine the status of tuberculosis (TB) infection control in hospitals. Method: This study was a cross-sectional descriptive study in which self-administered questionnaires were used to survey 77 hospitals. Data were collected from August 12 to September 15, 2012. Results: Only 27 institutions (35.1%) were monitoring patients infected with or suspected of having TB. Most hospitals were conducting TB prevention education for patients' family and employees, and TB screening for employees along with follow-up examinations. However, private negative pressure rooms were more often available in wards and intensive care units than in outpatient departments, and in institutions with over 700 beds located in Seoul or GyeongGi Province. Most hospitals ensured that masks were placed on infected patients while transporting them. In addition, efforts to control TB infection such as placing respiratory etiquette posters in outpatient departments and airborne infection signs on the doors in the wards were also well established in most institutions. Conclusion: More efforts are needed to improve the status of TB infection control to ensure quality care, especially in terms of monitoring patients with TB infections and making private negative pressure rooms available in outpatient departments.

Outpatient Satisfaction at Private General Hospitals in Ho Chi Minh City, Vietnam

  • GIAO, Ha Nam Khanh;THY, Nguyen Thi Anh;VUONG, Bui Nhat;KIET, Truong Van;LIEN, Le Thi Phuong
    • The Journal of Asian Finance, Economics and Business
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    • v.7 no.7
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    • pp.323-334
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    • 2020
  • The quality of hospital services remains a concern of both the manager and the patient. The study aims to identify factors affecting outpatient satisfaction at private general hospitals in Ho Chi Minh City, establishing a scale for measuring them. Some 450 outpatients who were treated in five top private hospitals in Ho Chi Minh city (HCMC) in 2019 - An Sinh General Hospital, Hoan My General Hospital, Columbia Asia International Hospital, FV Hospital, and Vu Anh International General Hospital - were interviewed directly in the last quarter of 2019 to obtain the information. The SERVPERF model, plus the cost, together with the SPSS software, have been used to process information by Cronbach's alpha analysis, Exploratory Factor analysis, and linear regression analysis. The results show that there are five factors influencing outpatient satisfaction at private general hospitals in HCMC, in which four factors affects positively in the order of decreasing importance: treatment outcome, doctors and nurses' professional capacity, facilities and environment of the hospital, hospital care, and the treatment time factor affects negatively. The results of the study provide private hospital in HCMC managers with a number of suggestions to increase the level of hospital service quality, so that increase outpatients satisfaction.

The Effects of Hospital Resources on the Service Uses: Hospital Service Area Approach (병원서비스지역 내 병원자원과 의료서비스 이용 간의 관련성 분석)

  • Kwak, Jin-Mi;Kim, Da-Yang;Seo, Eun-Won;Lee, Kwang-Soo
    • Health Policy and Management
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    • v.25 no.3
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    • pp.221-228
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    • 2015
  • Background: This study explored the relationship between hospital resources and services uses in outpatient/inpatient-based hospital service area (HSA) in Korea. Methods: Study hospitals included all acute care hospitals except tertiary hospitals. Inpatient and outpatient hospital claims from the Korean National Health Insurance (NHI) program in 2010 were used to identify the service uses. Hospital resources and the degree of insurance premium in study areas were identified with the NHI corporation data. Study variables were computed by summing the service uses or hospital resources of study hospitals in each HSA. Service uses were represented by the total medical charges and number of visits/inpatient days. Hospital resources were measured by number of beds, number of doctors, and number of computed tomography (CT). The economic status of NHI enrollees in each HSA was controlled by the average monthly premium of NHI program per household in each HSA. The degree of using local hospitals was controlled with the localization index. Results: Analysis results showed that hospital resources such as beds, CT were statistically related to the service uses. And also localization index was found to have positive significant relationships with service uses. Conclusion: Hospital resources such as beds, CT had not only positive impacts on inpatient service uses, but also influences on the outpatient setting. Health policy makers will require monitoring and assessing the hospital resources in Korea.

The effect of social capital, health risk behavior and health status on medical care utilization by the elderly (노인의 사회자본과 건강위해 행위 및 건강수준이 의료서비스 이용에 미치는 영향)

  • Woo, Kyung-Sook;Seo, Jae-Hee;Kim, Gye-Soo;Shin, Young-Jeon
    • Health Policy and Management
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    • v.22 no.4
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    • pp.497-521
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    • 2012
  • Objectives This study aimed to investigate the effect of social capital, health risk behavior and health status on medical care utilization by the elderly. The data and Research method Data were obtained from the 4th wave survey of the Korea Welfare Panel Study. 4,087 household members aged 65 years and over were subject to analysis. Descriptive statistics are used to describe the basic features of the data in a study. we performed a structural equation modeling(SEM) analysis to evaluate the effect of social capital and mediating effect of health risk behavior and health status. Results Results showed that factors related to medical care utilization of the elderly were different depending on types of service (inpatient and outpatient service) except health status. Age, higher social capital, more health-risk behavior and poorer health status were associated with increased use of inpatient service. Social capital was found to have a positive direct effect on it. Also, social capital had an indirect effect on reducing use of inpatient services by improving health status. On the other hand, lower age and higher household income tended to increase use of outpatient service, while higher social capital and higher health status were inversely related. Social capital had a direct effect and an indirect effect on reducing use of outpatient service and, at that time, health status played a mediating role. Conclusions Social capital may contribute to improve health status and indirectly reduce medical care utilization of the elderly by enhancing their health status. These results provide evidence that more policy and strategy considerations should be needed for the elderly to strengthen their social capital in order to enhance their levels of health and more efficient utilization of medical care.

A Case Study and Implications on Improvements in Environmental Design of Outpatient Department and Health Examination Center in Mental Health Hospital - For Health Promotion Department of National Mental Health Center (정신의료시설 내 외래부 및 건강검진센터의 환경디자인 개선 사례 및 시사점 연구 - 국립정신건강센터 건강증진과를 대상으로)

  • Noh, Tae Rin;Lee, Seung Ji;Suh, Swoo kyung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.27 no.3
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    • pp.17-26
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    • 2021
  • Purpose: This study is a case study in which the space was improved by applying the design direction derived through the theoretical basis and service design process to the outpatient department and health examination center in mental health facilities used by various stakeholders. And it aims to present implications through this. Methods: The research method is based on the analysis of the service design process with a focus on literature review. Results: As a result of deriving the design direction, it was organized into 1) improvement of spatial arrangement, 2) improvement of wayfinding system, and 3) creation of comfortable environment. The design improvement plan suggested division of areas, change of nurse station location, creation of a pleasant waiting space for the outpatient department, reinforcement of access, improvement of room relocation and flow, and increased comfort of common spaces for the health examination center. Implications: First, it is necessary to expand research and application of spatial planning and environmental design reflecting the characteristics of patients and environments of mental health institutions. Second, in the medical environment, the divided territoriality should be reviewed for various stakeholders as well as the coexistence. Third, it is necessary to promote medical service and environmental improvement through the service design process.

Analysis of the Health Expenditure and Medical Usage Difference of the Baby Boomers between Male and Female: Depression as a Mediators (베이비붐세대의 남녀 간 의료비 지출 및 의료이용 차이: 우울을 매개변수로)

  • Jeong, Ji Yun;Jeong, Jae Yeon;Cha, Sun Jung;Lee, Hae Jong
    • Health Policy and Management
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    • v.29 no.2
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    • pp.160-171
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    • 2019
  • Background: This study purposed to compare the difference on medical utilization and health expenditure of baby boomer generation by depression between gender. Methods: Korea Welfare Panel Survey 2016, provided by the Korea Institute for Health and Social Affairs, was used for the analysis. For the research, we used the two-part model, yes or no of use (part 1), and frequency of use (part 2) for medical utilization. The dependent variables are the whether or not to use of hospitalization services, outpatient services, length of stay, outpatient service visits, and health expenditure. And the independent variables are used as the predisposing (education, spouse presence), enabling (insurance type, private insurance, economic activity, income), and need (chronic disease, self-rated health, disability) factors in the Andersen behavior model. Depression was used as intervening variables. Structural equation model and multiple group analysis by gender were used. Results: There were differences in the medical care usage and cost between men and women in baby boomer. For men, mediating effects of depression were present at the hospitalization (yes/no), length of stay, and health expenditure. On the other hand, for women, the mediating effect of depression was found only at the outpatient visits. Specially, depression was working at the medical services by the different way between gender. The size of effect (multiple group analysis) was affected by significant differences between men and women. Conclusion: This study found that the mediating effect of depression is increased medical usage and health expenditure and the effect factors are different by gender. Therefore, it is necessary to establish a medical care policy considering the socio-economic characteristics of baby boomers.

ANALYSIS ON THE OUTPATIENT ANESTHESIA AT DENTAL CLINIC FOR DISABLED IN SEOUL NATIONAL UNIVERSITY DENTAL HOSPITAL (서울대학교 치과병원 장애인진료실의 외래환자마취 실태 분석)

  • Park, Chang-Joo;Jung, Jun-Min;Kim, Hyun-Jeong;Jang, Ki-Taeg;Lee, Sang-Hun;Yum, Kwang-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.19-25
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    • 2004
  • Dentally disabled person means one who have difficulty in cooperating voluntarily with a dentist for routine dental care. Seoul National University Dental Hospital (SNUDH) Dental Clinic for Disabled has worked for them under outpatient anesthesia concept. The aim of this study was to determine the anesthetic characteristics of the patients attending for dental treatment at SNUDH Dental Clinic for Disabled in order to establish better future treatment plans. The data were drawn from the patients who visited SNUDH Dental Clinic for Disabled from January 1999 to October 2002. Total 93 dental treatments for 83 patients were enrolled in this study. Most patients had mental retardation and the conservative treatments were carried out under general anesthesia. Thiopental and vecuronium were mostly used for induction agent and neuromuscular blocker, respectively. Enflurane, with oxygen and nitrous oxide, was mostly used to maintain the anesthesia. Mean total anesthetic time was $164.4{\pm}57.2$ minutes and mean duration at the post-anesthetic care unit was $106.2{\pm}50.5$ min. Serious postoperative complications were not observed. These results showed our successful anesthetic outcomes without any severe side effect or complication and the needs of more outpatient centers for dental care for disabled.

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A Study on the Criteria for Selection of Medical Care Facilities (의료기관 선택기준에 관한 연구)

  • Cho, Woo-Hyun;Kim, Han-Joong;Lee, Sun-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.1 s.37
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    • pp.53-63
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    • 1992
  • There are increasing interest and need for information on health care consumer with the significance of hospital marketing and strategic planning being increasingly emphasized. This study was conducted to investigate the criteria for selection of medical facilities according to the characteristics of health care consumer by the types of medical services on a sample of 1,500 population aged 20 years and above. Major findings are as follows ; 1. When considering the criteria for selection of medical facilities into two factors, namely, quality or convenience factors, convenience factor was the major contributor for outpatient and dental services whereas it was quality factor for inpatient services. 2. Females and those residing in large cities selected medical facilities based on convenience factor in the outpatient services. In the case of inpatient service, persons who considered their present health status to be good and whose ages were 50 years old and above choose medical facilities based on quality factor. 3. Persons who considered medical facilities to be profit-making tended to choose medical facilities based on convenience factor for outpatient services. There were no differences in the cases of inpatient and dental services. 4. There was no significant difference on the criteria for selection of medical facilities according to the decision maker for selection or trust on medical facilities. On the use of health service information, selection of medical facilities was based on quality factor for those who made more use of the information in the cases of outpatient and dental services. 5. Analysis using the logistic regression model on the criteria for the selection of medical facilities with the characteristics of health care consumer as independent variables was performed. The selection of medical facilities was significantly related with residential area, sex, and use of information on medical facilities for outpatient services and with age, average monthly income, and perception of health status for inpatient services. For dental services significant association with residential area and use of information on medical facilities was seen. The results of this study, despite some limitations, can be used as baseline data for marketing and strategic planning of hospital management.

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