• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제20권3호
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• pp.41-48
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• 2014

Purpose: At the moment, a lot of Public Hospitals in Korea have adopted 5 or 6 bedrooms as a standard multi-bedroom type. However 5-6 bedrooms have many problems related to inpatient satisfaction and nosocomial diseases. Therefore 4 bedroom is under considering for standard multi-bed room in Public Hospitals in Korea. This paper tries to prove that adoption of 4 bedroom in Public Hospitals has nothing to do with economic loss which is now an obstacle in adopting 4 bedrooms. Methods: 3 Methods have been used in this paper. 1) Comparative analysis between medical insurance fee and service cost for hospitalization has been conducted through literature survey. 2) Scenario analysis has been used for the estimation of inpatient number when 4 bedrooms are adopted in Public Hospitals. 3) Relation analysis between profit and proportion of 4 bedroom in Public Hospitals. Results: Adoption of 4 bedroom as a standard multi-bedroom in Public Hospitals has been proved to have nothing to do with the economic loss of hospitals. Implications: It is necessary to introduce and expand 4 bedrooms instead of 5-6 bedrooms in hospitals for the upgrade of hospital environment and easy control of cross infection in inpatient bedrooms.

• 보건행정학회지
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• 제21권3호
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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.

• 기본간호학회지
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• 제4권2호
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• pp.245-265
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• 1997

The purpose of this study was to promote the effectiveness in managing disease or injury, by examining the length of stay in hospital according to characteristics concerned before and after operation, and by serving as a basis for reducing that length. As a result of investigating the length of stay in hospital according to inpatient's personal characteristics, clinical features and other characteristics concerned, the following characteristics appeared significant. The characteristics that showed a significant difference about the length of stay in hospital before and after operation were the age and the fact whether one was married or not among inpatient's personal characteristics. The significant ones among clinical features were the route to be taken to hospital, the form of insurance, the experience of re-hospitalization, whether another disease coexisted, the experiment of changing department, whether a diagnosis was determined by consultation, whether an intensive care unit was used, whether re-operation was performed, the total number of case of the experience of re-hospitalization, inpatient who were again sent to hospital under the same diagnosis was not included in the investigation, which was pointed out as a limit in this study. The significant ones among other characteristics concerned were the date and season when the patients were taken to hospital and the doctor in attendance. The doctor in attendance appeared to give a significant impact on the length of stay in hospital before operation, but no significant difference was noted in the mean among the doctors in attendance. And those characteristics were not found regularly among the selected departments. As stated above, one way to reduce the length of stay In hospital was to diminish the length of stay in hospital before operation. The term of hospitalization before operation shall be reduced by grasping the factors that affected that length before operation and by conducting examination as many as possible in the out-patient department. Also, the efforts should be put on that length after operation. The management of hospital seemed to be successfully carried out if those factors affected that length were effectively controlled.

• 대한소아치과학회지
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• 제44권4호
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• pp.403-411
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• 2017

본 연구의 목적은 치과적 외상이 있는 소아청소년 입원환자의 치과 협진 의뢰에 대한 본원의 현황을 분석하고 발전 방향을 모색하는 것이다. 이에 2011년 3월부터 2017년 2월까지 6년간 원주세브란스기독병원 의과에 입원한 소아청소년 환자의 치과 협진 의뢰에 대한 후향적 분석을 하였다. 조사 항목으로 협진 의뢰 주소와 치과적 진단명, 협진 의뢰과, 치과적 외상 후 협진 의뢰 시기, 입원 기간과 치과적 외상 후 협진 의뢰 시기의 관계, 외상으로 의과에 입원하는 것과 치과적 외상 발생의 관계, 치과적 외상의 원인과 발생 나이, 치과적 외상에 대한 치료, 치과적 외상 환자의 퇴원 후 치과 외래 재내원 등이 있었다. 협진 의뢰 주소와 치과적 진단명에서 치과적 외상이 차지하는 비율이 가장 높았고, 협진 의뢰과는 외과 계열의 진료과가 가장 높은 비율을 보였다. 입원 기간과 치과적 외상 후 협진 의뢰 시기는 양의 상관 관계를 보였다. 외상을 이유로 의과에 입원하는 것과 치과적 외상 발생은 통계적으로 유의하게 연관이 있었고, 교통 사고로 인해 의과에 입원한 환자의 경우 100% 치과적 외상이 동반되었다. 입원실에서 발생한 치과적 외상 환자의 나이는 유의하게 적었다. 치과적 외상과 입원 중 치료, 치과적 외상과 퇴원 후 치과 외래 재내원은 각각 통계적으로 유의한 연관이 없었다. 교통 사고에 의해 의과에 입원한 소아청소년 환자에 대해서 치과적 외상이 동반될 가능성이 크고, 치과 협진 의뢰 시기가 지연될 수 있다. 어린 소아 환자의 경우 입원실에서 치과적 외상의 발생 가능성이 크다. 또한, 치과적 외상 환자의 입원 중 치료와 퇴원 후 치과 외래 재내원이 잘 이루어지지 않고 있다. 이와 같은 결과들에 대해 협진 의뢰 체계의 개선, 입원 병동 내 전담 인력 배치와 치과 시설 및 장비 구비, 의과 주치의에 대한 교육, 주치의 간의 원활한 의사소통 등이 대안이 될 수 있다. 본 연구는 의과와 치과의 교육 및 연구 자료로 활용되어 치과적 외상이 있는 소아청소년 입원환자의 치과 협진 의뢰에 관한 발전에 기여할 것으로 기대된다.

• 동서간호학연구지
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• 제15권2호
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• pp.63-70
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• 2009

Purpose: The purpose of this study was to evaluate hospital service utilization by the types of hospitals in Type I Medicaid claims frequently cited by elderly beneficiaries. Methods: Three frequently claimed inpatient diseases were selected: cerebral infarction, hypertension and diabetes mellitus. Relevant data were collected for the year 2008 from the computer database of the National Health Insurance Corporation. The data was analyzed using SPSS by descriptive statistics, ANOVA and coefficient of variation. Results: The coefficient of variance of hospitalization per episode was higher than daily hospital expenditure among hospitals for all three diseases. The coefficient of variance of hospitalization per episode was highest for cerebral infarction. The coefficient of variation of hospital expenditure per hospital day was highest for hypertension. Conclusions: Evaluating of the volume and pattern of hospital service utilization and the appropriateness for hospital admission for Type-I Medicaid elderly beneficiaries is important for Medicaid-based case management.

• 한국의료질향상학회지
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• 제4권2호
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• pp.184-195
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• 1997

Background : The purpose of this research was to evaluate the appropriateness of preoperative hospital days in a tertiary care hospital and to examine the reasons of the inappropriateness, so as to provide basic information and policy for enhancing appropriateness of preoperative hospitalization and benefit of patients and hospital. Methods : The subjects of the research were the 344 patients who received operation among discharged patients during January, 1996 in surgical departments including general surgery, neurosurgery, orthopedic surgery, plastic surgery and ophthalmology. Their medical records were reviewed and appropriateness of hospital days was evaluated by the Appropriateness Evaluation Protocol. Result : The results of evaluating the appropriateness of preoperative hospitalization showed that inappropriate hospital days were 80.8%. The reasons of inappropriate hospital stays were the tests or preparation which could be done in outpatient basis' followed by 'possible tests or preparation on the operation day' and 'cancelation of operation'. Conclusion : In order to shorten the inappropriate preoperative length of stay, it is recommended that lengthening of laboratory running time and doing most of tests necessary for operations on the outpatient basis prior to admission should be considered. In addition, the operation at the same day of hospitalization and usage of day surgery should be encouraged. Finally there should be changes in the inpatient management system and attitudes and behaviors of surgeons to shorten unnecessary preoperative and maximize the benefit for patients and hospital.

• 한국병원경영학회지
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• 제25권3호
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• pp.29-37
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• 2020

Purposes: The purpose of this study was to identify the factors related to the long-stay hospitalization of dementia patients aged 65 years or older who had received inpatient care at geriatric hospitals according to the minute facility characteristics and patient features. Methodology: This study was conducted on 317,353 cases of 1,512 geriatric hospitals using the Health Insurance Review and Assessment Service dataset. The data collected were processed using the SAS Enterprise Guide 4.3 for descriptive statistics, the chi-square test, and the binary logistic regression analysis. Findings: As a result of the study, in the facility characteristics of geriatric hospitals, the long-stay hospitalization of the aged with dementia were found to be related to the type of facility establishment, the number of hospital beds, the number of medical specialists, the number of nursing personnel, and the number of geriatric hospitals by region and province. In the personal features of patients, the long-stay hospitalization was found to be associated with the gender, age, insurance, and the patient classification groups. Practical Implication: Considering the results of this study, it seems that securing the sufficient medical personnel in a geriatric facility, providing the good quality medical services, and preparing the appropriate discharge plan can reduce the unnecessary long-stay hospitalization and spend the medical expenses for the older patients.

• 대한간호학회지
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• 제30권2호
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• pp.463-475
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• 2000

The purpose of the study was to identify the effects of inpatient cardiac rehabilitation programs on motivation, the performance of health behavior, and quality of life in patients with coronary artery disease. The subjects consisted of 31 patients who participated in the rehabilitation program during their hospital stay, and were compared with 34 patients who did not participate. The study results are as follows: 1. The mean of cardiac risk factor scores for the subjects was 22.5 (SD = 5.5) at the level of low to moderate risk with some possibility to improve. The physiological and behavioral risk factors for the subjects were also in the normal range or slightly above the normal range. 2. The motivation level to preform health behaviors for both groups was improved after discharge. Also, perceived self-efficacy was significantly higher for the program participants than for the comparison group at the post-test. 3. The performance of cardiac related health behaviors improved for both groups after discharge, but there were no significant differences between the two groups. The program participants reported better performance in most health behaviors at the post-test, but the results failed to reach a statistical significant level. 4. As for motivation and health behavior, the subjects in the both groups showed an improved quality of life after the discharge. In addition, the program participants produced significantly higher scores in health and functioning dimension than the comparison group during the post-test. In conclusion, the study partially supported the effects of the inpatient cardiac rehabilitation program to motivate and improve the quality of life, and provide the need to apply early rehabilitation interventions for the patients after cardiac events. Further study with a longitudinal design is also suggested to verify the effect of cardiac rehabilitation program from hospitalization to discharge and subsequently to fully recover to the level of pre-hospitalized state.

• 한방안이비인후피부과학회지
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• 제35권4호
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• pp.95-105
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• 2022

Objectives : The purpose of this study is to retrospectively analyze 3 years of inpatient dermatologic and surgical consultation to Korean medicine ophthalmology, otolaryngology & dermatology department in Korean medicine hospital. Methods : We classified dermatological and surgical inpatient consultations between September 1st, 2019 and August 31st, 2022, based on electronic medical record by gender, age, hospitalized department, categories of diseases. Results : Total number of consultations were 336. The proportion of female and male were 2.5:1, and the average of age was 65.6 and 60, respectively. The most frequently referred skin disease category was infectious skin disease(39.9%), followed by eczema(20.2%), dermatoses due to physical forces(10.1%), pigment anomalies(7.1%), nevi and tumors(4.8%), diseases of the skin appendages(4.2%), urticaria(3.9%), and others(4.9%). Consultations from department of Korean rehabilitation medicine, and Korean internal medicine were most common, because they have a comparatively large number of inpatients and long hospitalization period. In case of infectious disease and skin ulcer, patients from Korean internal medicine were frequently consulted due to characteristics of stroke and internal diseases. Conclusions : This study identified the frequency of consultation and the disease group with many requests for each department. Identifying the characteristics of diseases with a high frequency of consultation will prevent various dermatological problems that may occur by department. In addition, it was found that a prompt consultation was needed for accurate diagnosis and treatment in dermatological problem.

• 한방안이비인후피부과학회지
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• 제36권4호
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• pp.19-29
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• 2023

Objectives : The purpose of this study is to retrospectively analyze 3 years of inpatient ophthalmology consultation to Korean medicine ophthalmology, otolaryngology & dermatology department in Korean medicine hospital. Methods : We classified ophthalmological inpatient consultations between September 1st, 2019 and August 31st, 2022, based on electronic medical record by gender, age, hospitalized department, categories of diseases. Results : Total number of consultations were 111, and the average of age was 63.6. The proportion of female and male were 2.5:1. Among the 136 cases of eye disease referred, lacriminal production and discharge diseases accounted for the most at 54 cases(39.7%), of which 44 cases were dry eyes syndrome. Excluding dry eye syndrome, conjunctival disease occurred the most with 24 cases(17.6%). Consultations from department of Korean rehabilitation medicine, and Korean internal medicine were most common, because they have a comparatively large number of inpatients and long hospitalization period. Conclusions : This study identified the frequency of consultation and the disease group with many requests for each department. When inpatients complain of eye disease, consultation to Korean medicine ophthalmology, otolaryngology & dermatology department should be encouraged as accurate diagnosis and treatment using specialized equipment is possible and can be used for the purpose of progress observation and examination.