• Title/Summary/Keyword: hospital logistic

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Influences of Injury Severity and Age on Severe Anxiety in Posttraumatic Stress Disorder Patients with no Previous History of Psychiatric Disorders (정신건강의학과 치료 과거력이 없는 외상후 스트레스 장애 환자에서 나이와 손상 심각도가 중증 불안에 미치는 영향)

  • Park, Woon Yeong;Park, Sang Hag;Kim, Sang Hoon;Kim, Seung Gon;Park, Jung In;Choo, Il Han
    • Anxiety and mood
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    • v.9 no.1
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    • pp.54-60
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    • 2013
  • Objectives : Posttraumatic stress disorder (PTSD) is classified as an anxiety disorder. PTSD occurrence is known to be increased in middle-aged and older people, female, and individuals with a previous history of psychiatric disorders, lower education levels, low socioeconomic status, and severely injured patients. Anxiety symptoms are also related to later development of PTSD. In this study, we investigate the influences of injury severity and sociodemographic factors on severe anxiety in PTSD patients with no previous history of psychiatric disorders. Methods : Forty-one PTSD patients without previous history of psychiatric disorders were recruited from the psychiatric clinic at Chosun University Hospital. Subjects underwent psychiatric and physical examinations including the Injury Severity Score (ISS), Beck Anxiety Inventory (BAI), and Korean-Wechsler Adult Intelligence Scale (K-WAIS). We defined severe anxiety as a BAI scores of 30 or more. Logistic regression analyses and multi-step model selection were applied to identify predictive factors for severe anxiety. Results : In univariate analysis, age, ISS, and socioeconomic status were found to be significant factors. Through multivariate logistic regression analyses and a stepwise model selection, we found the combination of age and ISS to be the best-fitted model for affecting severe anxiety in PTSD patients without a previous history of psychiatric disorders. Conclusion : Our findings suggest that the combination of age and ISS could develop severe anxiety in PTSD patients with no previous history of psychiatric disorders.

Prevalence and factors associated with hyponatremia in older adults who visited emergency department (응급실을 방문한 노인 환자의 저나트륨혈증 유병률 및 위험인자 분석)

  • Kim, Geonnyeon;Shin, Sangmi;Suh, Yewon;Namgung, Hyungwook;Lee, Jeonghwa;Lee, Euni;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.2
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    • pp.67-73
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    • 2022
  • Objectives: Hyponatremia is prevalent electrolyte disorder and can be fatal in older adults. Evaluative studies on hyponatremia among older adults are scarce, especially targeting for those who visited emergency department (ED). We aimed to estimate the prevalence and to identify risk factors of hyponatremia among elderly patients visiting the ED. Methods: A retrospective chart review was completed including 65 or older patients who visited ED at Seoul National University Bundang Hospital from September to December 2019. Patients with the serum sodium concentration of less than 130mEq/L was defined as a hyponatremia group. Logistic regression analysis was conducted to assess predictive factors for hyponatremia. Results: Of the total 2,445 patients, 155 (6.3%) were confirmed to have hyponatremia at the time of ED visits. Risk factors for hyponatremia identified in logistic regression analysis were thiazides (aOR=2.64, 95% CI 1.66-4.21), opioids (exclude tramadol) (aOR=3.45, 95% CI 1.72-6.94), and desmopressin (aOR=6.98, 95% CI 2.45-19.84). Compared to the use of thiazides alone, it was confirmed that the possibility of hyponatremia was more than quadrupled when proton pump inhibitor (PPI) was used together (aOR=4.08, 95% CI 1.74-9.55). Conclusions: About 6.3% of older adults visiting the ED had hyponatremia. Age, number of medications taken, previous history of hyponatremia, heart failure, cirrhosis, pneumonia, sepsis, prescribed drugs including thiazides, opioids (exclude tramadol), or desmopressin or taking PPI together with thiazides was confirmed to correlate with the risk of hyponatremia.

Risk of insomnia symptoms according to Work-Family Conflict by workers' characteristics

  • Kwanghyun Seo;Seungjun Ryu;Saebomi Jeong;Hee-Tae Kang;Sung-Kyung Kim;Sang-Baek Koh;Kyoung Sook Jeong;Sung-Soo Oh
    • Annals of Occupational and Environmental Medicine
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    • v.35
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    • pp.36.1-36.11
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    • 2023
  • Background: Work-Family Conflict means that the demands of work and family roles cannot be met simultaneously, so one cannot concentrate on one's work or family role. This conflict can negatively affect mental health and cause insomnia symptoms. Methods: This study was conducted on 20,442 subjects. Insomnia symptoms were assessed using the Minimal Insomnia Symptom Scale, and other variables were assessed using the questionnaire method. Logistic regression analyses were performed to evaluate the effect of Work-Family Conflict on insomnia symptoms, and subgroup logistic regression analyses were also performed. Results: The number of people with insomnia symptoms was 4,322 (15.1%). Compared with Low Work-Family Conflict, the odds ratios (ORs) for the risk of insomnia symptoms were 1.84 (95% confidence interval: 1.56-2.16) in High work-to-family conflict, 1.16 (1.02-1.32) in High family-to-work conflict, and 3.19 (2.87-3.55) in High Work-Family Conflict. The ORs were higher for men than women in High WFC but higher for women than men in High Work-Family Conflict. Conclusions: The risk of insomnia symptoms was highest in High Work-Family Conflict.

Development of Prediction Algorithm for Replete Pulse and Vacuous Pulse by using Clip-type Pulsimeter with Hall Device Measuring a Magnetic Field (자기장 측정 홀소자 집게형 맥진기를 이용한 허맥과 실맥 예측 알고리즘 개발)

  • Lee, Nam-Kyu;Kim, Keun-Ho;Lee, Sang-Suk;Yu, Ji-Hye;Yu, Jun-Sang;Sun, Seung-Ho;Chang, Sei Jin;Hong, Yu-Sik
    • Journal of the Korean Magnetics Society
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    • v.23 no.3
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    • pp.104-109
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    • 2013
  • Clip-type pulsimeter equipped with Hall device and a minute permanent magnet as sensing the minute movement of a radial artery was developed. The clinical data of the 120 number of subject acquisited through the clip-type pulsimeter did treated with a typical statistical logistic regression analysis. The prediction algorithm for the replete pulse and vacuous pulse was studied. The reflective peak time and the notch peak time were major parameters to discern the replete pulse and vacuous pulse. The discrimination rate was 65%. It suggests that the logistic regression equations are possible to use the diagnosis index to predict and discern the oriental pulse wave.

Fibromyalgia diagnostic model derived from combination of American College of Rheumatology 1990 and 2011 criteria

  • Ghavidel-Parsa, Banafsheh;Bidari, Ali;Hajiabbasi, Asghar;Shenavar, Irandokht;Ghalehbaghi, Babak;Sanaei, Omid
    • The Korean Journal of Pain
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    • v.32 no.2
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    • pp.120-128
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    • 2019
  • Background: We aimed to explore the American College of Rheumatology (ACR) 1990 and 2011 fibromyalgia (FM) classification criteria's items and the components of Fibromyalgia Impact Questionnaire (FIQ) to identify features best discriminating FM features. Finally, we developed a combined FM diagnostic (C-FM) model using the FM's key features. Methods: The means and frequency on tender points (TPs), ACR 2011 components and FIQ items were calculated in the FM and non-FM (osteoarthritis [OA] and non-OA) patients. Then, two-step multiple logistic regression analysis was performed to order these variables according to their maximal statistical contribution in predicting group membership. Partial correlations assessed their unique contribution, and two-group discriminant analysis provided a classification table. Using receiver operator characteristic analyses, we determined the sensitivity and specificity of the final model. Results: A total of 172 patients with FM, 75 with OA and 21 with periarthritis or regional pain syndromes were enrolled. Two steps multiple logistic regression analysis identified 8 key features of FM which accounted for 64.8% of variance associated with FM group membership: lateral epicondyle TP with variance percentages (36.9%), neck pain (14.5%), fatigue (4.7%), insomnia (3%), upper back pain (2.2%), shoulder pain (1.5%), gluteal TP (1.2%), and FIQ fatigue (0.9%). The C-FM model demonstrated a 91.4% correct classification rate, 91.9% for sensitivity and 91.7% for specificity. Conclusions: The C-FM model can accurately detect FM patients among other pain disorders. Re-inclusion of TPs along with saving of FM main symptoms in the C-FM model is a unique feature of this model.

A Study on Relationship between Outsourcing and Organizational Effectiveness in Hospital (병원의 아웃소싱과 조직유효성의 관계에 관한 연구)

  • Kim, Young-Hoon;Oh, Su-Jin;Kim, Han-Sung;Kim, Key-Hoon;Kim, Hyo-Jeong
    • Korea Journal of Hospital Management
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    • v.18 no.3
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    • pp.83-105
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    • 2013
  • The purpose of this study is to make managerial information regarding outsourcing more concrete by identifying and evaluating how outsourcing as an useful strategic tool for hospitals influences organizational effectiveness. The survey was performed to 311 general hospitals and tertiary hospitals, and 63 questionnaires were recovered and analyzed. As the result of measuring organizational effectiveness after introduction of outsourcing, non-financial performance(3.34) was higher than financial performance(3.25) and satisfaction(3.08). According to the characteristics of organizational structure, financial performance showed statistically significant difference when categorizing the hospitals. It was higher in the general hospitals than in the tertiary hospitals. In addition, the hospitals that outsource the logistic and patient affairs parts have higher financial performances than non-financial ones. Especially, there was statistically significant difference depending on the sub-parts of the logistics, which means the hospitals outsourcing the logistic part have higher financial performance than the hospitals without outsourcing the logistics.

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Maternal and Hospital Factors Impacting the Utilization of Rooming-in Care in South Korea: Secondary Analysis of National Health Data (모자동실이용에 영향을 미치는 산모와 의료기관 요인: 전국 자료를 이용한 2차 분석)

  • Kim, Yun-Mi;Kim, Eun-Young
    • Journal of Korean Academy of Nursing
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    • v.41 no.5
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    • pp.593-602
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    • 2011
  • Purpose: In this study analysis was done of utilization of rooming-in care in South Korean hospitals in order to examine the factors related to mothers and hospitals that affect rooming-in care. Methods: With the involvement of 254,414 mothers who gave birth across 953 hospitals, the analysis used the health insurance qualification data of the National Health Insurance Corporations and Health Insurance Review and Assessment Service (2006). Factors associated with rooming-in care were analyzed using a GEE logistic regression analysis to consider factors related to both mothers and hospitals. Results: Only 45.1% of the mothers used rooming-in care. The results of the regression analysis revealed that individual factors of the mothers were not associated with rooming-in care, whereas group factors of the hospitals were. Rooming-in care use was primarily related to small hospital, location of hospital, and higher nurse staffing level. Conclusion: The findings of this study indicate that the utilization of rooming-in care is not associated with factors an individual mother, but rather with the group factors of the hospitals. Thus, a policy-based approach considering both of these types of factors is required to enhance the utilization of rooming-in care.

Analysis of Medication Errors of Nurses by Patient Safety Accident Reports (환자안전사고 보고서를 통한 간호사 투약오류 분석)

  • Koo, Mi Jee
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.1
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    • pp.109-119
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    • 2021
  • Purpose: The purpose of this study was to identify and analyze the characteristics of nurses' medication errors during three years. Methods: Retrospective survey study design was used to analyze medication errors by nurses among patient safety accidents. Data were collected for three years from January, 2017 to December, 2019. Data were analyzed using frequency, percentage, 𝑥2-test, and logistic regression with SPSS 26.0 program. Results: Of a total 677 medication errors, 40.6% were caused by nurses. Among the medication errors, near miss (n=154, 56.0%), intravenous bolus injection (n=170, 61.8%), wrong dose (n=102, 37.1%) and carelessness for repetitive work (n=98, 35.6%) were the most common. Medication errors differed by department, and nurses' career, and patient safety accident type. The results of the logistic regression analysis showed that the risk factors of adverse events were medication of fluids (OR=3.93, 95% CI: 1.26~12.27), insulin subcutaneous injection (OR=39.06, 95% CI: 4.58~333.18), and occurrence of extravasation/infiltration (OR=7.26, 95% CI: 1.85~28.53). Conclusion: The simplest and most effective way to prevent medication errors is to keep 5 right, and a differentiated education program according to department and nurse career is needed rather than general education programs. Hospital-level integrated interventions such as a medication barcode system or a team nursing method are also necessary.

The Effect of Inpatient Elderly Patients' with Chronic Diseases on Fall Experience (입원 노인환자의 만성질환 보유가 낙상경험에 미치는 영향)

  • Park, Ju Hyee;Suh, Won Sik
    • Korea Journal of Hospital Management
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    • v.26 no.4
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    • pp.29-37
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    • 2021
  • Purpose: The purpose of this study is to identify the characteristics and factors affecting falls among elderly inpatients with chronic diseases based on the data from the discharge damage depth survey of the Korea Disease Control and Prevention Agency(KDCA) from 2014 to 2018. Method: The study selected elderly inpatients aged over 65 who were hospitalized(n=1,173). Their data were analyzed after being assigned to either a fall group(KSCD, W00-W19) or a non-fall group. Frequency analysis, cross-tabulation analysis, and binary logistic regression analysis were conducted, using SPSS 28. Results: According to the analysis on category of fall and non-fall group were statistically significant difference in age and having chronic diseases. Based on the binary logistic regression analysis of factors affecting falls, The risk of falls was 1.058 times higher with age, and E11-E14 and I63 as main diagnostic codes, the risk of falls was 2.049 times and 2.437 times higher. Conclusion: It is necessary to develop customized educational manuals and muscle exercise programs considering the characteristics of chronic diseases and to create a safe hospital room environment, and this result is expected to be used as basic data for fall prevention education and manual development for elderly inpatients with chronic diseases.

Ultrasound Utility for Predicting Biological Behavior of Invasive Ductal Breast Cancers

  • Zhang, Lei;Liu, Yu-Jie;Jiang, Shuang-Quan;Cui, Hao;Li, Zi-Yao;Tian, Jia-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8057-8062
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    • 2014
  • Purpose: The aim of the study was to evaluate the correlation of ultrasound features with breast cancer molecular status. Materials and Methods: A retrospective review was performed of ultrasound findings in 263 patients diagnosed with breast invasive ductal carcinoma for comparison with immunohistochemistric results were obtained from each lesion. Relationships between ultrasound findings and molecular status were investigated by using multiple regression analysis by means of stepwise logistic regression. Differences in ultrasound criteria were assessed among women with different molecular status. Results: ER positivity was associated with small size, lobulate, angular or spiculated margin contours, absence of calcification, posterior tumor shadowing and low elasticity score; PR positivity was associated with small size, lobulate or angular or spiculated margin contours and absence of calcification; HER2 positivity was associated with presence of calcification and absence of any echogenic halo. The calculated models of predicted molecular status were accurate and discriminating with AUCs of 0.78, 0.74, and 0.74, respectively. Conclusions: Breast cnacer ultrasound features show some correlation with the molecular status. These models may help to expand the scope of ultrasound in predicting tumor biology.