• 디지털정책학회지
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• 1권1호
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• pp.21-26
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• 2022

본 연구에서는 요양병원이 입원비 지출 발생에 기여도가 큰점을 주목하여, 요양병원의 입원정책을 살펴보고, 불필요한 입원비발생을 유발한 점이 있다면, 해외사례를 참조하여 개선방안을 제안하고자 한다. 본 연구는 건강보험공단과 건강보험심사평가원에서 발행한 건강보험통계연보, 건강보험 주요통계를 주로 활용하여 연구를 진행하였다. 이를 바탕으로 요양병원이 입원비 발생에 가장 큰 기여를 한다는 것을 추론하였다. 본 연구 결과 요양병원의 입원규정이 명문화 되지 않았다는 문제점을 발견하였고, 명문화 되지않은 입원 기준이 불필요한 입원비 발생해 기여 할수 있다는 점을 발견하였고, 이를 극복하기 위한 개선방안을 우리보다 먼저 고령화를 경험한 미국의 사례에서 제안해보았다. 본연구를 시작으로 요양병원에서의 불필요한 입원비 지출을 줄인 보다 많은 외국의 사례들을 찾아야 할 것이다.

• 한국의료질향상학회지
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• 제11권1호
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• pp.16-30
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• 2004

Background: Although the number of cancer patients increase, the resources for cancer management are not increased. If the outpatient chemotherapy administration room is operated, the shift of patients from inpatient 10 outpatient is occurred. So the capacities for chemotherapy increased and the shifted rooms were occupied with new non-chemotherapy patients. The income of the hospital increased. The purpose of this study was to assess usefulness and cost-effectiveness of the outpatient-chemotherapy adminstration model. Method: There are six beds, two chairs and two nurses and one personnel in the outpatient chemotherapy room. The satisfaction study by patients/family and doctors and the cost analysis over 12 months, by comparing costs of chemotherapy administration at outpatient chemotherapy room with inpatient at ward and inpatient-nonchemotherapy at ward were done. Results: The 97.1 percent of patients/family and the 94.4 percent of doctor who involved chemotherapy were satisfied with outpatient chemotherapy administration. The 91.7% of doctors said there were no differences in treatment outcome between outpatient and inpatient chemotherapy administration. The average number of patients in outpatient chemotherapy room increased from 10.7 to 15.4 but in inpatient from 19.4 to 18.3. The average number of inpatient chemotherapy were not changed related to increase of the average number of outpatient chemotherapy. The profit between outpatient chemotherapy and inpatient chemotherapy administration was 45,344,710 won and the profit between outpatient chemotherapy and non chemotherapy treatment was -185,294,614 won. Conclusion: The outpatient chemotherapy administration model is good for patients/family, doctors and hospital partially. But the hypothesis described above was not correct. The process of cancer patients treatment were from diagnosis and treatment to first administration of chemotherapy. So the shift from inpatient to outpatient was not occurred. In economic aspect, the profit between outpatient chemotherapy and non chemotherapy treatment was in the red. As the level of health care fees was so low, the hospitals hesitate operating the room of outpatient chemotherapy. It is necessary to raise the level of health case fees for outpatient chemotherapy administration.

• 한방안이비인후피부과학회지
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• 제16권1호
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• pp.130-140
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• 2003

Objectives : Lately the oriental medical treatment of Bell's palsy is various. In various treatments. this study reports the effect of our clinical treatment using aqua-acupuncture with hominis placenta and electroacupuncture treatment for Bell's palsy, The other purpose of this study is to compare the outcome of inpatient group with that of outpatient group. Materials and Methods : From March 1, 2003 to June 30, 2003, we observe 25 patients who visited to the department of oriental medical surgery, ophthalmology & otolaryngology, in oriental medicine hospital Sang-ji university with Bell's palsy. limited to patients who receive treatment more than 5th times and 4 weeks poured aqua-acupunture with homonis placenta both inpatient group and outpatient group, Inpatient group used electroacupunture treatment after 1 week after onset and outpatient group used electroacupunture treatment after 4 weeks after onset. Results and Conclusions : 40$\%$ were male and 60$\%$ female. Of 25 cases. 30's and 50's were 24$\%$ respectively, 40's, 60's and over 70 were 16$\%$ respectively, 20's were 4$\%$. 50$\%$ of male and 60$\%$ of female had the affected side at left side and right occured at 50$\%$ of male and 40$\%$ of female. The most common cause of Bell's palsy was nonspecific 36$\%$, followed by labor 28$\%$, stress 20$\%$, In 48$\%$ of all cases, 2~3 days were spent before a patient visited the hospital after onset, followed by 4~7 days (24$\%$), 44$\%$ were treated 11~20 times followed by those who received 21~30 times (28$\%$). The results of treatment with aqua-acupunture wth hominis placenta and electroacupunture treatment showed that 21 of 25(84$\%$) patients achived fair or more recovery. the overall therapeutic rate of inpatient group was 90.9$\%$, which was higher than that of outpatient group(78.6$\%$).

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권3호
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• pp.196-202
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• 2018

Purpose: Treatment of chronic constipation and fecal impaction is usually outpatient and requires high or frequent doses of laxatives. However, there are children who fail outpatient treatments, sometimes repeatedly, and are ultimately hospitalized. We sought to compare the characteristics of the children who failed outpatient treatment and needed inpatient treatment vs those who achieved success with outpatient treatment, in an effort to identify attributes that might be associated with a higher likelihood towards hospitalization. Methods: In this retrospective cohort study, we reviewed the medical records of all patients aged 0 to 21 years, with chronic functional constipation and fecal impaction seen in the pediatric gastroenterology clinic over a period of 2 years. Results: Total of 188 patients met inclusion criteria. While 69.2% were successfully treated outpatient (referred to as the outpatient group), 30.9% failed outpatient treatment and were hospitalized (referred to as the inpatient group). The characteristics of the inpatient group including age at onset of $3.6{\pm}3.6years$ (p=0.02); black ethnicity (odds ratio [OR] 4.31, 95% confidence interval [95% CI] 2.04-9.09); p<0.001); prematurity (OR 2.39, 95% CI 1.09-5.26; p=0.02]; developmental delay (OR 2.20, 95% CI 1.12-4.33; p=0.02); overflow incontinence (OR 2.26, 95% CI 1.12-4.53, p=0.02); picky eating habits (OR 2.02, 95% CI 1.00-4.08; p=0.04); number of ROME III criteria met: median 4, interquartile range 3-5 (p=0.04) and $13{\pm}13.7$ constipation related prior encounters (p=0.001), were significantly different from the outpatient group. Conclusion: Identification of these characteristics may be helpful in anticipating challenges and potential barriers to effective outpatient treatment.

• 한국병원경영학회지
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• 제22권3호
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• pp.133-143
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• 2017

Purpose : This study is to analyze the inpatients's experience of medical services provided by hospital including medications, treatments, and environment. Based on the results of surveys conducted as part of the inpatient experience evaluation in A hospital in Goyang, Gyeonggi province. Methodology : A sample of 300 adults aged 19 years or older who had more than one day of hospitalization was selected. The questionnaire was conducted from April 3rd to June 21st, 2017 by telephone. Findings : It is found that recommendation intention influenced by medical services, hospital environment, medication treatment process. but it turns out that there is no moderate effects of health condition between patient's experience and recommendation. Practical Implication : In order to improve the inpatient experience, there should be a way to improve experience in providing patient-centered services in the hospital s environment, medication and treatment.

• 대한치과의사협회지
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• 제41권4호통권407호
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• pp.268-276
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• 2003

• 한국사회복지학회:학술대회논문집
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• 한국사회복지학회 2004년도 추계공동학술대회 자료집
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• pp.461-492
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• 2004

This study examined the effects of gender, parental support and treatment type on the treatment outcome of adolescent substance abusers. Outcome variable was the successful graduation (or drop) from an Intensive Adolescent Outpatient Program. Adolescents with their parents' support were treated in one of three treatment models (2-weeks Inpatient plus 6 week Intensive Croup-Oriented Outpatient, 8-weeks Intensive Croup-Oriented Outpatient, and 8-weeks Individual-Family Therapy) within a private hospital-affiliated treatment center by managed care practice allowing their own choice (non-random natural assignments). Several hypotheses were tested for main effects by the Log-Linear Analyses for a multi-dimensional contingency table with 440 adolescents (284 boys and 156 girls treated during 1992-l997) from middle-class families with private health insurances. The following results were found. Odds of graduating versus dropping out of the treatment program among : (1) girls were 1.7 times higher than those among boys; (2) adolescents with two-parent were 2.2 times higher than those among adolescents with one-parent ; (3) adolescents with Inpatient plus Outpatient was 1.7 times higher than that of those with Outpatient; (4) adolescents with Individual-Family Therapy was 2.3 times higher than that of those with Outpatient Model. There was no statistically significant outcome difference between the Individual-Family Therapy and the Inpatient plus Outpatient. Implications from the results were discussed. Suggestions were made to improve the treatment components in the areas of gender sensitivity, securing more parental support, alternatives for separation from peer group and integrating new peer groups, and flexibility for the unique needs of individual family. Also, some research questions for future studies were suggested.

• 임상간호연구
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• 제23권2호
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• pp.202-210
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• 2017

Purpose: In this study an investigation was done of injuries from inpatient falls and diagnostic tests and treatment after falls to identify what factors affect the occurrence of injury from inpatient falls in a tertiary hospital. Methods: Data for this cross-sectional study were retrieved for 428 fall events from data reported between January 1 and December 31, 2015 and were retrieved from the patient-safety reporting system in the hospital's electronic health records. A multivariate logistic regression model was developed with STATA 13.0. Results: Of the patients, 197 (46.0%) had physical injuries due to falls, 119 (27.8%) were given further diagnostic tests, and 358 (83.6%) received treatment including close observation after inpatient falls. Logistic-regression results identified that age, department, and risk factors had significant impact on injuries from falls. Conclusion: Findings indicate that to reduce the severity of injury after inpatient falls, each hospital should regularly evaluate identified factors, design fall-prevention practices specialized for elders and vulnerable patients, and initiate environmental and equipment innovations.

• 한국산학기술학회논문지
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• 제13권7호
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• pp.3094-3101
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• 2012

본 연구는 병원에서 제공하는 입원 서비스에 대한 입원환자 만족도를 분석하여 보다 나은 의료서비스를 제공하는데 활용하고, 의료서비스를 향상시켜 타 병원과의 경쟁에서 우위에 설 수 있도록 기초자료를 제공하고자 본 연구를 시도하였다. G시에 소재한 지방 상급종합병원의 입원환자를 대상으로 2011년 9월19일부터 9월 30일까지 설문조사를 실시하여 320부를 최종 분석한 결과, 첫째, 입원환자 서비스 만족도는 총 4점 만점에 평균 3.25점이였고, 둘째, 일반적 특성과 의료인서비스 만족도 결과는 진료과, 건강상태, 입원횟수에서, 병원 환경. 입 퇴원 절차 및 기타서비스 만족도에서는 연령, 진료과, 건강상태, 입원횟수에서 통계적으로 유의하였다. 셋째, 입원환자 서비스 만족도간의 상관관계에서는 통계적으로 유의미한 정(+)의 상관관계를 보였고, 넷째, 입원환자 만족도에 미치는 요인을 분석한 결과 의사서비스와 기타서비스가 통계적으로 유의미한 정(+)의 영향을 미치는 것으로 나타났다. 결론적으로 입원환자 만족도를 높이기 위해서는 환자와 접촉이 상대적으로 많은 진료과의 인력을 충분히 확보하고 입원기간 동안 환자가 만족 할 수 있는 다양한 프로그램 개발과 운영이 요구되며, 그에 따른 효과를 검증할 수 있는 후속 연구가 필요하다.

• Physical Therapy Rehabilitation Science
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• 제8권2호
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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.