• Health Policy and Management
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• v.3 no.1
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• pp.102-123
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• 1993

This study investigates effcts of HMO internal structural arrangements on performance, specially cost reduction measured by hospitalization rate. This study formulates formalization, centralization measured by decision-making participation, differentiation, and coordination as structural factors, considering coordination as an intermediate factor between the rest of structural factors and hospitalization rate. The commonly used HMO types is assumed not effective in explaining performance differences. For the empirical test, I use bootstrap regression analyses with 48 HMOs. The results of the analyses show that HMO types fail to explain differences in hospitalization rate. However, dicision-making participation and differention effectively reduce hospiatalization rate, while frmalization increases hospitalization rate and coordination has nonessential effect on hospitalization rate. And, formalization and decision-making participation positively contribute to achieve coordination in HMO. These findings suggest that the theoretical framework derived from rational-citingency theory of formal organization better explains performance differences of HMOs than HMO types.

• Korean Journal of Adult Nursing
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• v.29 no.1
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• pp.1-11
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• 2017

Purpose: The purpose of this study was to identify the factors and the relative risk associated with admission of patients with diabetes mellitus (DM). Methods: The sample included one hundred twenty-eight patients with type II DM. Seventy-seven patients who were admitted within six months of a hospitalization to one hospital from the first of February to the 31st of August 2014, were compared with fifty-one patients who regularly attended an outpatient clinic and had no hospitalizations. Results: Hospitalization probabilities among patients who had only diet and exercise or took oral diabetic medication were 0.03 (p=.004) and 0.21 (p=.007) times independently lower than the ones with insulin injection. The risks for hospitalization increases 6.33 times if there is absence of a spouse (p=.027) whereas the presence of a spouse seems to make hospitalization less likely. The risk among the ones having diabetic complications was 5.15 times higher than ones having no recognition of the complications (p=.040). For every one point increase in self-efficacy and every 1 mg/dL increase in high density lipoprotein (HDL) cholesterol, there was a 0.84 (p=.005) and a 0.96 (p=.036) decrease in hospitalization risk, respectively. Conclusion: Nurses should be sensitive to the risk groups of hospital admission among patients with DM including no spouse, insulin injection, diabetic complications, low self-efficacy, and low HDL cholesterol.

• Journal of Sasang Constitutional Medicine
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• v.27 no.4
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• pp.404-418
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• 2015

Objectives This study investigated the effect of camping style Hospitalization program for atopic dermatitis female adolescent patients. 6 patients, 12-14 year old female adolescent, admitted for camping style hospitalization program.Methods 6 patients were admitted for camping style hospitalization program (2014.08.13~2014.08.16). The program included acupuncture, herbal medicine, examination, education, psychotherapy, dressing, exercise. The patients were analyzed by Severity Scoring Atopic Dermatitis(SCORAD) index and measured skin pH value(pH). Also, patients evaluated themselves by writing an atopic dermatitis diary which consists of diet, emotion, severity of pruritus, and sleep loss, and checked questionnaires which consist of atopic dermatitis, self treatment methods and degree of satisfaction of each program.Results Most of subjective symptoms which patients complained were improved and also SCORAD index total scores were decreased by sasang constitutional medication.Conclusions We expect that the camping style hospitalization program based on sasang constitutional medicine could be helpful for female adolescent patient of atopic dermatitis.

• The Journal of Pediatrics of Korean Medicine
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• v.28 no.2
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• pp.40-55
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• 2014

Objectives This study investigated the effect of camping style Hospitalization program for atopic dermatitis children patients. Methods 6 patients were admitted for camping style hospitalization program. The program includes acupuncture, herbal medicine, examination, education, psychotherapy, dressing, exercise. The patients were analyzed by Severity Scoring Atopic Dermatitis (SCORAD) index and measured skin pH value (pH). Also, patients evaluated themselves by writing an atopic dermatitis diary which consists of diet, emotion, severity of pruritus, and sleep loss. Checked questionnaires which consists of atopic dermatitis, self treatment methods and each program satisfaction. Results After 7 days of hospitalization program, the patient's SCORAD index scores were decreased and most of the patient's symptoms were improved. Conclusions The hospitalization program could be helpful for atopic dermatitis children patients.

• Journal of Preventive Medicine and Public Health
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• v.42 no.6
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• pp.416-423
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• 2009

Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.22 no.3
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• pp.178-187
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• 2009

Background : Atopic dermatitis is chronic exzemaous dermatitis and the recurrence rate of atopic dermatitis is high. Many patients are suffering from pruritus. Objective : This study compared ambulatory care with hospitalization for atopic dermatitis treatment of one patient, and investigated the effect of Oriental medicine program for atopic dermatitis patients during short term hospitalization. Method : We treated a 5 year-old boy with uncontrollable atopic dermatitis by ambulatory care and hospitalizaion. Herbal medication and herbal dressing was done samely during ambulatory care and hospitalization. Intensive life management, education for compliance was done only during hospitalization. Results : Even though he had been treated for 5 months by ambulatory care, he still suffered from severe itching, erythema, oozing and insomnia. Admission duration was 10 days. During admission, the SCORAD scores and subjective scores were decreased rapidly. Conclusion : We concluded that effects of the treatments can be different due to compliance of the patient and in that view the short term hospitalization program could be more helpful than ambulatory care for uncontrollable atopic dermatitis patients.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.3
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• pp.79-85
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• 2018

Objectives The purpose of this study is to find a relation between hospitalization time and the overall outcome of treatment, and suggest an optimal hospitalization date. Methods We analyzed the medical records of patients who received admission treatment at Mokhuri Neck and Back Hospital in April, 2018. Results By analyzing the difference in visual analog scale (VAS) scores according to the hospitalization date, it was shown in this study that when hospitalization was held out by the fourth day of accident there was a significant difference in the improvement of symptoms than any other day. There were no statistically significant differences in initial VAS scores and admission periods. Conclusions It is the most effective for a traffic accident patient to receive hospitalization within the first four days of accident for the most effective reduction in overall pain.

• Journal of Korean Academy of Nursing
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• v.44 no.3
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• pp.339-349
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• 2014

Purpose: This study was done to develop a measurement for stress experienced by patients with schizophrenia during hospitalization. Methods: The preliminary tool was developed through in-depth interviews and a validity verification test of content. For data collection, 15 inpatients with schizophrenia were selected as participants for in-depth interviews and 195 patients admitted to one of eight psychiatric hospitals in four provinces were recruited as participants to test reliability and validity of the preliminary tool. Results: The questionnaire was developed as a four-point Likert-type scale in a self-report form with 28 items. Factor analysis showed 28 items in six factors. Factors were named 'Unjust human rights infringement', 'Futureless life', 'Alienation from other family members', 'Infringement of basic needs', 'Infringement of personal preference' and 'Inconvenience of shared living'. The six factors explained 63.5% of the total variance. Cronbach's alpha for the total items was .93 and for the factors ranged from .65 to .87. Conclusion: A tool to measure stress in patients hospitalized with schizophrenic was developed based on identified hospitalization stress experiences. Study results indicate that this tool can be used to evaluate hospitalization stress in these patients and will contribute to establishing nursing interventions for relief of hospitalization stress.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.713-718
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• 2007

Purpose: The aim of this study is to develop and apply the critical pathway to the orbital wall fracture patients and to elucidate its effect. Methods: Critical pathway(CP) sheet and questionnaire were developed by a team approach. Critical pathway was applied to 7 orbital wall fracture patients (CP group) from April 2006 to September 2006. Length of hospitalization and cost for hospitalization of CP group were compared to those of the 10 patients who had same disease entities and treated by conventional regimen(control group). Results: Length of hospitalization in the CP group (7.20 day) were insignificantly shorter than that of control group(8.71 day). Mean cost for hospitalization of the CP group(776,398 won) were insignificantly lower than that of control group(1,028,531 won). The patients satisfaction for the explanation regarding operation procedure, therapeutic operation fee, length of hospitalization and medical personnel were all affirmative. Conclusion: Critical pathway that we developed for orbital wall fracture definitely improved the quality of treatment. Furthermore, other critical pathways should be developed for another facial trauma patients.

• Health Policy and Management
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• v.21 no.3
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• pp.397-413
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• 2011

Purpose: The purpose of this study is to examine the relationship between the income level and the healthcare utilization by health insurance type in all cancer patients in year 2005. Methods: The target population was cancer patients with health insurance who used healthcare as a diagnosis code (C00-C97) from January 1 to December 31 of 2005. The Korea Central Cancer Registry Center's Cancer Patient Registry Data, the list of cancer patients of the National Health Insurance Corporation, and the claim data of the Health Insurance Review & Assessment Service were used. The I was the wealthiest, followed by II, III, IV. The V was the poorest in this study. For the analysis, the $x^2$-test, ANOVA (and Kruskal-Wallis test), and regression were used. Results: Outpatient and hospitalization medical expenses, and outpatient visit days of cancer patients with self-employed health insurance were highest in I (p<.001, respectively), and the hospitalization days were the highest in II (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days of cancer patients with occupational health insurance were the highest in I (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days in cancer patients were higher in I compared to V, and higher in II and III, IV compared to V (p<.001, respectively). Conclusion: Supporting plan for cancer patients' outpatient healthcare utilization are necessary. Moreover, we should make specialized strategy for low income cancer patients with self-employed health insurance when we develop quality improvement policy for inpatient service.