• 한국의료질향상학회지
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• 제2권2호
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• pp.56-71
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• 1996

Background : Review of readmissions in health care facilities is necessary from the viewpoint of both economic concerns and quality considerations. To identify the characteristics, factors, and causes of multiple admissions in comparison with single admissions is essential for both providers and payers in order to assure quality care and efficient use of medical resources. Methods: All discharges from an university hospital in 1993 were analyzed, and the characteristics of multiple admissions were identified and were compared with those of single admissions by using the data bases of the discharge abstract and billing for reimbursement. Medical records of patients readmitted within 6 days after the previous discharge were reviewed to identify the reasons for such prompt readmission. Statistical analysis between groups of patients were performed by using SPSS. Result : The mean age was higher in multiple admissions than those of single admissions, and the average length of stay was longer in multiple admissions than in single admissions. The hospital cost per day is higher in single admissions while the cost per case is higher in multiple admissions. More than half of readmissions occurred within one month after the preceding discharges. Above 15% of the readmission within 6 days after the preceding discharges seemed to have close relationship with quality of care provided during the preceding hospitalization. The death rate of the patients readmitted within 6 days was the highest in comparison with multiple admissions and single admissions. Conclusion : Potential preventable readmissions should be reduced by identifying characteristics of multiple admissions, especially unplanned readmission, and by applying some interventions such as standard predischarge assessment or careful follow-up care after discharge for high risk readmission groups. As the results of these efforts, health care facilities could achieve quality improvement in medical care, and effective use of hospital resources.

• 의학교육논단
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• 제12권2호
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• pp.13-18
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• 2010

This study is aimed to reflect non-cognitive traits that should be assessed in admissions interviews for medical school applicants, with the goal being to increase the reliability of the admissions interview. The admissions interview is valued for its ability to assess noncognitive and nonteachable attributes of good doctors, especially which cannot be evaluated with other admission assessment tools. Various characteristics of applicants including age, gender, exam scores, and nonverbal communication were found to have influenced the interview results. Bias from interviewers was a significant factor in the results of the interview. A Structured interview in multiple stations such as the Multiple Mini-Interview showed the highest reliability and validity. To make the interview fair, no information about the applicants was provided to the interviewers and interviewers were recruited from different backgrounds. There have been few research papers on admission interviews in Korea. Active research on the qualities of good doctors and effective and reliable admission interview methods should be encouraged. A strategy should be developed to overcome the philosophical obstacles that medical school professors want to admit academically excellent applicants.

• 한국병원경영학회지
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• 제15권4호
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• pp.125-142
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• 2010

Objective : To determine demographic, clinical, health care utilization factors predicting unplanned readmission(within 28 days) to the hospital. Methods : A case-control study was conducted from January to December 2009. Multiple logistic regression was used to examine risk factors for readmission. 180 patients who had been readmitted within 28 days and 1,784 controls were recruited from an university hospital in Seoul. Results : Six risk factors associated with readmission risk were identified and include mail sex, medical service rather than surgical service, number of comorbid diseases, type of patient's room, lenth of stay, number of admissions in the prior 12 months. Conclusions : One of the association with readmission risk identified was the number of hospital admissions in the previous year. This factor may be the only risk factor necessary for assessing prior risk and has the additional advantage of being easily accessible from computerized medical records without requiring other medical record review. This risk factor may be useful in identifying a group at high readmission risk, which could be targeted in intervention studies. Multiple risk factors intervention approach should be considered in designing future prevention strategies.

• 여성건강간호학회지
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• 제12권2호
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• pp.132-141
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• 2006

Purpose: The purpose of this study was to supply basic data for a health promoting program and to elevate the level of it by examining whether university students' health promoting behaviors were related to health perception, health concept, self- esteem, perceived benefits of action, perceived barriers of action, perceived self-efficacy, activity-related affect, social support, preference, prior related behavior, and a plan for action. Method: Subjects were 192 university students in K city. Data collection method was a structured questionnaire. Data was analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation, and stepwise multiple regression. Result: The most powerful predictor was previous related behavior (36%). Altogether previous related behavior, health status, a plan for action, perceived self-efficacy and number of admissions were proven to account for 57% of health promoting behaviors. Conclusion: It suggested that prior related behavior, health status, a plan for action, perceived self-efficacy, and number of admissions should be considered when developing a students' health promoting program.

• Child Health Nursing Research
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• 제26권1호
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• pp.55-63
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• 2020

Purpose: The purpose of this study was to evaluate the current level of sleep quality among Korean middle-school students using the Pittsburg Sleep Quality Index (PSQI), and to analyze the factors influencing sleep quality. Methods: The study used a descriptive cross-sectional design and a self-report questionnaire. The participants were 744 middle-school students. The questionnaire included the PSQI and health-related questions, such as the types of diseases they had been diagnosed with and the frequency of hospital admissions. The data were analyzed using the independent t-test, analysis of variance, Pearson correlation coefficients, and linear multiple regression. Results: The global PSQI score was 4.21, which indicated good sleep quality. The major factors that were associated with the sleep quality of middle-school students were the number of diseases they had been diagnosed with (β=.54, p=.001) and atopic dermatitis (β=.32, p=.001). In addition, asthma and the frequency of hospital admissions were significant factors influencing each component of the PSQI. Conclusion: The findings from this study suggest that sleep quality was associated with several health-related factors. Thus, nurses, school nurses, and nursing researchers may need to assess the health-related factors associated with adolescents' sleep quality as part of efforts to improve their sleep quality.

• 한국병원경영학회지
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• 제9권2호
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• pp.102-127
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• 2004

The objective of this study is to analyze a current trend of and relating factors on profitability of the Korean Public Corporation Medical Centers(KPCMCs, hereinafter, hospitals) in Korea. There are 34 hospitals in Korea as of 2004. Among these hospitals some are red ink hospitals, others are black inks in terms of profitability. Data were collected by Korea Health Industry Development Institute(KHIDI) Statistics for Hospital Management 2000-2002 and Ministry of Health and Welfare(MOHW) financial data of public hospitals which was planned to coordinate public health care services roadmap in the long run. The samples are 32 hospitals. Profitability was measured in the aspect of profit rate with normal profit to total assets, and normal profit to gross revenues as dependent variables in respective. Independent variables were classified by general factors, i.e., location, intern/resident training, period of opening, number of beds, and managerial factors(current ratio, fixed ratio, liability to total assets, total assets turnover, personnel costs, materials cost, administrative cost), and finally factors related to patient treatment(average length of stay, bed occupancy rate, admission ratio of outpatients). The methods of analysis are correlation and multiple regression analysis. This study shows firstly, a lot of hospitals are optimal current ratio. Hospitals in upper 100% current ratio are 81.2%. And the personnel cost in total costs are high. Secondly, the trend of normal profit to gross revenues of hospitals are deteriorating gradually. And lastly, as a result of multiple regression analysis, the factors had on significant effect on normal profit to total assets are fixed ratio(+), liability to total assets(-), bed occupancy rate(+), admissions of outpatients(+), etc. And the factors had on significant effect on normal profit to gross revenues are current ration(+), fixed ratio(+), personnel cost(-), administrative expenses(-), admissions of outpatients(+), etc. In conclusion, to improve the profitability of hospitals, the efforts to reduce personnel cost and average length of stay might be needed. And also beds utilization rate need to be increased.

• Journal of the Korean Data and Information Science Society
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• 제21권4호
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• pp.729-736
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• 2010

본 논문에서는 부산 소재 K 대학교 신입생들의 학업성취도에 대해 신입생의 특성변수를 포함한 전형관련 변수들에 대한 영향력 분석을 연구한다. 이를 위해 모수적인 방법인 다중회귀분석과 비모수적인 방법인 의사결정나무 분석을 통하여 학업성취도에 대한 전형관련 변수들에 대한 주효과와 상호 작용효과를 각각 분석하였다.

• Journal of Trauma and Injury
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• 제34권3호
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• pp.155-161
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• 2021

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has necessitated a redistribution of resources to meet hospitals' service needs. This study investigated the impact of COVID-19 on a regional trauma center in South Korea. Methods: We retrospectively reviewed cases of polytrauma at a single regional trauma center in South Korea between January 20 and September 30, 2020 (the COVID-19 period) and compared them to cases reported during the same time frame (January 20 to September 30) between 2016 and 2019 (the pre-COVID-19 period). The primary outcome was in-hospital mortality, and secondary outcomes included the number of daily admissions, hospital length of stay (LOS), and intensive care unit (ICU) LOS. Results: The mean number of daily admissions decreased by 15% during the COVID-19 period (4.0±2.0 vs. 4.7±2.2, p=0.010). There was no difference in mechanisms of injury between the two periods. For patients admitted during the COVID-19 period, the hospital LOS was significantly shorter (10 days [interquartile range (IQR) 4-19 days] vs. 16 days [IQR 8-28 days], p<0.001); however, no significant differences in ICU LOS and mortality were found. Conclusions: The observations at Regional Trauma Center, Pusan National University Hospital corroborate anecdotal reports that there has been a decline in the number of patients admitted to hospitals during the COVID-19 period. In addition, patients admitted during the COVID-19 pandemic had a significantly shorter hospital LOS than those admitted before the COVID-19 pandemic. These preliminary data warrant validation in larger, multi-center studies.

• 보건행정학회지
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• 제3권1호
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• pp.53-83
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• 1993

A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the elderly patients. They have spent 814.126won per on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Goverment should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.

• 한국과학교육학회지
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• 제30권4호
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• pp.452-471
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• 2010

수능이 1994학년도에 처음 시행된 이후 17년 동안 시행되어 오면서 기출을 피하면서 사고력을 측정하는 참신한 문항을 출제하는 것이 점점 어려워지고 있다. 그러므로 수학능력 측정을 위한 양호한 문항의 개발을 위한 지속적인 연구가 필요하다. 이러한 맥락에서 수능 문항 개발에 필요한 시사점을 도출하기 위해 수능과 같은 국가 수준의 선다형 대입 관련 시험 분석의 일환으로 일본 센터시험을 분석하였다. 이 연구에서는 센터시험의 체제와 이과 출제 과목 및 응시과목의 수나 응시자 현황을 파악하고, 2009년 1월에 시행한 '이과' 시험의 검사지 구성, 문항 유형, 특이 사항 등을 분석하였다. 또한 센터시험 문항을 수능과 관련하여 내용 요소 및 행동영역에 따라 분석하였고, 아울러 우리나라 수험생의 관점에서 예상 정답률을 추정하였다. 분석 결과, 센터시험 문항은 고급 사고력보다는 지식 측정 또는 낮은 사고력을 주로 측정하고 있다. 또한 문항 당 배당되는 시간이 수능보다 길며 문항 수가 고정되지 않았고, 배점과 답지 수도 다양하다. 그리고 실생활 소재를 많이 사용하면서 문장 표현을 엄격하게 하지 않는 경향이 있다. 센터시험에서 원점수를 사용하는 것으로 보아 선택 과목 간 유 불리 문제가 크지 않은 것으로 보인다. 또한 문과나 이과의 계열 구분 없이 대부분의 학과에서 선택 과목으로 과학과목 성적을 요구하고 있다.