• International Journal of Heart Failure
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• v.6 no.1
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• pp.1-10
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• 2024

Heart failure (HF) stands as a prevalent chronic ailment, imposing a substantial burden on global healthcare systems due to recurrent hospitalizations, intricate management, persistent symptoms, and polypharmacy challenges. The augmentation of patient safety and treatment efficacy across various care stages, facilitated by a multidisciplinary HF team inclusive of a clinical pharmacist, emerges as paramount. Evidence underscores that the collaborative engagement of a physician and a clinical pharmacist engenders proficient and secure management, forestalling avoidable adversities stemming from drug reactions and prescription inaccuracies. This synergistic approach tailors treatments optimally to individual patients. Post-discharge, the vulnerability of HF patients to re-hospitalization looms large, historically holding sway as the foremost cause of 30-day readmissions. Diverse strategies have been instituted to fortify patient well-being, leading to the formulation of specialized transitional care programs that shepherd patients effectively from hospital to outpatient settings. These initiatives have demonstrably curtailed readmission rates. This review outlines a spectrum of roles assumed by clinical pharmacists within the healthcare cohort, spanning inpatient care, transitional phases, and outpatient services. Moreover, it traverses a compendium of studies spotlighting the affirmative impact instigated by integrating clinical pharmacists into these fields.

• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.80-92
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• 1999

The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

• Korean Journal of Psychosomatic Medicine
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• v.19 no.2
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• pp.66-73
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• 2011

Objectives:The present study investigates the status of inpatient psychiatric consultations at a general hospital in order to find factors that contribute to treatment compliance related to psychiatric consultations. Methods:The subjects were 333 patients who were hospitalized at Korea University Medical Center Ansan Hospital from 1 September 2009 to 31 July 2010.The patients were referred for psychiatric consultation during hospitalization. This study investigates demographic data, request department, referral causes, requestor, psychiatric history and diagnosis, andpsychiatric treatment compliance. Treatment compliance was defined as whether or not the patient had accepted psychiatric treatment during hospitalization or outpatient department(OPD) follow-up. This study ascertains the factors that have impact on compliance, by taking binary logistic regression with compliance and other variables. Results:Among the patients that were offered psychiatric treatment during hospitalization(N=310), treatment compliance was 82.9%. Among the patients that were offered OPD treatment(N=111), compliance was 55.8%. Elderly group(>65 years) showed better compliance to treatment during hospitalization than the younger patient group(OR=4.838, p=0.004). Patients with secondary psychiatric disorders showed better OPD follow-up compliance than patients with secondary psychiatric disorders(OR=8.520, p=.008). Conclusion:Elderly patients showed better compliance for psychiatric treatment during hospitalization. However they commonly have disorders such as delirium and mood disorders that have impact on the patient's physical state, hence further active measures should be carried out. Patients referred due to primary psychiatric disorders showed poor OPD compliance. Therefore clinicians have to suggest multidisciplinary interventions that will improve treatment compliance of such patients.

• Journal of Korean Academy of Nursing
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• v.13 no.1
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• pp.42-53
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• 1983

The purpose of this study is to help the care of patient and to his family through comparison of the level of anxiety which between the family of admitted patient and the family without in patient, and to his family through comparison of the level of anxiety which between the family of admitted patient and the family without inpatient and exclude the factors which raised the level of anxiety in them. The experimental group in this study were samples of 200 patient's family selected by random sampling in H. University hospital located in Seoul (Department of patient were internal medicine, surgery, pediatrics and neuropsychiatry). The control group were samples of 70 family without inpatient selected by random sampling in Seoul. The data were collected through STAI (State-Trait Anxiety Inventory) by Spielberger (1970) for measurement to level of state and trait anxiety from April 1st to April 15th in 1982. The contents of data analysis by EDPS included the difference of level of anxiety between experimental and control group, correlationship between general characteristics of experimental group and level of anxiety, and correlation of trait and state anxiety in experimental group. The Findings of this study were as follows: 1) Level of anxiety of experimental group is higher than control group. 2) In the correlation between general characteristics and level of anxiety of experimental group, there were no significant difference which revealed in correlation with age of family member, family life cycle, marital status, the relation between patient and family member, the degree of symptom, number of admission, admission or nonadmission of medical insurance, number of family member, and division of disease to level of anxiety However, according to the sex of family member, hospitalization period, a monthly income of family, the degree of confidence toward medical team, religion of family, academic background of family, a tendency of significant differences to level of anxiety were seen. To put them in the concrete, they were as follow; a) Level of. anxiety on female family member is higher than male in experimental group. b) Admission period of patient is positively related to the level of anxiety of patient's family. c) The degree of confidence of patient's family toward medical team is in inverse proportion to the level of anxiety. d) A monthly income of patient's family is in inverse proportion to the level of anxiety. e) Levlt of anxiety of believer in patient's family is lower than unbeliever. f) The academical background of patient's family is in inverse proportion to the level of anxiety g) Level of state anxiety of patient's family at the time of admission is positively related to the level of trait anxiety.

• Journal of Digital Convergence
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• v.13 no.7
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• pp.259-268
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• 2015

This research grasped the difference of between the daily medical expenses and the medical expenses reduction rate also the cause of change. In the centre, it was conducted in order to offer the necessary basic data to a recuperation pay management solution's establishment. This research surveyed across the country's urban region 50-general hospital's the infective enteritis disease for a year. Then it was conducted the average daily medical expenses and the average medical expenses reduction rate as a distinguishable survey that is a hospitalization and an outpatient the result is followed. The inpatient daily medical expenses correlated with the total number of medical institution personnel, and the outpatient daily medical expenses correlated with the number of beds.. Inpatient medical expense reduction rate was correlated with number of beds and the total number of medical institution personnel. The interaction between medical institution information and daily medical expenses was found to have a positive (+) effect on the total number of medical institution personnel, as well as the numbers of inpatients vs. outpatient. This research about the medical expense reduction rate and daily medical expense help medical institution's efficient, rational decision making and it will be an important basis of a priority recuperation pay's policy.

• The Journal of the Korea Contents Association
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• v.17 no.4
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• pp.585-595
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• 2017

The purpose of this study is to analyze the difference of medical care between medical assistance and health insurance patients to evaluate the increase of medical care costs due to the moral hazard of medical care patients and to provide a basis for rational medical care policy decision. For this purpose, we compared health insurance benefit data for Seoul citizens by gender, age, and type of medical institutions. The results of the analysis are as follows. First, all of the hospitalized and outpatient use of the advanced general Hospitals, medical assistance patients were less than those of the health insurance patients, so that the medical assistance patients could not use the high cost medical services. Second, in general hospitals, patients with health insurance are often hospitalized. On the other hand, medical assistance patients use a lot of outpatient services because they are less burdened. Third, in hospitals and clinics, medical benefits patients often use inpatient and outpatient services. Therefore, medical assistance patients are likely to use unnecessary medical care of outpatient and hospitalization clinics and hospitals, outpatient of general hospitals. But, in hospitalization and outpatient use in advanced general hospitals and medical assistance patients can not use due to excessive medical burden. Therefore, the policy to reduce the burden of medical expenses for patients with severe illness will continue, and the medical care patients using clinics and hospitals should be careful not to use unnecessary medical services.

• The Journal of the Korea Contents Association
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• v.17 no.11
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• pp.435-445
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• 2017

This study was conducted to overcome the limitations of prior research on the equity of medical care performed by identifying simple differences in the use of medical care or using limited medical needs and medical utilization indicators. Specifically, we used activity limits, chronic diseases, and subjective health status as medical needs, and used outpatient, inpatient, and emergency services as medical uses. In addition, we used concentration index, concentration curve, and Le Grand factor to analyze the equity of medical use considering medical needs. The main results are as follows. First, the amount of medical care for the low-income class is higher than that of the high-income class when considering the concentration of medical use. In particular, the number of hospitalization days for low-income households and hospitalization fees were higher than the fees of outpatient medical consultation and emergency room usage. Second, medical needs were concentrated in the low income class. In other words, low-income group is not as healthy as the high-income group. Third, the Le Grand factor was calculated in order to confirm the fairness of the medical uses considering the medical needs. Even if medical needs are taken into consideration, the high-income earners will have a large amount of medical care. In addition, when considering the limitation of activity and the number of chronic diseases, the medical use of the high income class was more frequent. However, when the subjective health condition and the chronic illness were considered, medical use of the low income class was more frequent. This may be due to the underestimation of the medical needs of the low-income earners by neglecting their own health status and perception of chronic diseases.

• Korean Journal of Health Education and Promotion
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• v.17 no.2
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• pp.183-205
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• 2000

This research was designed to compare the health condition and the quality of life of the elderly inpatients with those of the normal elderly people. The subjects of study were 482 elderly inpatients and 304 normal elderly people. The research was conducted in July and August using the instrument WHOQOL. The results of the research are as follows: For the level of health, it was recognized that male was healthier than female, having higher the education, living in the city rather than in the rural, keeping the normal life than being in the hospital. There were little difference in the past medical histories of the elderly inpatients and the normal elderly people. As to the diseases currently under the treatment, there were some difference between the elderly inpatients and the normal elderly people but the tendency was similar in the kinds and the frequencies. As to the recognition for the quality of life between the elderly inpatients and the normal elderly people based on the records reflected on each of the domains of WHOQOL, the normal elderly people more positively recognized in the overall quality of life and the following domains: physical, psychological, level of independence, and spirituality/religion/personal beliefs. The normal elderly people more positively recognized especially in the level of independence domain (mobility, activities of daily living, dependence on medication or treatments, working capacity). In the social relationships domain only the sexual activity was significant and the normal elderly people more positively recognized. The elderly inpatients showed the correlation of over 0.5 in the overall quality of life and the following domains: environment, social relationships, physical, psychological, level of independence. It was over 0.6 in the physical domain and the domains of psychological and level of independence. and the psychological domains of level of independence and social relationships. For the points of overall quality of life, it had no correlation with hospitalization but the health condition, residential district, occupation, and taste exerted a significant effect. As a result of separate analyses of the elderly inpatients and the normal elderly people, the health condition and the age only were the common variable which would exercise a significant effect. Besides, the primary factors which would exercise the quality of life were the occupation and taste for the elderly inpatients, and the residential district and source of income for the normal elderly people. In conclusion, it is first and foremost important to improve the standard of health for the overall quality of life for the elderly people, regardless of hospitalization. Therefore, a plan must be urgently drawn up for revitalization of the health promoting projects for the elderly people and the public health projects for the elderly people, and the investment must be increased for settlement of health problems of the elderly people.

• Journal of Industrial Convergence
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• v.20 no.10
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• pp.51-59
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• 2022

This study aims to investigate the changes in health status of inpatients before and after a fall accident, and it is a retrospective study using data from 328 inpatients who fell from January 1, 2016 to December 31, 2020, reported to the patient safety reporting system. The average age of the study subjects was 68.57(±14.13), and those in their 70s accounted for the most at 30.49%. Falls occurred on average 13.86(±25.03) days after hospitalization, and the time when the most falls occurred was between 22:30 and 06:59 with 42.99%. Before and after a fall during hospitalization, bowel problems (x²=314.0, p<.001), urination problems (x²=284.0, p<.001), intravenous fluid therapy (x²=85.16, p<.001), and walking (x²=69.77. p<.001), bedridden state (x²=51.60, p< .001), mental state and performance (x²=17.52, p<.001) patient's attitude (x²=220.17, p<.001), there was a statistically significant difference. It is necessary to develop an appropriate method and education program for fall prevention in hospital by considering the individual characteristics of inpatient.

• Korean Circulation Journal
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• v.53 no.12
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• pp.829-839
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• 2023

Background and Objectives: There is limited data on the impact of type 2 myocardial infarction (T2MI) during the coronavirus disease 2019 (COVID-19) pandemic. Methods: The National Inpatient Sample (NIS) database from January 2019 to December 2020 was queried to identify T2MI hospitalizations based on the appropriate International Classification of Disease, Tenth Revision-Clinical Modification codes. Monthly trends of COVID-19 and T2MI hospitalizations were evaluated using Joinpoint regression analysis. In addition, the multivariate logistic and linear regression analysis was used to compare inhospital mortality, coronary angiography use, and resource utilization between 2019 and 2020. Results: A total of 743,535 patients hospitalized with a diagnosis of T2MI were identified in the years 2019 (n=331,180) and 2020 (n=412,355). There was an increasing trend in T2MI hospitalizations throughout the study period corresponding to the increase in COVID-19 hospitalizations in 2020. The adjusted odds of in-hospital mortality associated with T2MI hospitalizations were significantly higher in 2020 compared with 2019 (11.1% vs. 8.1%: adjusted odds ratio, 1.19 [1.13-1.26]; p<0.01). In addition, T2MI hospitalizations were associated with lower odds of coronary angiography and higher total hospitalization charges, with no difference in the length of stay in 2020 compared with 2019. Conclusions: We found a significant increase in T2MI hospitalizations with higher in-hospital mortality, total hospitalization costs, and lower coronary angiography use during the early COVID-19 pandemic corresponding to the trends in the rise of COVID-19 hospitalizations. Further research into the factors associated with increased mortality can increase our preparedness for future pandemics.