• 디지털융복합연구
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• 제22권1호
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• pp.23-32
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• 2024

본 연구는 퇴원손상심층조사 자료를 선정하여 2016년 1월부터 2018년 12월까지 입원 치료 후 퇴원한 환자 중 주진단이 한국표준질병·사인분류(KCD-7th) 기준 S00-T98(손상, 중독 및 외인에 의한 특정 기타 결과)인 환자 92,364명을 최종 대상으로 분석하였다. 연구결과 손상 및 외상환자의 일반적 특성을 분석한 결과 성별은 남자가 발생률이 높았으며 연도가 증가할수록 여성의 발생비율이 증가하였다. 손상 및 외상환자의 손상 외인 특성을 분석한 결과 손상 의도는 비의도성 손상 비율이 높았고, 손상장소는 길/도로에서 가장 높았으며 연도가 증가할수록 감소 추세를 보이며 주거지에서 증가 추세를 보였다. 이상의 결과 손상 예방을 위한 관련 시스템의 구축의 기초 자료로 활용될 수 있을 것이다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제8권1호
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• pp.70-82
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• 1997

본 연구는 비행청소년의 사회심리적 특성을 파악하고 비행을 직접적으로 유발시키는 요소를 알아보고자 실시되었다. 청소년 병동에 입원한 환자 중 정신증 진단을 제외한 210명을 비행의 정도에 따라 경찰체포후 훈방된군(60명), 재판 판결을 받은군(35명), 이러한 사실이 없는 정서적으로 혼란된 비교군(105명)으로 나누어 인지-학습, 감정상태, 자살사고, 성격특성, 가족구조, 생활사건 영역에 관한 표준화된 검사를 실시하고 그 결과를 비교분석하였다. 공유진단을 파악하고자 이중 무작위로 60명은 구조화된 면담을 실시하였다. 연구결과 비행청소년은 비교군에 비해 1) 입양, 성생활의 문란, 가출, 정신과 입원력이 높았으며, 2) 언어성 지능지수 및 학습능력이 떨어지고, 3) 성격구조상 충동적이고 사회순응도가 낮으며, 강압적이며, 4) 가족단위의 여가활동이 적고, 낮은 종교 도덕관을 가진 가족의 특성을 보였으며, 5) 부정적 생활 경험이 많았고, 6) 품행자애, 반항장애, 주의력 결핍 과잉행동장애 진단율이 높았다. 우울, 불안, 자살사고는 3군중 훈방된군에서 가장 낮게 나왔다. 따라서 비행청소년을 다룰 때 비행에 관여하는 인지학습측면, 충동적인 성격구조, 가족구조, 부정적 생활경험, 파탄적 행동장애 측면에 관한 보다 집중적인 대처방안이 강구되어져야 하겠다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제1권1호
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• pp.148-160
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• 1990

본 논문은 아동분리반응척도 개발에 관한 것으로 그 신뢰도와 타당성, 그리고 정신과 입원 아동들에 대한 임상 연구 이용도를 검증하였다. 아동분리반응척도는 신뢰성과 타당성있는 연구 기구임이 나타났고 아동의 분리반응을 들의 정신병리와 구별지어주는데 유용한 것으로 나타났다. 이것은 또한 감별진단하는데 임상가들에게 도움이 될것으로 보이며 아동의 정신과 입원시 일어날수 있는 분리반응과 그 부작용에 대한 이해의 필요성을 시사하였다. 이 기초연구는 입원치료 프로그램은 입원 아동들의 발달적 요구와 능력 그리고 정신병리시 나타나는 특정한 결함에 대해 반드시 관심을 보여야 한다는 개념을 지지하였다.

• 정신신체의학
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• 제4권2호
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• pp.163-169
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• 1996

The authors examined for risk factors for suicide among psychiatric patients who had committed suicide through the analysis of demographic, clinical and psychological characteristics of the patients. The total number of suicides committed during social adjustment period was 9. Male and female ratio was 5:4 and the highest incidence occurred in the age group of 21-29 years. Of the 9 cases, schizophrenia accounted for two-third of the suicides. Among the committed suicides, 4 were in hospitalization and rest were postdischarge state. We found that 4 of 5(80%) suicides occurred in the first year after discharge, and that three fifth(60%) occurred within three months of discharge. In this result, most of suicides occurred immediately or soon after discharge and some during inpatient care. The major precipitating factors the patients showed before committing suicide were realistic and psychological problems. Consquently, they become dejected, experience feelings of hopelessness, go on to a depressed mood, and, in that case, have suicidal ideas that are eventually acted on. We believe that the ability to recognize risk factors for suicide and develop appropriate interventions is key to suicide prevention.

• 보건행정학회지
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• 제11권3호
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• pp.31-45
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• 2001

With an economic development and epidemiologic transition, the burden of disease due to chronic diseases and accidents is increasing. However, in most of developing countries, long-term care facilities are not available, therefore acute care facilities should provide both acute and long-term care services. It is also true in Korea. The demand for long-term care services needs to be estimated to establish the adequate supply system of health resources. This article introduces the reclassification methodology of inpatients' healthcare utilization to acute and long-term care services. All discharged patients from hospitals for one month were analyzed. The distribution of inpatients' hospital days were fitted to Chi-squared distribution by ICD disease categories, and they were grouped in five clusters. For each cluster, the lower and upper limit of classification criteria to acute and long-term care services were chosen. Summarizing all hospital days corresponding to acute and long-term care respectively, 24 to 28 percent of inpatient services fumed out to be long-term care services. The study results are consistent with those of the existing studies. They can be used practically in the allocation of long-term care resources.

• 지역사회간호학회지
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• 제27권3호
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• pp.272-283
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• 2016

Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6985-6989
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• 2013

Background: This study aimed to examine out-of-pocket expenditure for cancer treatments of hospitalized patients and to analyze changing patterns over time. Materials and Methods: This study examined data of all cancer patients receiving inpatient care from two tertiary hospitals from January 2003 to December 2010. Medical expenditures per admission were calculated and classified into those covered and uncovered by the Korean National Health Insurance (NHI) and co-payment. Results: The medical expenditure per admission increased slowly from 3,455 thousand Korean won (KRW) to 4,068 thousand KRW. While expenditures covered by the NHI have increased annually, co-payments have generally decreased. The out-of-pocket expenditure ratio, which means the proportion of uncovered expenditure and co-payment among total medical expenditure dropped sharply from 2005 to 2007 and was maintained at a similar level after 2007. Medical expenditures, NHI coverage, and the out-of-pocket expenditure ratio differed across cancer types. Conclusions: It is necessary to continually monitor the expenditure of uncovered services by the NHI, and to provide policies to reduce this economic burden. In addition, an individual approach considering cancer type-specific characteristics and medical utilization should be provided.

• 한국병원경영학회지
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• 제15권2호
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• pp.15-26
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• 2010

Stroke is a high-risk disease. The future of the medical environment is that the proportion of elderly population is increasing, the average life expectancy is being increased, while the fatal rate of stroke will be low. These situation will due to the financial burden on medical insurance. The most important factor that affects on the medical costs of stroke patients is the length of stay. In this study the mean length of hospital for stroke stay was 21.81days(37.97days for intracerebral hemorrhage, 18.89 days for cerebral infarction). The payment per case of stroke was 6.86 million won(12.6 million won for intracerebral hemorrhage, 5.72 million won for cerebral infarction). The payment per case of intracerebral hemorrhage was 2.2 times more than that of cerebral infarction. The payment in the day of hospitalization was the highest and until the second day medical costs was high. After the third day medical costs tended to decline, after that seemed to show an almost constant level. The length of hospital stay was found to be the most important determinant of inpatient charges for stroke. Accordingly rational management of the length of stay will be beneficial to health care consumers, providers, states.

• 임상간호연구
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• 제27권1호
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• pp.77-84
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• 2021

Purpose: Malnutrition affects all age groups, but older adults are particularly more vulnerable to nutritional deficiencies. This study evaluated the age-specific factors affecting malnutrition in hospitalized older adults. Methods: A retrospective study was conducted on inpatient elderly people who received artificial nutrition from 2010 to 2017. Data of demographics, diagnosis, type of nutrition therapy, number of comorbidity, fall risk assessment, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, and intensive care unit admission were collected. Malnutrition was defined as a body mass index (BMI) of less than 18.5 kg/m². Patients were classified as the young-old (65~74 years old), the old-old (75~84 years old), or the oldest-old (85 years old or older). Results: A total of 7,130 older adults were included, and 4,028 patients were classified as the young-old, 2,506 into the old-old, and 596 into the oldest-old. Proportion of malnutrition was higher in the oldest-old compared to the other groups. In multivariate analysis, parenteral nutrition, alcohol, and high risk of falls were factors affecting malnutrition in all groups. Parenteral nutrition and alcohol in the young-old, high risk of falls in the old-old, and male sex in the oldest-old were the factors affecting malnutrition by the age group. Conclusion: Older age was the most significant factor affecting malnutrition. Specific strategies by age are needed to improve nutritional status in hospitalized older adults as influencing factors for malnutrition vary among different age groups.

• 한방재활의학과학회지
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• 제32권3호
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• pp.179-187
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• 2022

To report improvement of 2 hospitalized patients who had clavicle fractures due to traffic accident with Korean medicine complex treatment. We collected a data from February 2020 to April 2022. A total of 2 patients were studied and we compared numeric rating scale (NRS), neck disability index (NDI), range of motion (ROM) at admission and discharge date of hospitalization. After receiving an average of 28.5 days of Korean medicine inpatient treatment, both patients had reduced NRS, NDI scores and increased ROM. After Korean medicine complex treatment, 2 patients with clavicle fracture showed to have been effective. But further studies need to be done.