• Title/Summary/Keyword: admission patient

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An Analysis of Primary Causes for Waiting for Inpatient Admission and Length of stay at Emergency Medical Center(EMC) (응급의료 센터의 체류 및 입원대기 시간 지연 요인 - 일개 의료기관을 중심으로 -)

  • Kil Suk-Yong;Kim Ok-Jun;Park Jin-Sun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.3
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    • pp.522-531
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    • 1999
  • This research identifies the ingress to egress primary factors that causes a patient to receive delayed emergency medical care. This material was collected between February 1st to 28th, 1998. Research envolved 4,118 people who visited the college emergency medical center in Kyeongido Province, South Korea. Medical records were examined, using the retrospective method. to determine the length of stay and the main cause for waiting. Results are as follows : 1. The age group with the highest admission rate was 10 and under, approximately 1,394 (33.9%). Followed by an even distribution for ages between 11-50 at 10-15% for their respective ranges. The lowest admission rate was 50 years and above. 2. From the 4,118 records examined, 3,489 received outpatient treatment (84.7%); 601 were admitted for inpatient care (14.6%); 25 arrived dead on arrival (0.6%); and 4 people died at the hospital. 3. Between 7PM to 12AM, 42.9% were admitted to the EMC. The hours from 9PM to 11PM recorded the highest admission rate and 5AM to 8AM was the lowest From 8PM to 12AM, the most beds were occupied. 4. For most patients. the average length of stay was approximately 2.2 hours. By medical department, external medicine was the longest for 2.8 hours. Pediatrics was the shortest for 1.6 hours. The average waiting period for inpatient admission was 2.6 hours. Inpatient admission for pediatrics and external medicine was 3.4 hours and 2.2 hours respectively. 5. Theses are primary factors for delay at EMC: 1) pronged medical consultations to decide between inpatient versus outpatient treatment, and delaying to be inpatient, 2) when you call physicians they are delayed to come 3) Understaffing during peak or critical hours, 4) Excessive consulting with different medical departments, 5) some patients require longer monitoring periods, 6) medical records are delayed in transit between departments, 7) repeated laboratory tests make delay the result, 8) overcrowded emergency x-ray place causes delay taking x-ray and portable x-ray, 9) the distance between EMC and registration and cashier offices is too far. 10) hard to control patient's family members. The best way to reduce EMC waiting and staying time is by cooperation between departments, both medical and administrative. Each department must work beyond their job description or duty and help each other to provide the best medical service and satisfy the patient needs. The most important answer to shortened the EMC point from ingress to egress is to see things from a patient point of view and begin from there to find the solution.

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The Changes in Psychopathological Behavior of Schizophrenics in the Ward (정신분열증환자 간호에 대한 임상적 고찰)

  • 강흥순
    • Journal of Korean Academy of Nursing
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    • v.3 no.1
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    • pp.1-4
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    • 1972
  • A study designed to provide effective nursing care for schizophrenic patient was carried out to 22 patients who were admitted to the psychiatric in-patient service, St. Malays Hospital, Catholic Medical Center. The main purpose of the study was to provide effective means of discriminating the effects of nursing care for schizophrenic patients. The experimental group sampled consisted of 10 male and female patients who have been given patient-centered nursing care while the control group consisted of 12 male and female patients who have been given only routine care. The administration of the WBI manual in both groups obtained the changes in the psychopathological behavior of them. The result were found to be as follows. 1. The greater number of the patient in both groups were below 30 years of age (70%). 2. Uptill 15 days after admission there was no difference between the change of the psychopathological behavior the subject group and that of the control. 3. There as a difference between the change of the psychopathological behavior of the subject group and that of the control uptill 30 days after. admission(p<0.08).

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A Study of the Anxiety Levels of Hospitalized Psychiatric Patients in Terms of Length of Hospitalization (정신과 입원환자의 입원기간에 따른 불안정도에 관한 연구)

  • 김윤희
    • Journal of Korean Academy of Nursing
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    • v.11 no.1
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    • pp.45-63
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    • 1981
  • This study was done to determine the relationship between the anxiety levels of hospitalized psychiatric patients and various influencing variables. The purpose of this study was to determine factors that may help hospitalized psychiatric patients to experience lower levels of anxiety in relation to changing situations and provide the basic data for a dynamic approach which is important in the field of modern psychiatric nursing that understands and analyses the meaning of patients behavior. The anxiety may produce stress, which is a common experience among all human beings. Patients may merely feel uncomfortable in the state of mild anxiety, however, the severe state could be an obstacle to treatment and recovery from disease. The anxiety of the psychiatric patient is a factor which greatly influencing the patient's behavior, so his disorderd behavior is an expression of defence or pathologically fixed behavior. According the psychiatric patient's anxiety at the time of admission is the concern of the health team. The nurse's special concern has to do with understanding and supporting the patient and meeting his individual needs by frequent close contact during the entire hospitalization period, compared to other teamembers the nurse's responsibility in this regard is greated. So this study emphasizes the necessity of creating conditions these, but above all the psychiatric nurse should create a therapeutic environment by not only regarding the patient's behavior or symptoms but understanding the meaning of them. The subjects of this study were 57 psychiatric patients selected from the K neuropsychiatric hospital located in Kunsan city. Data were collected twice from the same patients within a 24 hour period after admission and 10 days after admission. (September 18th to November 8th, 1980). The data collected method was through direct interview, and the interview time was 20 minutes for each patient. Data analysis included Item Analysis & Internal Consistency Reliability Tests, Percentages, t-test, analysis of variance and stepwise multiple regression analysis. The findings of this study were as follows. A. Test of Hypothesis a. Hypothesis 1 :“The anxiety level of psychiatric patients within 24 hours after admission will be higher than those of the same patients 10 days after admission,”was accepted. (t = 3. 15 ; p < 0.005) b. Hypothesi 2:“The more the number of admissions the higher the level of anxiety related to two categories”, was accepted. (affective anxiety: F = 5.50, p < 0.005, Somatic anxiety: F = 9.12, p <.

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Diagnostic Radioopacity in Chloroform Ingestion -A Case Report- (방사선 비투과성 클로로포름 음독 1례)

  • Lee Sung Woo;Choi Sung Hyuk;Hong Yun Sik;Kim Su Jin;Moon Sung Woo;Moon Jun Dong;Jung Sang Hyun;Park Jong Su
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.48-51
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    • 2005
  • Diagostic imaging can help in management of toxicologic emergencies. We report a patient who presented to the emergency department with coma and suppressed respiration after ingestion of unknown substance. We documented chloroform with radiopaque material in bowel on abdominal radiograph. We used activated charcoal and laxative to decontaminate bowel. Hepatotoxicity occurred on 3rd admission day and elevation of liver enzyme reached peak level on 5th admission day. The patient received hemoperfusion, N-acetylsystein and supportive cares. The patient was improved from hepatic dysfunction and discharged without complication on 11th admission day. Radiograph in toxicology may confirm a diagnosis and assist in therapeutic intervention.

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말기 환자에서 사망 전 의료비 지출 현황과 환자관리 대책

  • Kim, Gi-Gyeong
    • Korean Journal of Hospice Care
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    • v.5 no.1
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    • pp.26-32
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    • 2005
  • Purpose: To know for what the medical expenditure had been used and to seek the way how it can be efficiently redistributed, I investigated total medical expenditure according to the time period to death in the expired patients for recent 2 years. Methods: 21patients were enrolled in this study. Total medical expenditure including benefit charge and non-benefit charge charged to patients in in-patient department(IPD) and out-patient department(OPD) was counted according to the period for one year by death. Results: 94.7% of the total medical expenditure had been payed for admission-related expenditure and 89% during period 3 and 4 for 6months before death, which may be due to the more days of admission during those periods. 70.1% of the total expenditure had been charged on the admission-fee, room charge, diet, and administration of the fluid, medicines, and blood etc. Conclusion: Majority of medical expenditure has been used in the affairs being unable to improve the survival or quality of life of patients and during the periods closer to death. Here, it would be needed heartily to look for the best ways in detail how the idea of hospice can come true through nation-wide and social consensus.

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Liability for Damage due to Doctors' Unfaithful Medical Practice (의사의 불성실한 진료행위로 인한 손해배상책임)

  • Jeon, Byeon-Nam
    • The Korean Society of Law and Medicine
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    • v.15 no.2
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    • pp.317-343
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    • 2014
  • In order to account for whether a doctor should indemnify damages resulted from violation of duty of care, the fact that a doctor violated duty of care, that damages were incurred, and the link between violation of duty of care and damages incurred, respectively, should be verified. So even though a doctor violated duty of care to patients, he or she will not bear the responsibility to indemnify damages unless it is not verified. If a doctor's negligence in medical practices is assessed that obviously unfaithful medical practice far exceeds the limit of admission of a patient, it will not go against people's general perception of justice or law and order to constitute a medical malpractice itself as an illegal action that will require liabiliy for damage. However, when the limit of admission is set too low, a patient's benefit and expectation of proper medical treatment can be violated. In contrast, if the limit of admission is set high, it can leave too little room for doctors' discretion for treatments due to a bigger risk of indemnification for damages. Thus, a reasonable balance that can satisfy both benefit and expectation of patients and doctors' right to treatment is needed.

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A Study on the Informal Cost Burden of the Patients Admitted to the Hospital (입원환자의 비공식적 의료비용 부담에 관한 연구)

  • Han, Mi-Hyun
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.5-14
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    • 2001
  • To estimate total burden of hospital admission over patient of gamily, we need to know the unofficial private expenses in addition to explicit hospital admission fees. This study was conducted from June 29, 2,000 to August 10, 2,000. Subjects were 104 patient at university hospital located at chungnam province. After thorough explanation of purpose and procedures, notebooks are given to each patient or guardian. They are requested to recorded all relevant expenditures occurred during hospital stay. Incomplete records were filled-up by direct personal contact or phones. Datas were summarized and analyzed using SAS statistical package. P-value less than 0.05 was considered significant. The results of the study are as follows: 1. In 96.1% of the patient, guardians stayed at hospital to take care of patients. In 38,8% one of the family members get work-leave or temporary resting from job. Average date of leave was 7.5days. 2. Average informal cost burden per patient was 204,467 won (14,330 won${\sim}$1,594,870 won). Average hospital cost paid by the patient was 1,061,807 won. The ratio of informal cost burden to hospital cost paid by the patient was 0.327. 3. According to the regression analysis, the relevant factors affection informal cost burdens were distance from home to hospital(p=0.018), and duration of hospitalization(p=0.0001). 4. Informal cost burden was composed of expenses for personal expense of care giver (126, 720 won/patient), meal (86,924 won/patient), transportation (77,648 won/patient), necessaries of life (18,789 won/patient), tests and treatments not covered by insurance (17,289 won/patient), medical supplies not covered by insurance (15,280 won/patient), treat for visitors (14,757 won/patient), TV coin (8,247 won/patient), and others (7,582 won/patient). In addition to the hospital cost paid by the patient for hospital admission, the informal cost burdens should be recognised explicitly because it is not small. Significant proportion of informal cost burden is composed of care-giver's personal expense, transportation, meal. It is suggested that some polices are to be devised and implemented enabling that this portion of informal expenses be directed to formal professional nursing care. Thus we can improve the quality of care and decrease discomfort of patient's relatives.

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Factors associated with treatment outcomes of patients hospitalized with severe maxillofacial infections at a tertiary center

  • Kim, Hye-Won;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.3
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    • pp.197-208
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    • 2021
  • Objectives: The purpose of this retrospective study was to evaluate the variables associated with length of stay (LOS), hospital costs, intensive care unit (ICU) use, and treatment outcomes in patients hospitalized for maxillofacial infections at a tertiary medical center in South Korea. Materials and Methods: A retrospective chart review was conducted for patients admitted for treatment of maxillofacial infections at Dankook University Hospital from January 1, 2011 through September 30, 2020. A total of 390 patient charts were reviewed and included in the final statistical analyses. Results: Average LOS and hospital bill per patient of this study was 11.47 days, and ₩4,710,017.25 ($4,216.67), respectively. Of the 390 subjects, 97.3% were discharged routinely following complete recovery, 1.0% expired following treatment, and 0.8% were transferred to another hospital. In multivariate linear regression analyses to determine variables associated with LOS, admission year, infection side, Flynn score, deep neck infection, cardiovascular disease, admission C-reactive protein (CRP) and glucose levels, number and length of surgical interventions, tracheostomy, time elapsed from admission to first surgery, and length of ICU stay accounted for 85.8% of the variation. With regard to the total hospital bill, significantly associated variables were age, type of insurance, Flynn score, number of comorbidities, admission CRP, white blood cell, and glucose levels, admission temperature, peak temperature, surgical intervention, the length, type, and location of surgery, tracheostomy, time elapsed from admission to first surgery, and length of ICU use, which accounted for 90.4% of the variation. Age and ICU use were the only variables significantly associated with unfavorable discharge outcomes in multivariate logistic regression analysis. Conclusion: For successful and cost-effective management of maxillofacial infections, clinicians to be vigilant about the decision to admit patients with maxillofacial infections, perform appropriate surgery at an adequate time, and admit them to the ICU.

A Clinical Case Study of Paralytic Ileus Patient Improved by Euphorbiae Kansui Radix(Gan-sui) (마비성 장폐색환자의 감수로 호전된 증례)

  • 한경석;박은경;박성식
    • The Journal of Korean Medicine
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    • v.21 no.1
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    • pp.103-108
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    • 2000
  • Paralytic ileus is one of the gastro-intestinal symptoms of a patient who is in the post-symptom period resulting from stroke. The purpose of this study was to examine the efficacy of Euphorbiae Kansui Radix(Gan-sui) for a patient who has suffered from severe paralytic ileus as post-symptoms caused by 3rd stroke. The subject was a 70-year-old woman who had been troubled with dyspepsia, abdominal flatus and other pains during the past 10 years, and whose symtoms worsened because of her recent 3rd stroke. At the time of admission, she complained of abdominal flatus, conspitation, quadri weakness(Lt>Rt) and dysathria. For the first 10 days after admission, she was treated with Oriental' Western Medicine, which failed to relieve any symptom. However, after taking Euphorbiae Kansui Radix(Gan-sui), gastro-intestinal vermicular movement improved, so the symptoms of abdominal flatus and conspitation disappeared. As a consequence, the accompanying paralytic ileus condition also improved.

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Clinical Study of Oriental-Western collaborative medical treatment on 1 case of patient with Suppurative Arthritis (Suppurative arthritis 환자(患者) 1례(例)의 한(韓)·양방(洋方) 겸치를(兼治)를 통(通)한 임상적(臨床的) 고찰(考察))

  • Ha, Chi-Hong;Cho, Myung-Rae
    • Journal of Acupuncture Research
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    • v.17 no.3
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    • pp.277-285
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    • 2000
  • By process of treatment for a case which diagnosed as suppurative arthritis and admitted from the 5th, October, 1999 to the 15th, November, 1999, the results are as follows. Method & Results : In the earlier days of admission, this patient was diagnosed as damp-heat(濕熱) and medicated Cheongyeolsaseup-tang(qingrexieshi-tang). As the result, heating, pain in both knees and heating in both lmees are improved. In the later days of admission, this patient was diagnosed as impairment of the liver and kidney(肝腎虛損) and medicated Samgi-eum(sanqi-yin). As the reslut, weakness in lower limbs is improved. Conclusion : I consider that the rate of recovery for other infectious diseases including suppurative arthritis can be maximized by accumulation of clinical experiences and continuous research through both western medical treatment and oriental medical treatment.

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