• 한국보건간호학회지
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• 제16권1호
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• pp.201-212
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• 2002

This study was designed to identify the risk factors of unplanned readmission in a university hospital. The six-month discharge information from January to June, 2000 in a tertiary university hospital was used as a source of data through the medical record and hospital information system. To increase the effect of comparison. the data were collected by sampling 192 couples (384 patients) of unplanned readmission group through the matching by its disease groups, sex, and age. The accuracy of prediction for unplanned readmission was analyzed by constructing the predicted model of unplanned readmission through the logistic regression. The study results are as follows. The conditional logistic regression analysis was performed with nine variables at the significance level 0.05 through univariate analysis including residence, days after discharge, initial admission route, previous admission, transfer to special care unite, hospital stay days, medical care expenses, special cares, and laboratory and imaging services. As a result, the closer the patients live in Seoul and Gyeong-in area (Odds ratio=2.529, p=0.003), the shorter the days after discharge was (Odds ratio=0.600, p=0.000), and the more frequent admission rate was (Odds ratio=2.317, p=0.004), the more unplanned readmission was resulted. Also, the accuracy of prediction for data classification of this regression model showed $70.3\%$(032+83/306).

• 여성건강간호학회지
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• 제17권5호
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• pp.484-490
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• 2011

Purpose: This study was aimed to investigate the impact of job stress on low back symptoms among Clinical nurses (CNs) in university hospital. Methods: A total of 322 CNs employed in a hospital in Seoul were interviewed by a well-trained interviewer using the structured questionnaire. Data collected for this study includes demographics, social and work characteristics, low back symptoms, and job stress. To test the impact of job stress on low back symptoms, we used multiple logistic regression analysis. Results: The prevalence of low back symptoms was 25.8% in this study. Low back symptoms differed significantly by factors, such as physical work burden, past history of injury and work duration. Also low back symptoms differed significantly by organizational system among independent variables of job stress. In a multiple logistic regression analysis, the odds ratio of organizational system to low back symptoms was 2.07 after an adjustment. Conclusion: This study showed that organizational system among job stress was a significant variable in explaining low back symptoms. We suggest the improvement of organizational system category as a preventive strategy for low back pain in CNs working in hospital.

• 보건행정학회지
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• 제9권4호
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• pp.41-64
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• 1999

The major concern for this research is to discuss and to offer some solutions to bring the effectiveness of existing notifiable diseases reporting system over the physicians' attitudes of reporting, the actual condition of performance and the reasons of inertia in notifiable diseases reporting through examining the physicians of medical institutions in nationwide such as pediatrics, internal medicine and family medicine. The actual conditions of notifiable communicable diseases(NCD) reporting was surveyed by mail objectifying an internal medicine, pediatrics and family medicine in nationwide on the basis of stratified random sampling method divided into the classification of medical institutions and areas. As a result of survey. the rate of respondents showed 145 persons from physicians, 105 persons from hospitals. 120 persons from general hospitals, and 51 persons from tertiary hospitals. The total number of respondents were 421 and was rated 59.0 %. The analysis of collected survey went through a descriptive analysis primarily to grasp physicians' attitudes on the notifiable communicable diseases reporting, and then upon the dependent variables. Following are major findings obtained form the data analysis. 1. The results of a descriptive analysis on physicians' attitudes towards reporting NCD were as follows: First, the respondents who didn't know that yellow fever is reporting NCD were 11.0% of clinic, 10.5% of hospital. 5.0% of general hospital. 11.8% of tertiary hospital. and in case of hepatitis B, were 26.9% of clinic, 35.2% of hospital. 35.0% of general hospital. 23.5% of tertiary hospital. Second, The rate of physicians' knowledge on penalties of not reporting the NCD by their medical institution were 35.2% of clinic, 45.7% of hospital. 36.7% of general hospital. 62.7% of tertiary hospital. Third, among the no-reporting physicians in whole, the major reason of not reporting NCD were uncertainty of diagnosis(78.9%), no need to report(46.4%), no adequate actions from PHC(29.1%), no knowledge of the cases being notifiable ones in the order of their frequencies(30.4%), meddling from PHC(29.1%), concerning of patient's privacy(26.3%). 2. To analyze the characteristics related to the physicians' behaviors to report NCD, univariate and multiple logistic regression analyses were applied to the variables related to physician, 4 medical facility, PHC, and reporting system. The result were as follows: First, the result of the univariate analysis on physicians' attitude to report NCD and characteristics related to reporting in odds ratio was in the case of hospital. 3.4 times higher positive responses on physicians' attitude to report NCD came up as compared to the clinic. Second, the result of the univariate analysis on physicians' action of reporting NCD and characteristics related to reporting by the classification of medical institutions showed that the odds ratio of hospital was 2.3 times, the odds ratio of general hospital was 2.0 times, the odds ratio of tertiary was 6.8 times significantly higher than clinic. And the medical institution with significantly higher positive attitudes rate by multiple logistic regression analysis was hospital that rated 2.5 times significantly higher than clinic. Also in the PHC related characteristics of reporting, the rate of action in reporting NCD was significantly higher in medical institution that were endowed with the good condition of reporting. In multiple logistic regression analysis, the medical institution that has a good conditions of reporting showed a significantly higher positive rate on the action of reporting than the others.

• 대한치과의사협회지
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• 제44권10호통권449호
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• pp.658-670
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• 2006

1980년대 후반기부터 치주질환과 뇌경색(ischemic stroke)자료의 연관성을 모색하는 시도가 있어왔다. 이번 연구의 목적은 치주질환과 뇌경색 유무와의 어떤 관계가 있는지를 60세 이상의 노인을 대상으로 조사, 통계 분석하였다. 자료는 미국의 총 국민조사 격인 The Third Nation Health and Nutrition Examination Survey (NHANES III)를 이용하였다. 이번 연구에서 unadjusted logistic model 통계법을 이용하여 치아 상실수와 뇌경색 경험이 통계학적으로 유의한 수치의 상관성이 있음을 알게 되었다. 또한 나이와 흡연유무를 고려, 조정한 후 multiple logistic model 통계법으로 잔존치아가 적을수록 더욱 뇌경색에 걸릴 확률이 높음을 보였다. 그러나 두 질병에 동시에 선택된 중요한 위험인자 (risk factor)를 모두 고려, 조정 한 후에는 통계학적인 유의성을 찾지 못했다. 치은퇴축, 치주낭 깊이, 치석, 탐침시 출혈과 뇌경색 경험은 각각의 비교법에서 약간의 상관성을 보이나, 모든 통계법을 통해 일괄된 결과를 얻을 수는 없었다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6181-6185
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• 2012

Background: The aim of the study was to evaluate the available breast nomograms (MSKCC, Stanford, Tenon) to predict non-sentinel lymph node metastasis (NSLNM) and to determine variables for NSLNM in SLN positive breast cancer patients in our population. Materials and Methods: We retrospectively reviewed 170 patients who underwent completion axillary lymph node dissection between Jul 2008 and Aug 2010 in our hospital. We validated three nomograms (MSKCC, Stanford, Tenon). The likelihood of having positive NSLNM based on various factors was evaluated by use of univariate analysis. Stepwise multivariate analysis was applied to estimate a predictive model for NSLNM. Four factors were found to contribute significantly to the logistic regression model, allowing design of a new formula to predict non-sentinel lymph node metastasis. The AUCs of the ROCs were used to describe the performance of the diagnostic value of MSKCC, Stanford, Tenon nomograms and our new nomogram. Results: After stepwise multiple logistic regression analysis, multifocality, proportion of positive SLN to total SLN, LVI, SLN extracapsular extention were found to be statistically significant. AUC results were MSKCC: 0.713/Tenon: 0.671/Stanford: 0.534/DEU: 0.814. Conclusions: The MSKCC nomogram proved to be a good discriminator of NSLN metastasis in SLN positive BC patients for our population. Stanford and Tenon nomograms were not as predictive of NSLN metastasis. Our newly created formula was the best prediction tool for discriminate of NSLN metastasis in SLN positive BC patients for our population. We recommend that nomograms be validated before use in specific populations, and more than one validated nomogram may be used together while consulting patients.

• 한국응급구조학회지
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• 제17권3호
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• pp.169-179
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• 2013

Purpose: The performance rate to perform Cardiopulmonary Resuscitation (CPR) by witness in out-of-hospital Cardiac Arrest (OHCA) is very low in South Korea. To prevent the death caused by OHCA, it is important to encourage the witness to perform CPR actively. The purpose of the study is to investigate the influencing factors to affect bystander CPR rate. Methods: I conducted a questionnaire survey from 25 February to 4 March, 2013, receiving responses from 517 people in Korea. The questionnaire included social demographic factors, history of heart disease, knowledge of CPR, and the reliability of emergency medical service (EMS). A logistic regression analysis was conducted. Results: Among the 517 respondents, 294 (57.4%) had intention of performing CPR. Multiple logistic regression analysis found the following significant predictors of CPR intention: gender (odds ratio [OR] = 0.390), age (OR = 1.024), religion (OR = 0.843), and knowledge of CPR (OR = 4.734). Conclusion: This study indicated that the strongest predictor is knowledge of CPR. Therefore, it would be helpful to teach CPR nationwide to encourage performing CPR. In addition, effect of CPR education in religious facilities is necessary.

• 대한간호학회지
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• 제41권3호
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• pp.423-431
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• 2011

Purpose: The study was designed to determine the discriminating ability of a Bayesian network (BN) for predicting risk for pressure ulcers. Methods: Analysis was done using a retrospective cohort, nursing records representing 21,114 hospital days, 3,348 patients at risk for ulcers, admitted to the intensive care unit of a tertiary teaching hospital between January 2004 and January 2007. A BN model and two logistic regression (LR) versions, model-I and .II, were compared, varying the nature, number and quality of input variables. Classification competence and case coverage of the models were tested and compared using a threefold cross validation method. Results: Average incidence of ulcers was 6.12%. Of the two LR models, model-I demonstrated better indexes of statistical model fits. The BN model had a sensitivity of 81.95%, specificity of 75.63%, positive and negative predictive values of 35.62% and 96.22% respectively. The area under the receiver operating characteristic (AUROC) was 85.01% implying moderate to good overall performance, which was similar to LR model-I. However, regarding case coverage, the BN model was 100% compared to 15.88% of LR. Conclusion: Discriminating ability of the BN model was found to be acceptable and case coverage proved to be excellent for clinical use.

• 한국병원경영학회지
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• 제19권2호
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• pp.12-21
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• 2014

Purpose: This study was conducted to examine the factors associated with medical profit per bed related job satisfaction and patients satisfaction in public hospitals. Method: A cross-sectional survey was conducted through staff and patients in 39 hospitals (34 local province hospitals, and 5 red-cross hospitals) from September to October in 2011. A questionnaire was designed to collect information on job satisfaction, inpatients and outpatients satisfaction. The data of medical profit per bed was collected in 2011 annual financial reports from each 39 hospitals. Finally, data from 5,521 staff, 1,730 in-patients and 1,730 out-patients were analyzed. Multiple logistic regression analysis was performed to determine factors associated with medical profit per bed related job satisfaction and patients satisfaction in public hospitals. Results: The medical profit was positively correlated with job satisfaction of staff. As the results of multiple logistic regression, the significant variables of medical profit per bed, were communication satisfaction of staff(OR=0.48, 95% CI=0.25-0.91), hospital environment satisfaction of in-patients(OR=1.53, 95% CI=1.05-2.22). Conclusion: The satisfaction of patient and staff were significantly effect to medical profit in public hospitals. The Government and administrators have make an effort to improve satisfaction of staff and patients in public hospitals.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6353-6356
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• 2014

Background: The purpose of this study was to investigate and evaluate risk factors for lymph node metastases (LNM) in cases of endometrial cancer (EC). Materials and Methods: A retrospective single institution analysis of patients surgically staged for EC at Ankara Oncology Education and Research Hospital from 1996 to 2010 was performed. Roles of prognostic factors, such as age, histological type, grade, depth of myometrial invasion, cervical involvement, peritoneal cytology, and tumor size, in the prediction of LNM were evaluated. Fisher's exact test and logistic regression analysis were used to assess the effects of various factors on LNM. Results: LNM was observed in 22 out of 247 patients (8.9%) and was significantly more common in the presence of tumors of higher grade, deep myometrial invasion (DMI), cervical involvement, size >2cm, and with positive peritoneal cytology. Logistic regression analysis revealed that DMI remained the only independent risk factor for LNM. NPV, PPV, sensitivity, and specificity for satisfying LNM risk were 98.0, 19.5, 86.3, and 65.3%, respectively for DMI. Conclusions: The incidence of LNM is influenced independently by DMI. If data support a conclusion of DMI, LND should be seriously considered.

• Journal of Preventive Medicine and Public Health
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• 제54권2호
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• pp.129-136
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• 2021

Objectives: This study examined demographic factors hampering access to healthcare at hospitals and suggests policy approaches to improve healthcare management in Thailand. Methods: The data for the study were drawn from a health and welfare survey conducted by the National Statistical Office of Thailand in 2017. The population-based health and welfare survey was systematically carried out by skilled interviewers, who polled 21 519 384 individuals. The independent variables related to demographic data (age, sex, religion, marital status, education, occupation, and area of residence), chronic diseases, and health insurance coverage. The dependent variable was the degree of access to healthcare. Multiple logistic regression analysis was subsequently performed on the variables found to be significant in the univariate analysis. Results: Only 2.5% of the population did not visit a hospital when necessary for outpatient-department treatment, hospitalization, or the provision of oral care. The primary reasons people gave for not availing themselves of the services offered by government hospitals when they were ill were-in descending order of frequency-insufficient time to seek care, long hospital queues, travel inconvenience, a lack of hospital beds, unavailability of a dentist, not having someone to accompany them, and being unable to pay for the transportation costs. Multiple logistic regression analysis showed that failure to access the health services provided at hospitals was associated with demographic, educational, occupational, health welfare, and geographic factors. Conclusions: Accessibility depends not only on health and welfare benefit coverage, but also on socioeconomic factors and the degree of convenience associated with visiting a hospital.