• 제목/요약/키워드: hospital use

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Association between Inhaled Corticosteroid Use and SARS-CoV-2 Infection: A Nationwide Population-Based Study in South Korea

  • Lee, Sang Chul;Son, Kang Ju;Han, Chang Hoon;Jung, Ji Ye;Park, Seon Cheol
    • Tuberculosis and Respiratory Diseases
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    • 제85권1호
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    • pp.80-88
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    • 2022
  • Background: Although it is known that inhaled corticosteroid (ICS) use may increase the risk of respiratory infection, its influence on the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains unknown. Thus, the aim of this study was to investigate the association between ICS use and the positivity of SARS-CoV-2 infection among patients with chronic respiratory diseases. Methods: Nationwide data of 44,968 individuals with chronic respiratory diseases tested for SARS-CoV-2 until May 15, 2021 were obtained from the Ministry of Health and Welfare and Health Insurance Review and Assessment Service in Korea. The positivity of SARS-CoV-2 infection was retrospectively analysed according to the prescription, type, and dose of ICS taken one year before SARS-CoV-2 test. Results: Among 44,968 individuals tested, 931 (2.1%) were positive for SARS-CoV-2. A total of 7,019 patients (15.6%) were prescribed ICS one year prior to being tested for SARS-CoV-2. Low, medium, and high doses of ICS were prescribed in 7.5%, 1.6%, and 6.5% of total cases, respectively. Among types of ICS, budesonide, fluticasone, beclomethasone, and ciclesonide were prescribed in 3.7%, 8.9%, 2.3%, and 0.6% of total cases, respectively. A multivariate analysis showed no significant increase in infection with ICS use (odds ratio, 0.84; 95% confidence interval, 0.66-1.03). Moreover, there were no associations between the positivity of infection and the dose or type of ICS prescribed. Conclusion: Prior ICS use did not increase the positivity for SARS-CoV-2 infection. Moreover, different doses or types of ICS did not affect this positivity.

병원마케팅 실태와 전략방안 -지역사회의 일 종합병원을 대상으로- (Hospital Marketing Condition and Strategy -Of a General Hospital-)

  • 백명;노소영
    • 한국간호교육학회지
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    • 제6권2호
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    • pp.233-246
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    • 2000
  • The purpose of this study was to investigate the real condition of hospital marketing and concrete strategy on medical consumers need for enhance the effectiveness of hospital management. The data were collected from January 27 to February 3, 2000 at a general hospital located in M city to 205 in-patients and out-patients by questionnaires. The research tool was based on literatures. The data was analysed by the use of percentage, mean, t-test and ANOVA by SAS(Statistical Analysis System) Package Program. The results of this study are summerized as follows: 1. Mean score of the marketing mix (4P 's) was 3.1 in total and each mean score was 3.6 in product, 2.5 in prices, 3.3 in place and 3.1 in promotion. The following are the items which received the highest scores in each: 'The hospital is clean' in service category; 'the prices of meals at the restaurant the patients' families use are reasonable ' in price sphere. In distribution, 'it is easy to locate the hospital' and in promotion,'we'll use this hospital again' and 'we'll recommend this hospital to others'. 2. Marketing mix factors(4P's) was significantly different on the general characteristics in terms of marriage status, occupations and the period of hospitalization. 3. The most important reason for choosing this hospital was 'This is a general hospital with good facilities' and the next were 'The hospital staffs are kind and the hospital is clean' and 'The traffic is convenient to come'. The most important factors contributing to a good image formation of the hospital were 'this is a clean hospital', 'This is a hospital with kind people' and 'this hospital is equipped with good medical facilities'. 4. The factors for making a good image concerning the nursing service were professional knowledge, good nursing skills and kindness. After grasping the marketing conditions of the hospital aided by the above-mentioned research results, the researchers concludes that it is necessary to develop an institutionalized service strategy to increase the satisfaction the patients feel about the hospital facilities and kindness of the staff and as a result, to differentiate it from other medical institutions.

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적절성 평가지침과 이유목록의 적용 가능성 평가 (Applicability of Appropriateness Evaluation Protocol and Delay Tool)

  • 신영수;김용익;김창엽;김윤;김은경;송윤미;이영성
    • 한국의료질향상학회지
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    • 제1권1호
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    • pp.96-108
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    • 1994
  • Background: An appropriate use of hospital beds can improve productivity of hospital significantly. The authors' previous study revealed that approximately one third of Korean hospital bed days and one sixth of admissions were inappropriately used, when it was measured by Appropriateness Evaluation Protocol(AEP) and Delay Tool modified into Korean situation by the authors. This study aims to evaluate applicability of the instruments in a new hospital. More specifically the study aims to measure appropriateness of the instruments used by newly trained nurse reviewers at a new hospital setting. Methods: In order to evaluate applicability of these instruments, agreement rates of the scores recorded by newly trained nurse reviewers with by skilled nurse reviewer and also compared with the scores recorded by physician's implicit decision were assessed. Agreement rates were derived from concurrent application of AEP and Delay Tool to 52 admissions and 104 patient days from internal medicine, pediatrics, and general surgery of one university hospital. Overall agreement rate, specific nonacute agreement rate, and kappa statistics were used to indicate level of agreement. Results: Overall agreement rates on appropriateness between newly trained nurse reviewers and skilled nurse reviewer were 100% in admission and 98% in bed days. Overall agreement rates on reason for inappropriateness between newly trained nurse reviewers and skilled nurse reviewer were 96% in admission and 91% in bed days. Overall agreement rates between newly trained nurse reviewers and physician reviewer were 86% in admission and 87% in bed days. Conclusion: Results indicated that AEP and Delay Tool were applicable to a new hospital in detecting inappropriate utilization of beds and reasoning of the inappropriateness. These instruments could contribute to enhance efficiency of hospital use, through continuous monitoring of level of inappropriate hospital use at national or individual hospital level.

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Postmenopausal Hormone Therapy is Associated with in Situ Breast Cancer Risk

  • Ni, Xiao-Jian;Xia, Tian-Song;Zhao, Ying-Chun;Ma, Jing-Jing;Zhao, Jie;Liu, Xiao-An;Ding, Qiang;Zha, Xiao-Ming;Wang, Shui
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권8호
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    • pp.3917-3925
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    • 2012
  • Background: The relationship between postmenopausal hormone therapy (HT) and invasive breast cancer has been extensively investigated, but that with breast carcinoma in situ (BCIS) has received relatively little attention. The aim of our present study was to review and summarize the evidence provided by longitudinal studies on the association between postmenopausal HT use and BCIS risk. Methods: A comprehensive literature search for articles published up to May 2012 was performed. Prior to performing a meta-analysis, the studies were evaluated for publication bias and heterogeneity. Relative risk (RR) or odds ratio (OR) values were calculated using 14 reports (8 case-control studies and 6 cohort studies), published between 1986 and 2012. Results: There was evidence of an association between ever postmenopausal estrogen use and BCIS based on a random-effects model (RR = 1.25, 95% confidence interval (CI) = 1.01, 1.55). However, we found no strong evidence of an association between ever postmenopausal estrogen combined with progesterone use and BCIS using a randomeffects model (RR = 1.55, 95% CI = 0.95, 2.51). Furthermore, our analysis showed a strong association between "> 5 years duration" of estrogen or estrogen combined with progesterone use and BCIS. Furthermore, current use of any HT is associated with increased risk of BCIS in cohort studies. Additional well-designed large studies are now required to validate this association in different populations.

K 노인전문병원의 공간 통합도와 자연광의 상관관계 분석 (Correlation Analysis between Space Integration and Natural Light in K Senior Hospitals)

  • 문선영;이현수
    • 한국실내디자인학회논문집
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    • 제24권2호
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    • pp.189-196
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    • 2015
  • In case of Senior Hospitals, meticulous care is required in both amount and quality of natural lighting because of the semi-long term residence of patients. Natural lighting has a huge impact on the physical and psychological part for the seniors. Likewise, natural lighting is an important factor considered for hospital design because it can also effect hospitalization period of patients. Research subject was K Senior Hospital which was determined as the courtyard-type building made to provide healing environment through natural lighting. Analysis was performed by dividing the space of K Senior Hospital into Central Treatment Department directly used by patients, Outpatient Department(OPD), Ward Department, Common Use Department. Research was carried out in two ways of integration value analysis using SPACE SYNTAX and illumination intensity analysis using ECOTECT. K Senior Hospital intended to actively let in natural light through courtyard and to make patients exposed to natural light when they walk along the circuit corridor built around the courtyard. This environmental consideration affected the utilization rate of Common Use Department and residence time of patients raising the average of Common Use Department on every floor. As a resuit of this study presenting type C and type D, part of four types of illumination intensity, takes higher percentage of almost every spaces compare to the others therefore K Senior Hospital was designed on the assumption of healing environment composition through natural light. The result of this research would be used meaningfully in the space programming phase of Senior Hospitals in the future. Utilization rate can be adjusted using illumination intensity value in the space that integration rate should be planed to be high. The use(purpose) of space and integration rate can be used as a guideline to set illumination intensity of natural.

1인실과 다인실 입원 병상 이용에 관한 병상 선택 요인과 환자 만족도 분석 (Use of Single Bedrooms versus Multiple Bedrooms: Selection Factors and Comparison of Patient Satisfaction)

  • 이근찬
    • 한국병원경영학회지
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    • 제26권3호
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    • pp.68-83
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    • 2021
  • Background: It is widely acknowledged that single bedrooms have many potential advantages compared to multiple bedrooms. However, Korea has a reimbursement system that patients have to pay the additional fee if they will use single bedroom or pay-bed (1-3 bedroom). There is little research on patients' bed selection and relationship between patient satisfaction and bed type in the Korean setting. Methods: Using the 2017 Korea Health Panel (KHP) Survey data, we modified bed type by two dichotomous variables: single bedroom vs. multiple bedroom (2+ bedrooms) and pay-bed (1-3 bedroom) vs. reimbursed bed (4+ bedroom). Multivariate logistic regression is performed to determine the factors affecting the patient's choice of room types. Multivariate regression analysis was conducted to examine how hospital room types are affecting patient satisfaction. Results: Single room and pay-bed (1-3 bedroom) use was influenced by patient age (19- years old), male, a person at work, hospitalizing in a clinic, and birth. After controlling variables of the behavioral model of medical utilization, the association between patient satisfaction and use of single bedroom & pay-bed (1-3 bedroom). Cause of hospitalization, major treatment, and recognition of unnecessary care are statistically significant variables on patient satisfaction. Conclusion: Although the single room is about the standard for newly built hospitals in western countries, it remains unclear that single room or pay-bed (1-3 bedroom) has positive effects on patient's outcomes and satisfaction. In this empirical study, the difference in patient satisfaction by bedroom type was not noticeable. In terms of bed management by hospital staff, securing patient credibility in hospital care is an important task. Patients' perception of whether medical staffs have encouraged unnecessary treatment or tests has a significant impact on patient's satisfaction.

Intraoperative Recurrent Laryngeal Nerve Monitoring in a Patient with Contralateral Vocal Fold Palsy

  • Na, Bub-Se;Choi, Jin-Ho;Park, In Kyu;Kim, Young Tae;Kang, Chang Hyun
    • Journal of Chest Surgery
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    • 제50권5호
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    • pp.391-394
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    • 2017
  • Recurrent laryngeal nerve injury can develop following cervical or thoracic surgery; however, few reports have described intraoperative recurrent laryngeal nerve monitoring. Consensus regarding the use of this technique during thoracic surgery is lacking. We used intraoperative recurrent laryngeal nerve monitoring in a patient with contralateral vocal cord paralysis who was scheduled for completion pneumonectomy. This case serves as an example of intraoperative recurrent laryngeal nerve monitoring during thoracic surgery and supports this indication for its use.

The use of extracorporeal membrane oxygenation in children with acute fulminant myocarditis

  • Heinsar, Silver;Raman, Sainath;Suen, Jacky Y.;Cho, Hwa Jin;Fraser, John F.
    • Clinical and Experimental Pediatrics
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    • 제64권5호
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    • pp.188-195
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    • 2021
  • Acute fulminant myocarditis (AFM) occurs as an inflammatory response to an initial myocardial insult. Its rapid and deadly progression calls for prompt diagnosis with aggressive treatment measures. The demonstration of its excellent recovery potential has led to increasing use of mechanical circulatory support, especially extracorporeal membrane oxygenation (ECMO). Arrhythmias, organ failure, elevated cardiac biomarkers, and decreased ventricular function at presentation predict requirement for ECMO. In these patients, ECMO should be considered earlier as the clinical course of AFM can be unpredictable and can lead to rapid haemodynamic collapse. Key uncertainties that clinicians face when managing children with AFM such as timing of initiation of ECMO and left ventricular decompression need further investigation.