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The Actual Wearing Condition for the Uniform of Pediatric Inpatient (소아환자복의 착의실태에 관한 연구)

  • Kim, Mi Sung;Lee, Jeong Ran
    • Journal of the Korean Society of Clothing and Textiles
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    • v.36 no.11
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    • pp.1197-1207
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    • 2012
  • This study provides information for the design of pediatric inpatient uniforms with functionality and aesthetic beauty through a questionnaire-survey of the conditions of providing, wearing, preferences and improvement requirements for pediatric inpatient uniforms. As a result of the survey, intravenous injections were mostly given on the back of the hand, and the method of changing uniforms after intravenous injections was (in most cases) to pass the injection bottle through a sleeve or pant leg while the needle is inserted. The respondents answered that the sleeve length and pant length did not match. As a result of the preference of the pediatric inpatient design survey, respondents indicated they preferred pajama type, yellow color and medium size animal patterns. A similar ratio of set-in and raglan with no collar but with 3/4 length sleeve of round neck, front end, sleeve top opening, button closing and two pockets were preferred for shirts; however, a 3/4 length with rubber string on the waist, no opening and inner opening were preferred at the same ratio for pants. As for the method to adjust the length to assign functionality to pediatric inpatient uniforms, the most preferred sleeve was a roll-up sleeve with a strap and the most preferred pants were length adjusted pants that used a strap for both shirts and pants with a both sides strap. In addition, the majority of the respondents answered that a hand wrapper that protects the injection location during intravenous injections needs be developed. As for the development type, a half glove type and glove type were preferred in sequential order.

Propensity score matching analysis on inpatient period differences of hemorrhagic stroke survivors depending on medical insurance coverage

  • Kim, Sang-Mi;Kim, Young;Lee, Seong-A
    • Physical Therapy Rehabilitation Science
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    • v.8 no.2
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    • pp.67-73
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    • 2019
  • Objective: The purpose of this study was to compare the differences in the length of hospital stay between hemorrhage stroke survivors with health insurance and those with medical care after controlling all factors except for the type of medical insurance by using the propensity score matching (PSM) method. Design: Retrospective cohort study. Methods: Data from the Korean National Centers for Disease Control and Prevention's In-Depth Discharge Injury Survey between the years 2006 and 2012 were used for analysis. A total of 4,538 cases were defined as persons with hemorrhagic stroke (I60-I62) based on the block of categories in the International Classification of Diseases (10th). In order to analyze the inpatient period differences depending on the type of health care, which reflects one's socio-economic level, the chi-square and t-test was conducted. Results: Frequency and percentage were presented, and regression analysis was used to determine the factors affecting the inpatient period. Age, severity of disease, treatment outcome, and post-discharge status were no longer statistically significant after matching. The inpatient period of the persons receiving medical aid benefits was found to be significantly longer than those with national health insurance (p<0.05). Conclusions: The factors influencing the inpatient period of hemorrhagic stroke survivors were treatment outcomes, severity of disease, hospital admission process, and the type of health care. It is necessary for systematic and comprehensive governmental management for persons with hemorrhagic stroke to be transferred to long-term care facilities.

Econometric Analysis of the Difference in Medical Use among Income Groups in Korea: 2015 (한국의 소득수준 간 의료이용 차이의 계량적 분석: 2015)

  • Oh, Youngho
    • Health Policy and Management
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    • v.28 no.4
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    • pp.339-351
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    • 2018
  • Background: The purpose of this study is to estimate empirically whether there is a difference in medical use among income groups, and if so, how much. This study applies econometric model to the most recent year of Korean Medical Panel, 2015. The model consists of outpatient service and inpatient service models. Methods: The probit model is applied to the model which indicate whether or not the medical care has been used. Two step estimation method using maximum likelihood estimation is applied to the models of outpatient visits, hospital days, and outpatient and inpatient out-of-pocket cost models, with disconnected selection problems. Results: The results show that there was the inequality favorable to the low income group in medical care use. However, after controlling basic medical needs, there were no inequities among income groups in the outpatient visit model and the model of probability of inpatient service use. However, there were inequities favorable to the upper income groups in the models of probability of outpatient service use and outpatient out-of-pocket cost and the models of the number of length of stay and inpatient out-of-pocket cost. In particular, it shows clearly how the difference in outpatient service and inpatient service utilizations by income groups when basic medical needs are controlled. Conclusion: This means that the income contributes significantly to the degree of inequality in outpatient and inpatient care services. Therefore, the existence of medical care use difference under the same medical needs among income groups is a problem in terms of equity of medical care use, so great efforts should be made to establish policies to improve equity among income groups.

Cost-Effectiveness Analysis of Home-Based Hospice-Palliative Care for Terminal Cancer Patients

  • Kim, Ye-seul;Han, Euna;Lee, Jae-woo;Kang, Hee-Taik
    • Journal of Hospice and Palliative Care
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    • v.25 no.2
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    • pp.76-84
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    • 2022
  • Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.

Anatomic total shoulder arthroplasty with a nonspherical humeral head and inlay glenoid: 90-day complication profile in the inpatient versus outpatient setting

  • Andrew D. Posner;Michael C. Kuna;Jeremy D. Carroll;Eric M. Perloff;Matthew J. Anderson;Ian D. Hutchinson;Joseph P. Zimmerman
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.380-389
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    • 2023
  • Background: Total shoulder arthroplasty (TSA) with a nonspherical humeral head component and inlay glenoid is a successful bone-preserving treatment for glenohumeral arthritis. This study aimed to describe the 90-day complication profile of TSA with this prosthesis and compare major and minor complication and readmission rates between inpatient- and outpatient-procedure patients. Methods: A retrospective review was performed of a consecutive cohort of patients undergoing TSA with a nonspherical humeral head and inlay glenoid in the inpatient and outpatient settings by a single surgeon between 2017 and 2022. Age, sex, body mass index, American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), and 90-day complication and readmission rates were compared between inpatient and outpatient groups. Results: One hundred eighteen TSAs in 111 patients were identified. Mean age was 64.9 years (range, 39-90) and 65% of patients were male. Ninety-four (80%) and 24 (20%) patients underwent outpatient and inpatient procedures, respectively. Four complications (3.4%) were recorded: axillary nerve stretch injury, isolated ipsilateral arm deep venous thrombosis (DVT), ipsilateral arm DVT with pulmonary embolism requiring readmission, and gastrointestinal bleed requiring readmission. There were no reoperations or other complications. Outpatients were younger with lower ASA and CCI scores than inpatients; however, there was no difference in complications (1/24 vs. 3/94, P=1.00) or readmissions (1/24 vs. 1/94, P=0.37) between these two groups. Conclusions: TSA with a nonspherical humeral head and inlay glenoid can be performed safely in both inpatient and outpatient settings. Rates of early complications and readmissions were low with no difference according to surgical setting. Level of evidence: IV.

Guideline of Improvement and Evaluation of Prescribing Errors in Colorectal Chemotherapy (대장암 항암 화학요법의 처방 오류 평가 및 개선안 제시)

  • Lim, Hyun-Soo;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.2
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    • pp.158-166
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    • 2013
  • Background: Colorectal cancer shows a significant increase in South Korea due to westernization of diet, lack of dietary fiber, drinking and smoking, irregular defecation. There are surgery, chemotherapy, radiation therapy in treatment of colorectal cancer. There may be a medication errors in the process of chemotherapy because of its high toxicity, narrow therapeutic index and the health status of cancer patients. Consequently medication errors can cause increasing the risk of death, prolonging hospital stay and increasing the cost. Among medication errors on medication use process, prescribing errors are of particular concern due to higher risk of serious consequences. It is important for pharmacist to prevent the prescribing errors before reaching patient. Therefore we analyzed the prescriptions of colorectal cancer, classified prescribing errors, suggested guideline to reduce prescribing errors and verified the importance of pharmacist's role in prevention of medication errors activity. Methods: We collected the numbers of prescriptions of colorectal cancer(n=2,373) through anti cancer management program and EMR and analyzed the errors of prescriptions by categories from Oct 1st 2011 to Sep 30th 2012 at Chungbuk National University Hospital. We reviewed the prescriptions as follows - patients' characteristics, the result of test, previous prescriptions, characteristics of antineoplastic agents and patients' allergy, drug sensitivity, adverse events. Prescriptions are classified into inpatient and outpatient and analyzed the errors of prescriptions by categories (dosage form, dose, input, diluents, regimen, product). Results: Total prescription number of inpatient and outpatient of colorectal cancer was 1,193 and 1,180 and that of errors was 107(9%) and 22(1.9%), respectively. In case of errors of categories, the number of errors of dosage form is 69 and 8, errors of dose is 15 and 5, errors of input is 9 and 9 in inpatient and outpatient prescriptions, respectively. Errors of diluents is 8, errors of regimen is 3, errors of product is 3 in only inpatient prescriptions. In case of errors of categories by inpatient department, the number of errors of dosage form is 34 and 35, errors of dose is 7 and 8, errors of input is 6 and 3, errors of diluents is 4 and 4, errors of regimen is 2 and 1, errors of product is 2 and 1 in SG and HO, respectively. In case of outpatient department, the number of errors of dosage form is 8 in HO, errors of dose is 5 in HO, errors of input is 5 and 4 in SG and HO, respectively. Conclusions: The rate of errors of inpatient is higher than that of outpatient. Junior doctors are engaged in prescriptions of inpatient and pharmacist need to pay attention to review all prescriptions. If prescribing errors are discovered, pharmacist should contact the prescriber and correct the errors without delay. The guideline to reduce prescribing errors might be upgrading software of anti cancer management program, education for physicians as well as pharmacists and calling prescriber's attention to preventing recurrence of errors.

A study of inpatient satisfaction levels at general hospitals (일 지역 상급종합병원 입원환자의 만족도 연구)

  • Jung, Sang-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.7
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    • pp.3094-3101
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    • 2012
  • This study provides fundamental data in order to obtain improved medical services and competitiveness by analyzing the satisfaction level of patients receiving inpatient services at general hospitals. Data from self-administered surveys distributed to inpatient subjects at local general hospitals was collected from 09/19/2011 to 09/30/2011. Firstly, the results of 320 surveys show that the average level of satisfaction from inpatient services was 3.25 (maximum 4.0). Secondly, the results from general characteristics and satisfaction from medical care provider services showed that there is a statistical significance regarding medical treatment, health condition, the number of times admitted to the hospital, and hospital environment including hospital admittance/release proceeders. Also the satisfaction with other services is statistically significant with regards to age, medical treatment, health condition, and the number of times admitted to the hospital. Thirdly, there is a statistically significant positive correlation between inpatient services and levels of satisfaction. Finally, from the analysis of factors influencing inpatient satisfaction showed that physician services and other services significantly affect satisfaction. In conclusion, in order to increase inpatient levels of satisfaction the workforce involved medical treatment of patients need to be retained and a variety of programs need to be in operation that will satisfy patients while they stay in the hospital. Further research is expected.

An Analysis of Primary Causes for Waiting for Inpatient Admission and Length of stay at Emergency Medical Center(EMC) (응급의료 센터의 체류 및 입원대기 시간 지연 요인 - 일개 의료기관을 중심으로 -)

  • Kil Suk-Yong;Kim Ok-Jun;Park Jin-Sun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.3
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    • pp.522-531
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    • 1999
  • This research identifies the ingress to egress primary factors that causes a patient to receive delayed emergency medical care. This material was collected between February 1st to 28th, 1998. Research envolved 4,118 people who visited the college emergency medical center in Kyeongido Province, South Korea. Medical records were examined, using the retrospective method. to determine the length of stay and the main cause for waiting. Results are as follows : 1. The age group with the highest admission rate was 10 and under, approximately 1,394 (33.9%). Followed by an even distribution for ages between 11-50 at 10-15% for their respective ranges. The lowest admission rate was 50 years and above. 2. From the 4,118 records examined, 3,489 received outpatient treatment (84.7%); 601 were admitted for inpatient care (14.6%); 25 arrived dead on arrival (0.6%); and 4 people died at the hospital. 3. Between 7PM to 12AM, 42.9% were admitted to the EMC. The hours from 9PM to 11PM recorded the highest admission rate and 5AM to 8AM was the lowest From 8PM to 12AM, the most beds were occupied. 4. For most patients. the average length of stay was approximately 2.2 hours. By medical department, external medicine was the longest for 2.8 hours. Pediatrics was the shortest for 1.6 hours. The average waiting period for inpatient admission was 2.6 hours. Inpatient admission for pediatrics and external medicine was 3.4 hours and 2.2 hours respectively. 5. Theses are primary factors for delay at EMC: 1) pronged medical consultations to decide between inpatient versus outpatient treatment, and delaying to be inpatient, 2) when you call physicians they are delayed to come 3) Understaffing during peak or critical hours, 4) Excessive consulting with different medical departments, 5) some patients require longer monitoring periods, 6) medical records are delayed in transit between departments, 7) repeated laboratory tests make delay the result, 8) overcrowded emergency x-ray place causes delay taking x-ray and portable x-ray, 9) the distance between EMC and registration and cashier offices is too far. 10) hard to control patient's family members. The best way to reduce EMC waiting and staying time is by cooperation between departments, both medical and administrative. Each department must work beyond their job description or duty and help each other to provide the best medical service and satisfy the patient needs. The most important answer to shortened the EMC point from ingress to egress is to see things from a patient point of view and begin from there to find the solution.

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Inpatient Satisfaction and Dissatisfaction in Relation to Socio-demographics and Utilization Characteristics (입원환자의 사회인구학적 요인 및 의료이용 특성과 환자만족$\cdot$불만족간의 관련성)

  • Cho Sung-Hyun
    • Journal of Korean Academy of Nursing
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    • v.35 no.3
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    • pp.535-545
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    • 2005
  • Purpose: This paper reports a study exploring factors related to patient satisfaction and dissatisfaction with inpatient care. Method: A cross-sectional study design was used, employing data from the National Health and Nutrition Survey conducted in 2001. Socio-demographic factors, utilization, self-rated health status, and disease characteristics were assessed by employing univariate comparisons and multivariate logistic regression analyses. Result: Out of 37,769 respondents, 1,043 aged 20 years and over had been admitted to a hospital or clinic at least once during the past year. About a quarter of the respondents were discharged from tertiary hospitals and $21\%$ from clinics. The majority of patients ($58\%$) were satisfied with inpatient care received, whereas $11\%$ were dissatisfied. Greater satisfaction was found in patients aged 45-64 years and those having formal education, discharge from tertiary hospitals, national health insurance as a payer, medical expenses not being burdensome, good self-rated health status, and neoplasm. Living in non-metropolitan urban areas, shorter length of stay, and musculoskeletal diseases were associated with greater dissatisfaction. Conclusion: Different factors were related to patient satisfaction and dissatisfaction with care. Those factors need to be taken into account when evaluating and comparing satisfaction levels between health care institutions.

Inpatient care focused strategy and convergence performance in hospitals (병원의 입원 진료 집중화 전략과 융합적 운영 성과)

  • Yoo, Hai-Won
    • Journal of the Korea Convergence Society
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    • v.7 no.4
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    • pp.59-66
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    • 2016
  • This study analyzed the relationship between the convergence performance in hospital. This study examined previous research and calculated centralized index using diagnosis related groups. In addition, multiple regression analysis was used based on LOS in order to understand the effect of focused strategy which quality of medical inpatient service. The centralized level was examined by analyzing national inpatient sample data using 'Internal Herfindahl-Hirshman index' This study is significant because it reviewed medical inpatient service quality by measuring hospital centralized level which has been rarely studied before Korea.