• 기본간호학회지
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• 제6권3호
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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.

• 보건의료산업학회지
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• 제3권1호
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• pp.14-24
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• 2009

This study aims at deriving any useful information necessary to strengthen the competitiveness for growth through empirical analyses on general hospital located in a province in order to countermeasure the opening and competition of medical markets. The characteristics of user were identified on the basis of disease groups under KCD in the research method. In addition, the analysis on the expenses of diagnosis and treatment was divided into the treatment progress and degree of hospital resource utilization And the regression was carried out to identify the impacts of characteristics of inpatient users on the degree of hospital resource utilization. As a result of major research, the inpatient users of the general hospital located in the provincial area in consideration of inpatient users were formed around the inpatient disease groups representative for Korea(diseases of the respiratory system, injury and poisoning & certain other consequences of external causes). And it was understood that most of residents within a distance of 40 minute by the public transportation were using. And mostly were under the age of 9 or over 60, and the provision of medical features such as the degree of consultation and operational functions were inadequate. When we classify inpatient treatment cost for each resource application as the medical cost being the center of patient care function, the equipment and human resource application sector are constituted over half. Accordingly, the following suggestions are made as plans to strengthen the competitiveness for the growth of general hospitals located in the provincial areas on the basis of analytical results. First, it is necessary to have the characterization matching to the age and disease groups with a high frequency. Second, it is necessary to increase the degree of hospital resource utilization according to the characterization. Third, it is necessary to concentrate on public relations. The above suggestion, as a method for securing image improvement and competitive power as a general hospital, and through expansion of social function that a regional general hospital needs to secure not only as an individual institution but also as a general hospital, it can be seen that a general improvement of image as a regional general hospital is possible.

• Clinics in Shoulder and Elbow
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• 제26권4호
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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.

• 보건행정학회지
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• 제13권3호
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• pp.129-147
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• 2003

This study is to grasp a trend of profitability classified by characteristics of hospitals and to analyze related factors. Subjects are 145 hospitals which have gotten the standardization audit by Korean Hospital Association during 1998-200l. Profitability was measured in the aspect of operation profit rate with operating margin to gross revenue as proxy variables. Independent variables were classified by general factors (ownership, number of beds, period of establishment, competition), financial factors (liabilities to total assets, current ratio, fixed ratio, total asset turnover, inventories turnover), and factors related to patient treatment (average length of stay, bed occupancy rate, new outpatient ratio, admission ratio of outpatients, number of patients per specialist, personnel costs per adjusted inpatient, administrative costs per adjusted inpatient). Hierarchical multiple regression analysis model was used in this study. As a result of hierarchical multiple regression analyzation of operating margin to gross revenue, adjustive $R^2$ of general factors was relatively more powerful. The factors had significant effect on operating margin to gross revenue were ownership(+), number of beds(+), competition(+), current ratio(+), fixed ratio(+), total asset turnover(+), personnel costs per adjusted inpatient(-).

• 한국의류학회지
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• 제21권5호
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• pp.854-864
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• 1997

This study was initiated to develop a uniform design suitable for child inpatients. The experimental hospital inpatient uniform design was developed based on the results of the prior studies. The panel was composed of 5 experienced nurses and 5 clothing specialists. They evaluated the function of the experimental inpatient uniforms developed in this study. The experimental hospital gown design was reformed based on the panel's evaluation.1'hen the child inpatients performed the wear test for the reformed experimental hospital gown. The results of the study are as follows; 1. The child inpatient hospital gown design of the most hospitals were similar to the adult patient's uniform : the V-neckline shirts with full length set-in sleeves. The bottom was full length pull-on pants. The fabric was white cotton with blue hospital logo and stripe print in most cases. 2. The panel's specialty affected the evaluation of the uniform design. The nurses concerned about the durability after washing and ease for medical treatment. The clothing specialists cared about the features related to the clothing construction and ease for physical movement of body. 3. The most preferred hospital inpatient uniform design by the panels was the shirts or one- piece gown with three-quarter length sleeve and overarm seam opening. 4. The researchers developed one-piece dress gown for the children under two years old. Three different size pajamas were developed for children 2∼5 years old,5∼8 years and 8∼12 years old.

• 대한약침학회지
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• 제17권1호
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• pp.20-26
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• 2014

Objectives: The study aimed to determine changes in laboratory data for cancer patients receiving Korean medicine (KM) care, with a focus on patients' functional status, cancer-coagulation factors and cancer immunity. Methods: We conducted an observational study of various cancer patients in all stages admitted to the East-West Cancer Center (EWCC), Dunsan Korean Hospital of Daejeon University, from Mar. 2011 to Aug. 2011. All patients were under the center's multi-modality Korean-medicine-based inpatient cancer care program. The hospitalization stay at EWCC ranged from 9 to 34 days. A total of 80 patients were followed in their routine hematologic laboratory screenings performed before and after hospitalization. Patients were divided into three groups depending on the status of their treatment: prevention of recurrence and metastasis group, KM treatment only group, and combination of conventional and KM treatment group. The lab reports included natural killer cell count (CD16 + CD56), fibrinogen, white blood cell (WBC), lymphocytes, monocytes, neutrophil, red blood cell (RBC), hemoglobin, platelet, Erythrocyte Sedimentation Rate (ESR), and Eastern Cooperative Oncology Group (ECOG) performance status. Results: With a Focus on patients' functional status, cancer-coagulation factors and cancer immunity, emphasis was placed on the NK cell count, fibrinogen count, and ECOG scores. Data generally revealed decreased fibrinogen count, fluctuating NK cell count and decreased ECOG, meaning improved performance status in all groups. The KM treatment only group showed the largest decrease in mean fibrinogen count and the largest increase in mean NK cell count. However, the group's ECOG score showed the smallest decrease, which may be due to the concentration of late-cancer-stage patients in that particular group. Conclusions: Multi-modality KM inpatient care may have positive effect on lowering the cancer coagulation factor fibrinogen, but its correlation with the change in the NK cell count is not clear.

• Journal of Oral Medicine and Pain
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• 제33권1호
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• pp.15-26
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• 2008

다양한 전신질환으로 입원한 환자들 중에서 구강질환을 진료받기 위해서 내원한 환자의 전신질환 상태와 치과적인 주소 및 진단명 그리고 치료내용을 조사하고 이와 관련된 구강내과적인 주소가 무엇인지를 관찰함으로써 입원한 전신질환자와 구강질환과의 상관관계를 파악하고자 본 연구를 시행하여 다음과 같은 결론을 얻었다. 1. 구강질환을 진료받기 위해서 내원한 환자의 전신질환은 인슐린-비의존성 당뇨병 26%, 뇌경색 25.2%, 뇌내출혈, 다발성 관절증, 고관절증 각각 4.7%, 신경근 및 신경총 장애, 고혈압성 심장 및 신장 질환, 강직성 척추염 각각 2.4% 등의 순서로 나타났다. 2. 내원한 환자의 주소는 치통 28.6%, 정기검사 23%, 치아동요 8.7%, 치아지각과민 7.1%, 치주출혈 6.4% 등의 순서로 나타났다. 3. 내원한 환자의 진단된 구강질환은 치은염 및 치주질환 28.9%, 치아우식증 17.1%, 치수 및 치근단주위의 질환 15.1%, 타액선의 질환 10.5%, 치아경조직의 기타질환 8.6% 등의 순서로 나타났다. 4. 내원한 환자의 치료내용은 치주치료 17.95%, 치료거부 16.67%, 구강건조 및 구취 제거를 위한 약물치료 13.46%, 발치치료 12.18%, 보철치료 8.97% 등의 순서로 나타났다. 5. 내원한 환자의 구강내과적인 주소는 16% 이었으며, 구강연조직질환 6.4%, 두개하악장애 5.6% 그리고 구취 4% 등의 순서로 나타났다. 이상의 결과로 입원한 전신질환자를 통해서 전신질환이 있는 환자의 구강질환과 구강질환이 있는 환자의 전신질환에 대해서는 일정부분 파악이 되었으나 향후 구강질환과 전신질환과의 상관관계에 대한 연구가 계속적으로 이루어져야 한다고 사료된다.

• Journal of Oral Medicine and Pain
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• 제34권2호
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• pp.123-132
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• 2009

다양한 전신질환으로 입원한 환자들 중에서 구강질환을 진료받기 위해 내원한 구강내과적인 문제가 있는 54명 환자의 전신질환 상태와 치과적인 주소 그리고 구강질환 진단명을 조사함으로써 입원한 전신질환자의 구강내과적인 진료의 실태를 파악하고자 본 연구를 시행하여 다음과 같은 결과를 얻었다. 1. 구강내과 질환이 있는 환자는 남자 24명(44%) 여자 30명(56%) 이었으며, 연령은 50대 20명(37%), 60대 14명(26%), 40대 12명(22%), 30대 4명(7%) 순 이었다. 2. 전신질환의 진단명은 내분비, 영양 그리고 대사장애 36%, 순환계질환 36%, 신경계질환 10% 순 이었다. 3. 구강질환의 주소는 정기검사 26%, 두개하악장애 18%, 연조직 문제 18% 순 이었다. 4. 구강질환의 진단명은 타액선질환 32%, 치은염 및 치주질환 23%, 치아안면 이상증 16% 순 이었다. 이상의 결과로 입원한 전신질환자를 통해서 전신질환이 있는 환자의 구강질환과 구강내과적인 질환의 특성을 일정부분 파악하였으나 향후 구강질환과 전신질환과의 상관관계에 대한 연구가 계속적으로 이루어져야 한다고 사료된다.

• 한국임상약학회지
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• 제23권2호
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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.

• 한국병원경영학회지
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• 제17권1호
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• pp.23-42
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• 2012

The purpose of this study is to identify the inpatient service quality at mental hospitals and to examine the effect of service quality on patient's overall satisfaction and customer loyalty. Data collection was done through conducting a survey of inpatients in three mental hospitals located in Chungnam, Korea using self administered questionnaire. The questionnaire included the modified version of 'service satisfaction scale for psychiatric patients' invented by Chul Kwon Kim and other members, which consists of five dimension of service quality: staff attitude, treatment quality, ward environment, access/cost and ward rule. Total 236 questionnaires were gathered and 219 were used for analysis. The data was analyzed by using version SAS9.2 and path analysis model was applied to test our hypothesis. As a result, the four factors of service (staff attitude, treatment quality, ward environment and ward rule) were extracted, which counted for 62.89% of the common variance. Moreover, Cronbach Alpha showed relatively high internal consistency of answer, all exceeding 0.6. According to the study, ward environment and treatment quality turned out to have direct influence on the patient's satisfaction. In addition, staff attitude and overall satisfaction directly influenced the customer loyalty while ward environment and ward rule indirectly had influence using overall satisfaction as a medium. In conclusion, in order to enhance the satisfaction and customer loyalty in mental hospitals, efforts in improving environmental service quality in particular is highly demanded.