• Title/Summary/Keyword: length of hospital stay

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Effects of Music Therapy on Pain, Anxiety and Length of Stay of Patients with Laparoscopic Hysterectomy in the Postanesthesia Care Unit (선호 음악요법이 복강경 자궁적출술 환자의 수술 후 통증, 불안 및 회복실 체류시간에 미치는 효과)

  • Son, Youn-Jung;Park, Young-Suk;Kim, Hye-Un;Choi, Ju-Yeon;Lee, Kyung-Mi;Yi, Young-Hee
    • Journal of Korean Biological Nursing Science
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    • v.17 no.1
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    • pp.28-36
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    • 2015
  • Purpose: This study examined the effects of music therapy on pain, anxiety and length of stay of patients undergoing laparoscopic hysterectomy in the postanesthesia care unit (PACU). Methods: Sixty patients who received laparoscopic hysterectomy under general anesthesia from a PACU in a university hospital located in Cheonan city participated in this study. The experimental group (n=30) was offered the option to listen to their preferred music by using MP3 players and headphones for 30 minutes. The control group (n=30) received routine postoperative nursing care. Visual analogue scale was used to measure participants' pain and anxiety, length of stay in the PACU was examined by using their medical records. Data were collected from December 2013 to February 2014 and analyzed by descriptive statistics, ${\chi}^2$-test, Fisher's exact test, and independent t-test using SPSS version 21.0. Results: The result showed that the level of post-operative pain (t=2.44, p=.018), anxiety (t=2.37, p=.021), and the length of stay in PACU (t=3.06, p=.004) significantly decreased in the experimental group as compared to the control group. Conclusion: This study indicated that music therapy with the patients' preferred music showed positive effects. Therefore, it can be used as a therapeutic intervention for postoperative pain management of patients with laparoscopic hysterectomy.

A Study on Evaluation of the Appropriateness of Hospitalization for Patients with Stroke (뇌졸중 환자의 재원 적절성 평가에 관한 연구)

  • Choi, Eun-Mi;Yoo, In-Sook
    • Journal of Digital Convergence
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    • v.10 no.3
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    • pp.233-240
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    • 2012
  • This study aimed to clarify any factors that may have effect on the appropriateness of hospital admission and hospitalization with the intention of facilitating more efficient occupancy of hospital beds and better medical services in the aspect of their quality, minimizing unnecessary occupancy of beds, and ultimately helping patients requiring acute treatments to use immediately hospitals. This paper selected 154 Stroke patients who left neurology department of one general hospital from March, 1, 2006 to September, 31, 2010 as targets to meet the rate according to medical care security and to see the trend of recent 4 years. As study method, this paper analized medical treatment record with AEP to evaluate the appropriateness of hospital admission and stay and the collected data was computerized through SPSS 12.0. Based upon the results above, the conclusion was drawn that the higher appropriateness of hospital admission and the shorter length of hospital stay will lead to the higher appropriateness of hospitalization. In other words, it is required to provide hospitalized patients with all kinds of behaviors including medical treatments and nursing care service, management of pharmaceuticals, tests, rehabilitation and symptoms, as well as instructions and information for patients. Meanwhile, as it was found that the length of hospital stay may affect the appropriateness of hospitalization, the longer length of hospital stay may result in reduced bed turnover rate. In this light, it is necessary to organize a task force team responsible for evaluation and control of the appropriateness of hospitalization and hospital stay length to improve the quality of medical service in a medical center, so that patients can leave the center timely. Ultimately, governmental supports such as expansion of long-term care facilities will reduce the necessary length of hospital stay so that patients with stroke can receive rehabilitative treatments and long-term care service shortly after completion of acute treatments.

Early Pleurodesis for Postoperative Air Leak with Autologous Blood and 50% Glucose Solution

  • Jeong In Hong;Jun Hee Lee;Hyun Koo Kim
    • Journal of Chest Surgery
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    • v.56 no.1
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    • pp.16-22
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    • 2023
  • Background: Postoperative air leaks after pulmonary resection prolong the duration of chest drainage and the length of hospital stay. One of the many treatment options is bedside pleurodesis using various agents. This study evaluated the feasibility of an early intervention to stop postoperative air leaks with either autologous blood or a 50% glucose solution. Methods: We retrospectively reviewed 323 patients who underwent bedside pleurodesis between January 2017 and March 2022. Sixty-four patients received autologous blood patch pleurodesis, and 36 were treated with a 50% glucose solution after pulmonary resection. The primary endpoints were the total postoperative tube indwelling time, post-pleurodesis tube indwelling time, and hospital stay. A propensity score-matched analysis was performed. Results: In the autologous blood patch pleurodesis and 50% glucose solution groups, the mean initiation timing of postoperative pleurodesis were 2.06±1.62 and 3.28±1.56 days, the mean duration of the tube indwelling time after surgery was 6.58±3.02 and 6.42±4.92 days, and the mean duration of the tube indwelling time after pleurodesis, it was 4.53±3.10 and 3.11±4.80 days, respectively. In addition, the total length of hospital stay was 9.11±5.42 and 7.83±4.75 days in the autologous blood patch pleurodesis and 50% glucose solution groups, respectively. Conclusion: Early postoperative air leak cessation with autologous blood patch pleurodesis or 50% glucose solution pleurodesis is a feasible procedure with acceptable outcomes that effectively shortens the hospital stay.

In-hospital malnutrition among adult patients in a national referral hospital in Indonesia

  • Dyah Purnamasari;Nur Chandra Bunawan;Dwi Suseno;Ikhwan Rinaldi;Drupadi HS Dillon
    • Nutrition Research and Practice
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    • v.17 no.2
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    • pp.218-227
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    • 2023
  • BACKGROUND/OBJECTIVES: Malnutrition during hospitalization is linked to increased morbidity and mortality, but there are insufficient studies observing clinical factors contributing to weight loss during hospitalization in Indonesia. This study was therefore undertaken to determine the rate of weight loss during hospitalization and the contributing factors. SUBJECTS/METHODS: This was a prospective study involving hospitalized adult patients aged 18-59 yrs, conducted between July and September 2019. Body weight measurement was taken at the time of admission and on the last day of hospitalization. The factors studied were malnutrition at admission (body mass index < 18.5 kg/m2), immobilization, depression (Beck Depression Inventory-II Indonesia), polypharmacy, inflammatory status (neutrophil-lymphocytes ratio; NLR), comorbidity status (Charlson Comorbidity Index; CCI), and length of stay. RESULTS: Totally, 55 patients were included in the final analysis, with a median age of 39 (18-59 yrs) yrs. Of these, 27% had malnutrition at admission, 31% had a CCI score > 2, and 26% had an NLR value of ≥ 9. In all, 62% presented with gastrointestinal symptoms, and depression was documented in one-third of the subjects at admission. Overall, we recorded a mean weight loss of 0.41 kg (P = 0.038) during hospitalization, with significant weight loss observed among patients hospitalized for 7 days or more (P = 0.009). The bivariate analysis revealed that inflammatory status (P = 0.016) was associated with in-hospital weight loss, while the multivariate analysis determined that the contributing factors were length of stay (P < 0.001) and depression (P = 0.019). CONCLUSIONS: We found that inflammatory status of the patient might influence the incidence of weight loss during hospitalization, while depression and length of stay were independent predictors of weight loss during hospitalization.

Does Market Competition Reduce Hospital Charges & LOS for the Degenerative Lumbar Spinal Disease?: A Two-point Cross Sectional Study (병원시장 경쟁이 퇴행성 요추질환 환자의 진료비 및 재원일수에 미치는 영향)

  • Lee, Joo Eun;Park, Eun-Cheol;Lee, Sang Gyu;Kim, Tae Hyun
    • Korea Journal of Hospital Management
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    • v.22 no.4
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    • pp.33-49
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    • 2017
  • Background: Health care utilizations and costs of the patients with degenerative lumbar spine disease in Korea increased dramatically. We analyzed whether hospital market competition is associated with charges and length of stay for patients with degenerative lumbar spine disease. Methods: We used Medical claims data of 2002 and 2010 from the nationwide representative sample of National Health Insurance Service of Korea. The study subjects were inpatients with degenerative lumbar spine disease (N=24,768) in 2002 and 2010. We employed a multilevel linear mixed model that included patient- and hospital-level variables in hierarchical data. Results: Higher hospital competition was associated with lower charges (${\beta}=57.5$, p<.0001 in 2002; ${\beta}=353.7$, p<.0001 in 2010) and shorter length of stay (${\beta}=0.3$, p<.0001 in 2002; ${\beta}=0.9$, p<.0001 in 2010) in both 2002 and 2010. Compared to 2002, the magnitude of such association became greater in 2010. However, subgroup analyses show that the influence of competition on charges and length of stay differed by hospital size. Conclusions: This study showed that hospital market structure (e.g., hospital competition) affects hospital efficiency (i.e., hospital charges and length of stay). It is necessary to continue to monitor how changing market structure influences hospital outcomes, including more detailed outcomes such as patient satisfaction.

Analysis of Total Hospital Charges, Length of Stay, and Cost of Rehabilitation by Hospital and Stroke Type (의료기관별 뇌졸중 유형에 따른 진료비, 재원일수 이학요법료의 차이분석)

  • Kim, Sun-Mi;Kim, Da-Yang;Lee, Kwang-Soo
    • The Korean Journal of Health Service Management
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    • v.11 no.1
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    • pp.91-105
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    • 2017
  • Objectives : This study analyzed the differences in length of stay(LoS), total hospital charges(THC), and cost of rehabilitation(CoR) between two types of stroke patients, intracerebral hemorrhage(ICH) and cerebral infarction(CI). Factors associated with these differences were also assessed. Methods : Data were obtained from the 2011 National Inpatient Sample data of Health Insurance Review and Assessment Service. We used propensity score matching to match the characteristics of the two types of stroke patients, and conducted a regression analysis to analyze their associations. Results : The differences between THC, LoS, and CoR by stroke and hospital types were shown. Each type of hospital showed different results. Conclusions : A rapidly aging population will accelerate the number of stroke patients requiring effective management. Studies evaluating healthcare utilization of stroke patients will provide evidence for both healthcare resources allocation and healthcare policy decisions.

A Case Study of Food Qualiy in a Hospital Foodservice System -With Special Reference to Patient Satisfaction- (병원영양과의 급식 평가 사례 연구 -환자 만족도를 중심으로-)

  • 김혜진
    • Journal of Nutrition and Health
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    • v.29 no.3
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    • pp.348-356
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    • 1996
  • A survey of one hospital foodservice system in Seoul was undertaken and detailed in formation was collected from 538 patients. Patient satisfaction with the quality of hospital food and food-related service was evaluated by questionnaire survey. It was measured by assessing 24 variables. The effect of medical treatments, age, length of stay and appetite on patients' satisfaction satisfied with the food served, although the variety of food and seasoning of food received the lowest score. The highest rated items were attitude of personnel serving food, the portion size of cooked rice, and the cleanliness of dishes and tray. Younger patients were significantly less satisfied than were older patients. Female patients were significantly more satisfied nificantly more satisfied than were other patients. Medical treatments, age, length of stay of stay and appetite were found to be significantly correlated with patient satisfaction scores. Foodservice attributes for improvement were taste of meals, selection and variety of food and temperature of food.

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A Study on analysis of severity-adjustment length of stay in hospital for community-acquired pneumonia (지역사회획득 폐렴 환자의 중증도 보정 재원일수 분석)

  • Kim, Yoo-Mi;Choi, Yun-Kyoung;Kang, Sung-Hong;Kim, Won-Joong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.3
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    • pp.1234-1243
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    • 2011
  • Our study was carried out to develop the severity-adjustment model for length of stay in hospital for community-acquired pneumonia so that we analysed the factors on the variation in length of stay(LOS). The subjects were 5,353 community-acquired pneumonia inpatients of the Korean National Hospital Discharge In-depth Injury Survey data from 2004 through 2006. The data were analyzed using t-test and ANOVA and the severity-adjustment model was developed using data mining technique. There are differences according to gender, age, type of insurance, type of admission, but there is no difference of whether patients died in hospital. After yielding the standardized value of the difference between crude and expected length of stay, we analysed the variation of length of stay for community-acquired pneumonia. There was variation of LOS in regional differences and insurance type, though there was no variation according whether patients receive their care in their residences. The variation of length of stay controlling the case mix or severity of illness can be explained the factors of provider. This supply factors in LOS variations should be more studied for individual practice style or patient management practices and healthcare resources or environment. We expect that the severity-adjustment model using administrative databases should be more adapted in other diseases in practical.

The Variation of Factors of severity-adjusted length of stay(LOS) in acute stroke patients (급성 뇌졸중 환자의 중증도 보정 재원일수 변이에 관한 연구)

  • Kang, Sung-Hong;Seok, Hyang-Sook;Kim, Won-Joong
    • Journal of Digital Convergence
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    • v.11 no.6
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    • pp.221-233
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    • 2013
  • This study aims to develop the severity-adjusted length of stay(LOS) model for acute stroke patients using data from the hospital discharge survey and propose management of length of stay(LOS) for acute stroke patients and using for Hospital management. The dataset was taken from 23,134 database of the hospital discharge survey from 2004 to 2009. The severity-adjusted LOS model for the acute stroke patients was developed by data mining analysis. From decision making tree model, the main reasons for LOS of acute stroke patients were acute stroke type. The difference between severity-adjusted LOS from the decision making tree model and real LOS was compared and it was confirmed that insurance type and bed number of hospital, location of hospital were statistically associated with LOS. And to conclude, hospitals should manage the LOS of acute stroke patients applying it into the medical information system.

Relationship between the Distribution of Comorbidity and Length of Stay and Medical Cost for Planning Integrated Community Care Services among Inpatients at a Seoul Municipal Hospital (지역사회 통합 케어서비스 방안 마련을 위한 시립병원 입원환자의 동반질환 분포와 재원일수 및 진료비와의 관련성)

  • Kim, Jae-Hyun;Noh, Jin-Won;Lee, Yunhwan;So, Yekyeong;Hong, Hyeonseok
    • Health Policy and Management
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    • v.29 no.4
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    • pp.445-453
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    • 2019
  • Background: This study is to investigate the association between the distribution of multimorbidity and length of stay and medical expenses among inpatients in a municipal hospital to achieve an integrated care setting. Methods: We used the exploratory factor analysis and the generalized estimating equation model to analyze the data from patients living in the northeast region of Seoul, who were hospitalized from January 2017 to December 2017 in a municipal hospital. Results: As a result of the factor analysis, seven types of multiple chronic diseases were classified. Among the elderly patients admitted to municipal hospitals, the burden of medical expenses was mainly influenced by the length of stay (B=310,719, p-value <0.0001), not the type of disease (all not significant). Length of stay were mainly due to psychiatric illness (factor 1: B=4.323, p-value <0.0001) related to the brain and metabolic diseases (factor 2: B=2.364, p-value=0.003). Conclusion: This study showed that the medical expenses of the elderly patients were largely due to prolonged hospitalization, not multimorbidity. Therefore, it is necessary to develop an integrated care paradigm strategy cope with the multimorbidity of the elderly in the community and to alleviate the socio-economic burden.