• Child Health Nursing Research
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• v.21 no.3
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• pp.227-235
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• 2015

Purpose: The purpose of this study was to investigate disease prevalence, parent's educational needs, and disease management according to severity of respiratory infections in early childhood. Methods: Participants for this study were 173 mothers whose child was admitted to I university hospital in Seoul and whose child was an infant or toddler. Data were collected from December, 17, 2014 to February, 15, 2015 using self-report structured questionnaires. Data were analyzed using IBM/SPSS 21.0 program. Results: There were significant differences in the severity of respiratory infection according to neonatal admission due to dyspnea, feeding type, atopic dermatitis in the infant or allergic disease in father and siblings. Parent's educational needs for the severe respiratory infection group were higher than for the non-severe group. Parent's disease management for the severe respiratory infection group was lower than the non-severe group. Conclusion: As important care factors in neonatal admissions include dyspnea, cow milk feeding, eczema, family history of allergies, parent's educational needs and disease management, they should be considered when caring for young children with respiratory infections and their parents.

• Clinical and Experimental Pediatrics
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• v.61 no.6
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• pp.194-199
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• 2018

Purpose: Sacral dimples are a common cutaneous anomaly in infants. Spine ultrasonography (USG) is an effective and safe screening tool for patients with a sacral dimple. The aim of this study was to determine the clinical manifestations in patients with an isolated sacral dimple and to review the management of spinal cord abnormalities identified with USG. Methods: We reviewed clinical records and collected data on admissions for a sacral dimple from March 2014 through February 2017 that were evaluated with spine USG by a pediatric radiologist. During the same period, patients who were admitted for other complaints, but were found to have a sacral dimple were also included. Results: This study included 230 infants under 6-months-old (130 males and 100 females; mean age $52.8{\pm}42.6days$). Thirty-one infants with a sacral dimple had an echogenic filum terminale, and 57 children had a filar cyst. Twenty-seven patients had a low-lying spinal cord, and only one patient was suspected of having a tethered cord. Follow-up spine USG was performed in 28 patients, which showed normalization or insignificant change. Conclusion: In this study, all but one infant with a sacral dimple had benign imaging findings. USG can be recommended in infants with a sacral dimple for its convenience and safety.

• Journal of The Korean Society of Clinical Toxicology
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• v.13 no.1
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• pp.25-32
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• 2015

Purpose: The aim of this study was to investigate the independent factors associated with the registration rate for the community-based post suicidal care program in the emergency department (ED). Methods: This prospective observational study was conducted between March and December 2013 at the academic ED at the tertiary urban hospital. During the study period, the pre-designed registry was recorded. The variables examined included the following: patients' demographic data (Sex, age, address, type of insurance, marital status, level of education, and history of previous psychiatric disease), suicide-related data (suicidal methods, combined drink of alcohol and number of previous attempts), and management-related data (disposition at ED, physician's training level, etc.). Univariated and multivariated logistic regression analyses were performed for identification of factors affecting the registration rate for the community-based post suicidal care program. Results: A total of 163 suicides were included during the study period. Of these, 33 (20.2%) patients were registered in the post-suicide care program. Factors including a patient's address (OR: 14.92, 95% CI: 3.606-61.711), immediate intervention by psychiatric healthcare center (OR: 5.05, CI: 1.688-15.134), admissions in hospital (OR: 3.69, CI: 1.286-10.605), and history of previous psychiatric disease (OR: 3.52, CI: 1.216-10.201) showed significant association with registration for the program. Conclusion: The community-based post-suicidal care program, which is available 24 hours a day, should be operated in each district in order to increase the registration rate. Emergency physicians should actively consider the inpatient treatment program for suicidal patients and strongly recommend registration to the program, particularly for patients without previous history of psychiatric disease.

• The Korean journal of internal medicine
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• v.39 no.4
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• pp.668-679
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• 2024

Background/Aims: This cross-sectional study aimed to investigate biologics treatment disparities in rheumatoid arthritis (RA) patients based on socioeconomic status (SES). Methods: Data from the KOrean Observational Study Network for Arthritis (KORONA) database were analyzed to assess various factors associated with SES, health behaviors, and biologics use. Logistic regression and structured equation modeling (SEM) were utilized for data analysis. Results: Among 5,077 RA patients included, 393 (7.7%) patients were identified as biologics users. Within the entire cohort, 31.8% of the participants were in the low-income and low-education groups, and 39.3% of the participants were in the high-income and high-education groups. Despite the patients with low income or low education experienced higher disease activity at diagnosis, had more comorbidities, exhibited higher medication compliance, underwent more check-ups, and had more hospital admissions than their counterparts, the odds of patients with low-income receiving biologics were 34% lower (adjusted odds ratio = 0.76, 95% confidence interval: 0.60-0.96, p = 0.021) after adjustment for demographics and comorbidities. SEM and pathway analyses confirmed the negative impact of low SES on biologics use. Conclusions: The findings suggest that SES plays a significant role in biologics use among RA patients, indicating potential healthcare inefficiencies for low SES patients. Moreover, adverse healthcare habits negatively affect biologics use in RA patients. The study highlights the importance of considering socioeconomic factors while discussing biologics use and promoting equitable access to biologics for optimal RA management.

• Korea Journal of Hospital Management
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• v.25 no.3
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• pp.29-37
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• 2020

Purposes: The purpose of this study was to identify the factors related to the long-stay hospitalization of dementia patients aged 65 years or older who had received inpatient care at geriatric hospitals according to the minute facility characteristics and patient features. Methodology: This study was conducted on 317,353 cases of 1,512 geriatric hospitals using the Health Insurance Review and Assessment Service dataset. The data collected were processed using the SAS Enterprise Guide 4.3 for descriptive statistics, the chi-square test, and the binary logistic regression analysis. Findings: As a result of the study, in the facility characteristics of geriatric hospitals, the long-stay hospitalization of the aged with dementia were found to be related to the type of facility establishment, the number of hospital beds, the number of medical specialists, the number of nursing personnel, and the number of geriatric hospitals by region and province. In the personal features of patients, the long-stay hospitalization was found to be associated with the gender, age, insurance, and the patient classification groups. Practical Implication: Considering the results of this study, it seems that securing the sufficient medical personnel in a geriatric facility, providing the good quality medical services, and preparing the appropriate discharge plan can reduce the unnecessary long-stay hospitalization and spend the medical expenses for the older patients.

• Journal of Yeungnam Medical Science
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• v.27 no.1
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• pp.18-26
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• 2010

The clinical picture in severe cases of pandemic (H1N1) 2009 influenza is markedly different from the disease pattern seen during the epidemics of seasonal influenza as many of those affected were previously healthy young people. Current predictions estimate that during a pandemic wave, 12~30% of the population will develop clinical influenza (compared with 5~15% for seasonal influenza) with 4% of those patients requiring hospital admissions and one in five requiring critical care. Until July 6, 94,512 people have been infected in 122 countries, of whom 429 have died with an overall case-fatality rate of <0.5%. Most of the confirmed cases of S-OIV (Swine-Origin Influenza A Virus) infection have been characterized by a self-limited, uncomplicated febrile respiratory illness and 38% of the cases have also included vomiting or diarrhea. Efforts to control these outbreaks are based on our understanding of novel S-OIV (Swine-Origin Influenza A Virus) and the previous influenza pandemics. So, this review covers the experience with S-OIV (Swine-Origin Influenza A Virus) for the admission and background data and the clinical presentation, diagnosis and treatment of H1N1 in pediatric patient with S-OIV (Swine-Origin Influenza A Virus) at YUMC, 2009.

• Korean Journal of Adult Nursing
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• v.21 no.3
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• pp.293-302
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• 2009

Purpose: This study is descriptive study that confirms the affect of the factors of perceived stress and social support of the kidney transplantation recipient affect on the quality of life. Mothods: 167 subjects who have received kidney transplantation in a university hospital in G city. Data obtained are analyzed by SPSS Win 13.0. Results: The perceived stress based on transplantation related characteristics and general traits of kidney transplantation has significant differences only in frequency of admission. The subjects who had been supported by acquittances have more significant social support index. The quality of life has significant differences in number of admissions, gender and occupation. Also, when the perceived stress of kidney transplantation recipients is lower and social support is higher, the quality of life is higher. The perceived stress has 28.1% increment of quality of life. Adding social support, both of them affect 34.8% increment of quality of life. Conclusion: To decrease the factor to cause the stress of kidney transplantation recipients, it is necessary to have social support networks and to develop plans and programs to increase the quality of life of recipients.

• Journal of Trauma and Injury
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• v.35 no.4
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• pp.268-276
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• 2022

Purpose: Rib fractures are common injuries that can lead to morbidity and mortality. Methods: Data on all patients with rib fractures admitted to a single trauma center between January 1, 2008 and December 31, 2018 were reviewed. Results: A total of 1,671 admissions for rib fracture were examined. Patients' median age was 57 years, the median Injury Severity Score (ISS) was 14, and the median number of fractured ribs was three. The in-hospital mortality rate was 4%. Age, the number of rib fractures, and Charlson Comorbidity Index scores were poor predictors of mortality, while the ISS was a slightly better predictor, with area under the receiver operating characteristic curve values of 0.60, 0.55, 0.58, and 0.74, respectively. Multivariate regression showed that age, ISS, and Charlson Comorbidity Index score, but not the number of rib fractures, were associated with significantly elevated adjusted odds ratios for mortality (1.03, 1.14, and 1.28, respectively). Conclusions: Age, ISS, and comorbidities were independently associated with the risk of mortality; however, they were not accurate predictors of death. The factors associated with rib fracture mortality are complex and cannot be explained by a single variable. Interventions to improve outcomes must be multifaceted.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• Journal of Korean Clinical Nursing Research
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• v.19 no.3
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• pp.432-442
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• 2013

Purpose: The purpose of this study was to describe restraint use in care of patients with psychiatric disorders in an attempt to avoid unnecessary restraint use and provide information for developing standards regarding restraint use as a therapeutic maneuver. Methods: For this descriptive study, discharge records from N National Mental Hospital in the year 2009 were reviewed by trained nurses during Dec. 24, 2010 and Mar. 31, 2011. There were 596 restrains applied on 232 of 1,322 discharges. Data collected include general characteristic of patients, the frequency of restraint use, time since admission when restraint was applied, time of the day when restraint was applied, duration of restraint application, place of occurrence, reasons for restraint use, and degree of damage to the patent. Work experience of nurses who applied restraints, number of workforce at the time of restraint, and season of the year was also identified. Descriptive statistics, Chi-square test, t-test, ANOVA, $Scheff{\grave{e}}$ and Jonckheere-Terpstra were applied using SPSS 14.0 to analyze the data. Results: There were 596 restraint uses among 232 patients. Restraints were applied most frequently on males in their 40s, patients diagnosed with schizophrenia, and patients repeating admissions more than 6 times. Restraints were frequently applied within first week following admission, between 16:00 and 20:00, and the average duration of restraint was 5 hours. There were significant differences according to diagnoses of patients in the season restraint occured, time, place of occurrence, reason for restraint, and duration of restraint. Patients with alcoholism received longer restraint application. Conclusion: In order to avoid unnecessary restraint use in patients with psychiatric disorders, nurses and other health care team members need to acknowledge a group of patients such as patients with schizophrenia and alcoholism who relatively frequently restrained or receiving longer restraint. Reasonable and careful decision need to be made when applying restraint in the care of patients with alcohol problem.