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Discharge Analysis of Chungcheongbuk-do Residents using National Hospital Discharge In-depth Injury Survey in the Recent 5 Years (퇴원손상심층조사 자료를 이용한 최근 5년간의 충청북도 거주민의 퇴원 분석)

  • Kim, Hae-Sook
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.8
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    • pp.389-401
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    • 2021
  • This study was performed to generate basic data to establish a health promotion plan for residents of Chungcheongbuk-do by identifying characteristics of discharged patients residing in the Chungcheongbuk-do area from an In-Depth Post-Discharge Injury Survey reported by the Korea Centers for Disease Control and Prevention(KCDCP). The Report provided data on demographic characteristics, medical institution use characteristics, medical use characteristics, and disease characteristics of patients discharged from medical institutions with 100 or more beds from 2013 to 2017. The total number of Chungcheongbuk-do residents who were admitted and discharged from 2013 to 2017 was estimated to be 1,656,590, and the discharge rate was 21,089, which was higher than the national average of 13,882 in 2016. The regions where the discharge rate increased during this period include Goesan, Yeongdong, Boeun, Okcheon, Jeungpyeong, and Eumseong-gun, which are mainly rural areas. Among the patients hospitalized and discharged from hospitals outside the Chungcheongbuk-do area, the discharge rate of patients who used hospitals in Incheon/Gyeonggi areas and Daejeon/Chungnam areas increased slightly. Among the malignant tumor patients, the number of lung cancer(included trachea & bronchial cancer) patients was the highest. In addition, the discharge rate was highest for patients with respiratory diseases. This study suggests that efforts need to be made to lower the discharge rate for infection, circulatory disease, genitourinary disease, and musculoskeletal disorder patients

Injury Characteristics of Self-injury Patients Who Visit the Emergency Department (응급실로 내원한 자의 손상 환자의 특징)

  • Kwak, Young Soo;Lee, Kang Hyun;Shin, Hyung Jin;Park, Kyung Hye;Choi, Han Joo;Kim, Hyun;Hwang, Sung Oh
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.65-70
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    • 2009
  • Purpose: Many studies have addressed a psychiatric analysis of self-injury patients who have self-injurious behavior and who have attempted suicide. Few studies on the injury characteristics of self-injury related trauma patients have been conducted. We analyzed the injury characteristics of self-injury patients. Methods: A retrospective review of the medical records extracted from the injury surveillance system of Wonju Christian Hospital for the period from August 2006 to February 2008 was conducted. Of the 121 cases extracted, 103 were included in this study. We analyzed the sex ratio, age group, place of injury, injury mechanism, location of injury, management results, injury severity, and relation with drinking. Results: One hundred three cases were included (sex ratio: 1.06), and the mean age was $33.9{\pm}14.2$ years old. Fifty-six patients (54.4%) were discharged from the emergency department (ED) on the day of injury after primary care, and 9 patients (8.7%) were discharged, because they refused treatment. Seven patients (6.8%) died. Of these, 4 patients (3.9%) died after attempted cardio-pulmonary resuscitation in the ED, 1 patient (1%) was dead on arrival, and 2 patients (1.9%) died after admission. Sixteen patients (15.5%) were admitted to the hospital, including 2 patients (1.9%) needing emergency surgery. Sixteen patients (15.5%) were transferred to other hospitals. Sixty-one cases (59.2%) involved drinking, and 31 (30.1%) did not; for 11 cases (10.7%), the involvement of drinking was unknown. The mean revised trauma score (RTS) was $11.26{\pm}2.52$, and 88 cases (85.4%) hat a RTS of 12. The mean injury severity score (ISS) was $5.80{\pm}14.56$, and 9 (8.7%) severely injured patients had scores of more than 15. Conclusion: Most self-injuries were mild traumas related to drinking and occurred at a young age. Most cases were not so severe, and the patients were discharged from the ED, but some patients needed hospitalization. Other patients had injuries so severe that they died.

Polypharmacy in Patients Discharged from Oncology Department (종양내과 퇴원 환자의 다제병용 분석)

  • Bae, Hyunjin;Hahn, Jimin;Lee, Yong Hwa;Kim, Hyangsook;Lee, Hye Suk;Lee, Se-Hoon;Heo, Dae Seog;Lee, Juyeun
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.1
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    • pp.42-48
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    • 2013
  • Background: Patients diagnosed with cancer tend to have multiple risk factors for drug related problems such as old age, comorbid conditions, self-medication, additional medications for supportive therapy, and the cancer treatment itself. Objective: The aim of this study was to investigate notable polypharmacy and related problems in oncology patients during hospitalization or following clinic visit. Method: The electronic medical records of patients who were discharged from oncology division at Seoul National University Hospital (SNUH) from June $1^{st}$ to June $30^{th}$, 2011 were retrospectively reviewed. Results: A total of 334 discharged patients were included in this study. Among them, 221 patients had pre-admission medications. Forty percent of the patients, including 60.3% of elderly patients (over 65 years of age) were prescribed more than 5 kinds of medications. Twenty percent of the patients were prescribed to take medications more than 7 times a day. Medication duplications were observed in 2.4% of patients. In 10.5% of the reviewed patients, 47 cases of potential drug-drug interaction including 3 cases of contraindication and 17 cases of major clinical implication according to Micromedex were detected. Medication changes were made in 88% of patients during hospitalization and in 94.7% of patients at their first visit after discharge. Antidiarrheal agent (loperamide) was prescribed along with laxatives in 18.5% of the prescriptions and inadequate instructions on how to take it were observed in 63% of the prescriptions. Conclusion: This study identified the prevalence of polypharmacy and related problems in cancer patients, which presents the need for an active role of pharmacists in pharmaceutical care in oncology wards.

Reduction of inappropriate revisits to the emergency department 72 hours after being discharged by 'Discharge explanation report' ('퇴원설명문'에 의한 72시간내 부적절한 응급센터 재방문의 감소)

  • Park, Ha Young;Sim, Min Seob;Song, Hyoung Gon;Song, Keun Jeong
    • Quality Improvement in Health Care
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    • v.12 no.1
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    • pp.114-123
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    • 2006
  • Background : Patients who were discharged from the emergency department(ED) may revisit. These patients are divided into two groups; one is expected scheduled condition, the other is unexpected condition. These patients of inappropriate revisits to the ED would be unsatisfied, difficult to make rapport and take legal action as a result of additional medical charges. The purpose of this study was to reduce inappropriate revisits to the ED with a new method which was developed by analyzing inappropriate revisits in 2002. Methods : This study was conducted in a tertiary hospital consisting of 1,278 beds. The most common cause of inappropriate revisits was the medical team's lack of explanation about a disease. Thus we decided that the effective method was to offer full explanations to patients to understand the clinical pathway of a disease. We made four types of stickers to explain most common 4 diseases in 2003. An emergency physician completed 'discharge explanation report' and explained it to patients in 2004. Results : In 2002 inappropriate revisited patients were 164, patients with four diseases were 79. During the same period of 2003, inappropriate revisited patients were 56 (-65.9%), four disease patients were 6 (-92.4%) and in 2004 inappropriate revisited patients were 52, four disease patients were 19. Causes of revisits were lack of explanation about a disease in 35 patients (44.3%) in 2003, and 5 patients (83.3%) in 2003, and 16 patients (84.2%). Conclusions : Application of 'explanation stickers' at discharge reduced inappropriate revisits from 34.5% in 2002 to 15.9% in 2003. Application of 'Discharge explanation report' by emergency physician reduced inappropriate revisits from 15.9% in 2003 to 13.5% in 2004. Reduction of inappropriate revisits elevated the quality of medical treatment, and decreased patients' dissatisfaction in ED.

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An Experimental Study on Airborne Contamination and Decontamination for $Na^{131}I$ Solution ($Na^{131}I$에 의(依)한 오염도(汚染度) 및 오염제거(汚染除去)의 실험적(實驗的) 연구(硏究))

  • Chu, Sung-Sil;Park, Chang-Yun
    • Journal of Radiation Protection and Research
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    • v.9 no.2
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    • pp.112-117
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    • 1984
  • A lot of radioisotopes are applied to medical fields. It's very important to measure the activities on airborne radioiodine discharged in air from $Na^{131}I$ solutions and from patients treated with radioiodine. Also surface decontamination is another one important problem to be completly solved in the isotope laboratory where there is always the possibility of radiation contamination. The Authors measured the activities on airborne radioiodine with RI collector and scintillation counter. 1. The mean accumulative activity of airborne radioiodine discharged into air from $Na^{131}I$ solution was measured as $1.3{\times}10^{-3}/hr$ rate, and the maximum value was $1.8{\times}10^{-3}/hr$. 2. Radioactivity rate per hour of airborne iodine discharged into air from patients treated with $Na^{131}I$ was measured as $6.2{\times}10^{-5}/hr$ at 8 hour after administration of radioiodine and decreased into $2{\times}10^{-6}/hr$ after 24 hour. 3. Metalic surfaces such as stainless steel or aluminum are decontaminated 5 to 6 times more rapidly than wood and concrete surfaces. 4. Decontamination with wet wiping with detergent was 9 to 10 times more rapidly than dry wiping method, but dry wiping was useful for the first step to prevent spreading and flowing from liquid radioactive materials.

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The Relationship between Hospital Specialization and Operational Performance: Focusing on Diseases of the Musculoskeletal System and Connective Tissue (병원의 전문화 전략과 운영성과 간의 관계: 근골격계 및 결합조직 질환을 중심으로)

  • Seo, Seul-Ki;Kim, Yang-Kyun
    • Korea Journal of Hospital Management
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    • v.25 no.3
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    • pp.53-66
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    • 2020
  • This study is aimed at investigated and compared the differences in the affect of hospital specialization according to hospital size using claims data of the Health Insurance and Review Assessment National Inpatient Sample in 2018 for diseases of the musculoskeletal system and connective tissue. To this end, we used multivariate hierarchical linear models(a.k.a., multi-level models) using two-tier data from 106,599 patients discharged after diseases of the musculoskeletal system and connective tissue from 734 hospitals. Multivariate results indicate that patients who were discharged with diseases of the musculoskeletal system and connective tissue from specialized hospitals with 200 beds or less stayed shorter and paid less inpatient charge than those who were discharged from less specialized hospitals. But for hospitals with 201-300 beds, no positive impact relationship was found between hospital specialization and operational performance. This finding may be limited evidence that the affect of a hospital's specialization strategy may vary depending on the size of the hospital. We discussed several managerial and health policy implications below.

Selected Characteristics and Degree of Physical Disability of Stroke Survivors at Discharge from Five General Hospitals in Seoul, 1975 (중추 신경계 혈관질환(C. V. A)환자 중 퇴원환자의 신체기능장애정도와 그 특성에 관한 고찰)

  • 이선옥
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.23-28
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    • 1976
  • This study was undertaken to obtain information about selected characteristics and the degree of physical disability of patients with a diagnosis of cerebrovascular accident upon their discharge from a general hospital. It was hoped that this information would contribute to the assessment of their needs for follow-up nursing care. Nurse's and Physician's Progress Notes of all stroke patients discharged from five general hospitals in Seoul from January to December 1975 were analysed using a prepared check list. Patients with other complicating diagnosis such as diabetes, tuberculosis or heart disease were excluded from the sample. According to six factors used to grade the total sample of 334 stroke victims degree of physical ability at discharge, 144 (43%) of the Survivors had good functional ability, 72 (22%) fair, 62 (18%) poor, and 57(17%) very Poor. Certain clinical diagnosis correlated with the degree of physical ability. Intra cranial Hemorrhage and Subarachnoid Hemorrhage tended to be related to poor and very poor outcome categories. There was no significant correlation between nae and ability outcome, women had revealed a significantly positive correlation with poor and very poor ability outcomes. The hospitalization period was less than three days for 37.5% of the total group, and more than one month for 4.7%. Those patients with less than three days hospitalization accounted for the highest relationship with poor and very poor ability outcomes. Of the total groups 175(50.99%), were discharged with a diagnosis of condition improved (though not necessarily with good physical ability). The results suggest serious need for comprehensive follow- up nursing care for stroke survivors discharged a from general hospitals in Seoul.

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Postcardiotomy Mechanical Circulatory Support in Congenital Heart Diseases (소아개심술 후 시행한 순환보조장치의 임상적 고찰)

  • 권오춘;이영탁
    • Journal of Chest Surgery
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    • v.33 no.5
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    • pp.385-390
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    • 2000
  • Background: To review the experience that used both ventricular assist device(VAD) and extracorporeal membrane oxygenation(ECMO) for children with congential heart disease requiring postcardiotomy mechanical circulatory support. Material and Method: Between March 1993 and May 1995, we applied mechanical assist device using centrifugal pump to the 16 patients who failed to be weaned from cardiopulmonary bypass(n=15) or had been in cardiogenic shock in intensive care unit(n=1). The diagnosis were all congenital heart diseases and the ages of patients ranged from 20 days to 10 years (mean age=2.5$\pm$3.5 years). Result: The methods of mechanical circulatory support were LVAD(n=13), BVAD (n=1), and ECMO(n=2). The mean assist times were 54.0$\pm$23.7 hours. Post-assist complications were in orders: bleeding, acute renal failure, ventricular failure, respiratory failure, infection, and neurologic complication. It was possible for 9 patients(56.3%) to be weaned from assist device and 5 patients(31.3%) were discharged from hospital. There was no statistical significant between hospital discharged group and undischarged group by age, body weight, cardiopulmonary bypass time, and assist time. Conclusion: The ventricular assist device is an effective modality in salvaging the patient who failed to be weaned from cardiopulmonary bypass, but multiple factors must be considered for improving the results of mechanical circulatory support ; such as patient selection, optimal time of starting the assist device, and prevention and management of the complications.

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A Study of the Relation Between Perceived Family Support and Social Adjustment of Discharged Patients with Chronic Mental illness (퇴원한 만성 정신 질환자가 지각한 가족지지와 사회적 적응과의 관계 연구)

  • 현명선
    • Journal of Korean Academy of Nursing
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    • v.22 no.3
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    • pp.352-361
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    • 1992
  • This study was designed to identify the relation between the perceived family support and social adjustment of discharged patients with chronic mental illnesses. The subjects for this study were 50 patients with chronic mental illnesses receiving out-patient treatment at one general hospital and one private hospital in Seoul. The data were collected during the period from April 25, 1991 to May 27, 1991. The perceived family support was measured by the Family Support Scale developed by Hyun Sook Kang. A questionnaire which was developed by Weissman was modified by the author of this study to measure the Social Adjustment. The data were analyzed by descriptive statistics and Pearson Correlation Coefficients, using the SPSS program. The results of this study can be summarized as following ; 1) For the perceived family support, the mean was 2.63 points and the source of family support was almost always the mother. 2) For the social adjustment level, the mean was 2.62 points, and the results showed the best social adjustment was in the area of parental role and family adjustment, and the poorer adjustment was in the area of work and leisure. 3) The relationship between the perceived family support and social adjustment revealed a significant correlation.(r=.38, p<.05) Therefore the hypothesis “the higher the level of perceived family support, the higher the social adjustment level” was accepted. In conclusion, the study revealed that family support is an important factor related to the social adjustment level in patients with chronic mental illnesses.

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