• 한국의료질향상학회지
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• 제2권2호
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• pp.56-71
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• 1996

Background : Review of readmissions in health care facilities is necessary from the viewpoint of both economic concerns and quality considerations. To identify the characteristics, factors, and causes of multiple admissions in comparison with single admissions is essential for both providers and payers in order to assure quality care and efficient use of medical resources. Methods: All discharges from an university hospital in 1993 were analyzed, and the characteristics of multiple admissions were identified and were compared with those of single admissions by using the data bases of the discharge abstract and billing for reimbursement. Medical records of patients readmitted within 6 days after the previous discharge were reviewed to identify the reasons for such prompt readmission. Statistical analysis between groups of patients were performed by using SPSS. Result : The mean age was higher in multiple admissions than those of single admissions, and the average length of stay was longer in multiple admissions than in single admissions. The hospital cost per day is higher in single admissions while the cost per case is higher in multiple admissions. More than half of readmissions occurred within one month after the preceding discharges. Above 15% of the readmission within 6 days after the preceding discharges seemed to have close relationship with quality of care provided during the preceding hospitalization. The death rate of the patients readmitted within 6 days was the highest in comparison with multiple admissions and single admissions. Conclusion : Potential preventable readmissions should be reduced by identifying characteristics of multiple admissions, especially unplanned readmission, and by applying some interventions such as standard predischarge assessment or careful follow-up care after discharge for high risk readmission groups. As the results of these efforts, health care facilities could achieve quality improvement in medical care, and effective use of hospital resources.

• Child Health Nursing Research
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• 제26권1호
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• pp.55-63
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• 2020

Purpose: The purpose of this study was to evaluate the current level of sleep quality among Korean middle-school students using the Pittsburg Sleep Quality Index (PSQI), and to analyze the factors influencing sleep quality. Methods: The study used a descriptive cross-sectional design and a self-report questionnaire. The participants were 744 middle-school students. The questionnaire included the PSQI and health-related questions, such as the types of diseases they had been diagnosed with and the frequency of hospital admissions. The data were analyzed using the independent t-test, analysis of variance, Pearson correlation coefficients, and linear multiple regression. Results: The global PSQI score was 4.21, which indicated good sleep quality. The major factors that were associated with the sleep quality of middle-school students were the number of diseases they had been diagnosed with (β=.54, p=.001) and atopic dermatitis (β=.32, p=.001). In addition, asthma and the frequency of hospital admissions were significant factors influencing each component of the PSQI. Conclusion: The findings from this study suggest that sleep quality was associated with several health-related factors. Thus, nurses, school nurses, and nursing researchers may need to assess the health-related factors associated with adolescents' sleep quality as part of efforts to improve their sleep quality.

• 한국병원경영학회지
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• 제15권4호
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• pp.125-142
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• 2010

Objective : To determine demographic, clinical, health care utilization factors predicting unplanned readmission(within 28 days) to the hospital. Methods : A case-control study was conducted from January to December 2009. Multiple logistic regression was used to examine risk factors for readmission. 180 patients who had been readmitted within 28 days and 1,784 controls were recruited from an university hospital in Seoul. Results : Six risk factors associated with readmission risk were identified and include mail sex, medical service rather than surgical service, number of comorbid diseases, type of patient's room, lenth of stay, number of admissions in the prior 12 months. Conclusions : One of the association with readmission risk identified was the number of hospital admissions in the previous year. This factor may be the only risk factor necessary for assessing prior risk and has the additional advantage of being easily accessible from computerized medical records without requiring other medical record review. This risk factor may be useful in identifying a group at high readmission risk, which could be targeted in intervention studies. Multiple risk factors intervention approach should be considered in designing future prevention strategies.

• 여성건강간호학회지
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• 제12권2호
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• pp.132-141
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• 2006

Purpose: The purpose of this study was to supply basic data for a health promoting program and to elevate the level of it by examining whether university students' health promoting behaviors were related to health perception, health concept, self- esteem, perceived benefits of action, perceived barriers of action, perceived self-efficacy, activity-related affect, social support, preference, prior related behavior, and a plan for action. Method: Subjects were 192 university students in K city. Data collection method was a structured questionnaire. Data was analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation, and stepwise multiple regression. Result: The most powerful predictor was previous related behavior (36%). Altogether previous related behavior, health status, a plan for action, perceived self-efficacy and number of admissions were proven to account for 57% of health promoting behaviors. Conclusion: It suggested that prior related behavior, health status, a plan for action, perceived self-efficacy, and number of admissions should be considered when developing a students' health promoting program.

• KDI Journal of Economic Policy
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• 제38권1호
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• pp.93-121
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• 2016

The excessive demand for universities in metropolitan areas as a result of location premiums and regulated admissions quotas diminishes the competition between universities and the incentive to enhance educational performance to attract more students. Cases in point are the lower graduate employment rates (a measure of educational performance) of universities in metropolitan areas compared to those in non-metropolitan areas despite higher quality students. Additionally, the graduate employment rates of non-metropolitan universities are influenced by educational input factors such as an increase in the percentage of courses taught by full-time faculty, while those of metropolitan universities are contingent merely on enrollees' entrance scores. Ergo, a structure that revitalizes the competition between universities and encourages them to improve their educational services must be established in order to enhance the quality of higher education.

• 한국병원경영학회지
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• 제9권2호
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• pp.102-127
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• 2004

The objective of this study is to analyze a current trend of and relating factors on profitability of the Korean Public Corporation Medical Centers(KPCMCs, hereinafter, hospitals) in Korea. There are 34 hospitals in Korea as of 2004. Among these hospitals some are red ink hospitals, others are black inks in terms of profitability. Data were collected by Korea Health Industry Development Institute(KHIDI) Statistics for Hospital Management 2000-2002 and Ministry of Health and Welfare(MOHW) financial data of public hospitals which was planned to coordinate public health care services roadmap in the long run. The samples are 32 hospitals. Profitability was measured in the aspect of profit rate with normal profit to total assets, and normal profit to gross revenues as dependent variables in respective. Independent variables were classified by general factors, i.e., location, intern/resident training, period of opening, number of beds, and managerial factors(current ratio, fixed ratio, liability to total assets, total assets turnover, personnel costs, materials cost, administrative cost), and finally factors related to patient treatment(average length of stay, bed occupancy rate, admission ratio of outpatients). The methods of analysis are correlation and multiple regression analysis. This study shows firstly, a lot of hospitals are optimal current ratio. Hospitals in upper 100% current ratio are 81.2%. And the personnel cost in total costs are high. Secondly, the trend of normal profit to gross revenues of hospitals are deteriorating gradually. And lastly, as a result of multiple regression analysis, the factors had on significant effect on normal profit to total assets are fixed ratio(+), liability to total assets(-), bed occupancy rate(+), admissions of outpatients(+), etc. And the factors had on significant effect on normal profit to gross revenues are current ration(+), fixed ratio(+), personnel cost(-), administrative expenses(-), admissions of outpatients(+), etc. In conclusion, to improve the profitability of hospitals, the efforts to reduce personnel cost and average length of stay might be needed. And also beds utilization rate need to be increased.

• 한국임상약학회지
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• 제21권2호
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• pp.170-181
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• 2011

Purpose: There is considerable variability in rates of hospitalization for patients with community-acquired pneumonia (CAP) in part because of physicians' uncertainty in assessing the severity of illness at presentation. The purpose of the study was to examine the current treatment patterns and factors influencing the Pneumonia Severity Index (PSI) and clinical outcomes in the patient with CAP. Method: The retrospective data collection of the patients with CAP was conducted and the data were reviewed. The collected data included demographic, clinical, laboratory and microbiological medical information. All patients were stratified into three risk groups according to PSI: low risk (PSI score I-II), moderate risk (III) and high risk (IV-V) groups. The examined treatment patterns were the appropriateness of admissions, category of antibiotics used. The prognostic factors associated with PSI and clinical outcomes were examined. Results: One hundred and six patients' medical data were reviewed. The overall appropriateness of admissions was low presenting many of patients were admitted or intensely treated in the hospital despite of lower risk of prognosis and treated with intravenous antibiotics instead of oral fluoroquinolones. Primary pneumonia pathogens were Klebsiella pneumoniae (27%) and Streptococcus pneumoniae (21.6%). Mean LOS was 8.5 days and was significantly longer (10.0days) (p<0.001) in high risk group. The patients with age >65 (p<0.001), diabetes mellitus (p<0.001), mental alteration (p<0.001), and/or $PaO_2$ <60 mmHg (p<0.001) had a tendency to have higher PSI. The prognostic factors associated with longer LOS were age >65 years (p=0.008), mental status alteration (p<0.001), dyspnea (p=0.002) and PSI score (p=0.001). The prognostic factors associated with mortality were congestive heart failure (p=0.038), systolic blood pressure <90 mmHg (p=0.002) and arterial pH <7.35 (p=0.013). Conclusion: Most of patients were found to over-utilize medical service according to appropriateness of admissions. The elderly, mentally altered patients with low $PaO_2$ had higher PSI score with increased risk of LOS. The mortality could be increased in the patient with disease state of congestive heart failure, high blood pressure, and/or acidosis.

• 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.

• Journal of Preventive Medicine and Public Health
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• 제36권1호
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• pp.47-53
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• 2003

Objectives : I used a case-crossover design to investigate the association between air pollution, and hospital admissions for asthmatic children under the age of 15 years in Seoul, Korea Methods : I estimated the changes in the levels of hospitalization risk from theinterquartile (IQR) increase in each pollutant concentrations, using conditional logistic regression analyses, with controls for weather information. Results : Using bidirectional control sampling, the results from a conditional logistic regression model, with controls for weather conditions, showed the estimated relative risk of hospitalization for asthma among children to be 1.04 (95% confidence interval (CI), 1.01-1.08) for particulate matter with an aerodynamic diameter less than or equal to 10m (IQR=40.4ug/m3); 1.05 (95% CI, 1.00- 1.09) for nitrogen dioxide (IQR=14.6ppb): 1.02 (95% CI,0.97-1.06) for sulfur dioxide (IQR=4.4ppb): 1.03 (95% CI, 0.99-1.08) for ozone (IQR=21.7ppb): and 1.03 (95% CI, 0.99-1.08) for carbon monoxide f10R=1.0ppm). Conclusions : This empirical analysis indicates the bidirectional control sampling methods, by design, would successfully control the confounding factors due to the long-term time trends of air pollution. These findings also support the hypothesis that air pollution at levels below the current ambient air quality standards of Korea is harmful to sensitive subjects, such as asthmatic children.

• 대한화학회지
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• 제54권6호
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• pp.818-828
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• 2010

대학수학능력시험(수능)이 1994학년도에 처음 시행된 이후 17년이 지나고 여러 번의 모의평가 출제로 인해 문항의 패턴화, 지식 중심의 출제라는 비판이 제기되고 있다. 이러한 문제에 대한 시사점을 얻기 위해 한국과 마찬가지로 국가 중심 교육과정이며 국가 수준에서 이루어지는 선다형 시험 유형을 가진 일본의 대학입시센터시험(센터시험) 문항을 분석하였다. 이 연구에서는 2009년 1월에 시행한 센터시험의 이과시험에서 화학 문항을 수능과 관련하여 내용 요소 및 행동 영역에 따라 분석하고, 문항 유형과 특이 사항을 분석하였다. 또한 한국 수험생의 관점에서 예상 정답률을 추정하여 수능의 화학 문항 출제에 주는 시사점을 도출하였다.