• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.11
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• pp.3480-3486
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• 2009

This research was based on the purpose of establishing predicted model of prematurely discharged patients using the mandatory information data, recorded in the medical institutes based on discharged patients of a University Hospital for the period of 1 year, from July. The result showed that the regression analysis model was the most excellent method of application model for preventing discharged patients, and when this is applied to discharged patients who are outpatients, the possibility of discharge can be less than staying in the emergency room. In addition, based on threshold 0.7, when we expect the discharged patients, out of 920 discharged patients, the actual patients who are discharged can become 136, showing the extract effectiveness of 14.78%. Based on the perspective of lift value, compared to random extract, this is 2.9 times (14.78/5.15) more effective.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.3
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• pp.86-97
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• 1996

The traditonal inpatient acute hospital setting is organized primarily for the intensive management of disease, but not well-suited for continuity of care for the chronically ill patients after being discharged from hospital. For the planning of the continuity of care, firstly, it is necessary to assess the home care needs of the discharged pateints in the context of the nursing diagnosis. Therefore, this study is designed to identify the home nursing care need trajectory of the patients with chronic illness after discharged from one of the the General Hospitals in Seoul, Korea. The subjects are the patients with chronic illness such as stroke, musculoskeletal disease, hypertension, cancer etc., in average age of 52. 2 years old. The findings of this study are as follows : 1) The limitaion of ADL has been constantly facing to the subjects and has not been changed 4 weeks after being discharged. And the sense of with-drawal was getting worse at 4th weeks than the 1st week after being discharged. 2) The lists of the patient's problems are the impairment of mobility, elimination pattern, inactivity, impairment of skin integrity, ineffective airway clearance, and potential anxiety, self concept deficit, ineffective family coing, etc. Those problems were diminished in quantity at the first week after discharged, but at the 4th week, those problems were getting worse. 3) The need of specialized nursing care such as tube feeding, ostomy care, $O_2$ inhalation, IV therapy, teaching and exercise are considered as the most consisting problems facing to the subjects. 4) In general, the chronically ill patients and their caregivers have not been adapted well even at the 4th weeks after being discharged. 5) Considering those findings, the basic care for patients should be given and the trainging for process of the adaptation after discharged should be encouraged prior being discharged from hostital. For this suggestion, the systematic discharge planning should be carried and the hospital based home nursing model should be implemented at the general hospital for the chronically ill patients.

• Korean Journal of Health Education and Promotion
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• v.26 no.4
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• pp.117-127
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• 2009

Objectives: The primary objective of the study is to analyze the utilization patterns of provincial patients discharged from hospitals located in Seoul area. Methods: For the analysis, the study employed the nationwide data on 'Survey of Injured Patients Discharged from Hospitals' conducted by KCDC (Korea Centers for Disease Control and Prevention). The statistical methodology used in the measurement model is a logistic regression model. Results: The study has three major findings. First, compared to other disease groups, the discharged on both 'neoplasm(cancer)' and 'congenital malformation, deformity and chromosomal abnormalities' disease groups are more likely to utilize hospitals in Seoul area. Second, as for 'neoplasm(cancer)' disease group, patients with 'bones and articular cartilage' areas are more likely to utilize hospitals in Seoul area. Finally, Hospitals with more than 1,000 beds was primary factor in selecting Seoul-based hospitals by the discharged in provincial areas. Conclusion: In sum, the study showed that patients in provincial areas are more likely to utilize hospitals located in Seoul area regardless of the severity of their cases. Local authority, therefore, is required to monitor local hospitals on regular basis, as well as support them to establish specialized medical centers by providing human and physical resources.

• Journal of Korean Academy of Nursing
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• v.40 no.4
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• pp.599-609
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• 2010

Purpose: The purpose of this study was to develop and evaluate a transitional care program for patients discharged from military hospitals. The study consists of two phases: developing the program and evaluating its effectiveness. Methods: The conceptual framework used to guide the development of the program was Meleis's transition theory. A quasiexperimental design was employed for this study. Participants were recruited from patients discharged from one military hospital, 72 in the control group and 56 in the experiment group. Data were analyzed using SPSS WIN 12.0 program with chi-square, Fisher's exact test, independent t-test, and mixed model. Results: Participants in the transitional care program reported promoting a positive personal condition, and more healthy patterns of response in the first week after being discharged and a smoother discharge transition. Conclusion: The transitional care program developed for discharge patients from military hospital promoted discharge readiness and promoted smooth discharge transition.

• Quality Improvement in Health Care
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• v.9 no.1
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• pp.18-32
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• 2002

Background : We developed a model for predicting premature discharge and identifying related factors. Methods : Prediction model was developed by data mining techniques. Basic data were collected from the total discharge data base of a university hospital in Chungnam Province during the period from July 1, 1999 to June 30, 2000. Results : 1. Among 22,873 patients, the number of patients discharged with usual discharge orders were 21,695 or 94.8%. The number of the prematurely discharged patients were 1,178 or 5.2%. 2. The primary reason for unusual discharge was transfer to other hospital. Move to a local hospital closer to their home and burdensome medical expenses were main reasons. 3. Predictability of each model was tested using the top 10 percent of patients with the highest probabilities of premature discharge. The neural network model was chosen as the most appropriate model for predicting prematurely discharged patients. 4. Ten percent of the total number of patients had been selected randomly to test the effectiveness of the neural network model. We have chosen the threshold of the neural network model as 0.7. The number of patients who were expected to discharge prematurely was 312. Among them, 241 had been discharged prematurely (77.2%). Conclusion : Of the several data mining techniques used, the neural network model was the most effective, It can be used to identify and manage the patients who are expected to discharge prematurely.

• Journal of Preventive Medicine and Public Health
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• v.32 no.3
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• pp.289-296
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• 1999

Objectives: This study describes the risk factors affecting the unexpected readmission of 261 patients who were discharged from a university hospital in Seoul. Methods: This case-control study reviewed medical records of inpatients who had been discharged from a hospital between 1 August 1995 and 31 October 1995 after the treatment for general diseases. The cases were 68 patients who were readmitted unexpectedly within 28 days of discharge from an index stay, and the controls were 193 Patients who were discharged without readmission during the study period. Results: Logistic regression analysis results were as follows; Patients who had no operation during their hospital stay were more likely to be readmitted unexpectedly than patients who had operation. Patients who had 1 or 2 parts of their body being involved in treatment were more likely to be readmitted unexpectedly than patients who hand more than 3 parts of their body being involved in treatment. Patients who had complications after surgery were more likely to be readmitted unexpectedly than patients who had no complications. Insufficient discharge planning caused unexpected readmissions. Conclusions: Discharge planning education should be extended to health care providers. And the assessment of discharge planning should be evaluated. Readmission is often necessary for the treatment of related problems of originating from initial hospitalization, which causes cost problems. Unexpected readmission is preventable and the models for readmission can serve as a valuable clinical tool for high risk patients.

• Journal of the Korea Convergence Society
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• v.13 no.2
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• pp.313-320
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• 2022

Discharge plans should be considered during rehabilitation depending on the location specified by the patients. This study aims to compare the demographics and rehabilitation function according to discharge location in people with rehabilitation one month after discharge. Among 300 discharged patients, 146 were discharged to their homes, 154 were transferred to facilities such as nursing homes. The results showed that rehabilitation function that scored using the modified Barthel Index were different according to discharge location. That is, the modified Barthel Index scored greater in home discharged patients than counter group. However, the home discharged patient's physical function and daily activities showed scores that required rehabilitation. Differentiated strategies should be needed for home and facility visit rehabilitation programs for rehabilitated patients.

• Quality Improvement in Health Care
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• v.9 no.1
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• pp.34-51
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• 2002

Background : The purpose for this study is to develop a critical pathway of bullectomy for spontaneous pneumothorax patients. Methods : For this study a conceptual framework of critical pathway was developed through a review of the literature including five critical pathways which are currently being used in USA, and opinions of the critical pathway development team members at Y university hospital. In order to identify the service contents required by these patients and to draw up a preliminary critical pathway, 33 cases of medical records of patients who had received bullectomy for spontaneous pneumothorax between September, 2000 to August, 2001 at the Respiratory Center of Y university hospital in Seoul was analyzed. Results : In order to test the clinical validity of the preliminary critical pathway, it was applied to ten patients who had received bullectomy for spontaneous pneumothorax from October, 2001 to December, 2001. The average discharge day was 4.89th post operation day, six patients discharged on the fourth post operation day which was the expected day, one patients discharged one day earlier than the expected day, one patient discharged three days later than the expected day, and one patient discharged six days later than the expected day. There were variances between the critical pathway and the actual practice. The variances came from tests, medications, and treatments. One item that showed variance in clinical applications was complemented, and three items were decided not to be corrected for the final determination of the critical pathway. Conclusion : This critical pathway is applicable to the care of patients with bullectomy for spontaneous pneumothorax, but it needs more clinical applications to grasp varied variances.

• Journal of Chest Surgery
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• v.27 no.2
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• pp.128-131
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• 1994

Recently we performed video-assisted thoracoscopic[VAT] examination and bullectomy under local anesthesia. Of the 10 patients undergoing VAT examination under local anesthesia with primary spontaneous pneumothorax, 8 patients underwent VAT bullectomy under local anesthesia using endo-GIA; 7 patients discharged within 24 hours after operation; 1 patient had an air leak after operation, so chemical pleurodesis with doxycycline was performed and discharged postoperative day 3. There have been no recurrence to date[60-120 days after operation]. We think spontaneous pneumothorax can be treated on an out-patient basis.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.9
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• pp.3336-3340
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• 2010

This study has been carried out against hospitals with less than 100 beds, which were excluded from the previous study on the discharged patients from January 1 to December 31, 2007. To analyze the discharged patients, the general characteristics of discharged patients, means of payment for medical costs, type of disease and surgery and current status of the use of medical services have been investigated based on the medical records. During the year of 2007, the number of discharged patients from the hospitals with less than 100 beds reached 4,697,095 (9.7% of total population). In other words, 9,693 people were discharged from a hospital per 100,000 populations with 9.8 days in terms of annual mean length of hospitalization. The number of patients who returned home after hospitalization reached 4,538,861 (male: 1,784,041, female: 2,754,821) while 119,378 patients were evacuated to other hospitals. Among them, 8,970 patients were returned back to the original hospital. Based on the results of this study, they could be used in could be used in planning a project which is aimed to reduce public health costs by investigating high-risk groups with particular injuries and preventing damage. In addition, the injury monitoring data which are continuously collected could be useful in monitoring and evaluating the efficiency of an injury prevention program.