• The Journal of the Korea Contents Association
• /
• v.11 no.9
• /
• pp.372-383
• /
• 2011

Our study was carried out to develop the severity-adjustment model for length of stay in hospital for percutaneous coronary interventions so that we would analysis the factors on the variation in length of stay(LOS). The subjects were 1,011 percutaneous coronary interventions inpatients of the Korean National Hospital Discharge In-depth Injury Survey 2004-2006 data. The data were analyzed using t-test and ANOVA and the severity-adjustment model was developed using data mining technique. After yielding the standardized value of the difference between crude and expected length of stay, we analysed the variation of length of stay for percutaneous coronary interventions. There was variation of LOS in regional differences, size of sickbed and insurance type. 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.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.4 no.2
• /
• pp.245-265
• /
• 1997

The purpose of this study was to promote the effectiveness in managing disease or injury, by examining the length of stay in hospital according to characteristics concerned before and after operation, and by serving as a basis for reducing that length. As a result of investigating the length of stay in hospital according to inpatient's personal characteristics, clinical features and other characteristics concerned, the following characteristics appeared significant. The characteristics that showed a significant difference about the length of stay in hospital before and after operation were the age and the fact whether one was married or not among inpatient's personal characteristics. The significant ones among clinical features were the route to be taken to hospital, the form of insurance, the experience of re-hospitalization, whether another disease coexisted, the experiment of changing department, whether a diagnosis was determined by consultation, whether an intensive care unit was used, whether re-operation was performed, the total number of case of the experience of re-hospitalization, inpatient who were again sent to hospital under the same diagnosis was not included in the investigation, which was pointed out as a limit in this study. The significant ones among other characteristics concerned were the date and season when the patients were taken to hospital and the doctor in attendance. The doctor in attendance appeared to give a significant impact on the length of stay in hospital before operation, but no significant difference was noted in the mean among the doctors in attendance. And those characteristics were not found regularly among the selected departments. As stated above, one way to reduce the length of stay In hospital was to diminish the length of stay in hospital before operation. The term of hospitalization before operation shall be reduced by grasping the factors that affected that length before operation and by conducting examination as many as possible in the out-patient department. Also, the efforts should be put on that length after operation. The management of hospital seemed to be successfully carried out if those factors affected that length were effectively controlled.

• Korea Journal of Hospital Management
• /
• v.3 no.1
• /
• pp.100-120
• /
• 1998

Tertiary been increasing rapidly. There has been shortage of beds in hospitals and effective management of beds had to b considered. For the efficient utilization of the exsisting hospital beds, bed turnover rate ha to be high and their length of stay in hospital has to be shortened. The sample of this study was in-patients admitted in 13 clinical departments of a tertiar hospital in Wonju. Daily medical fees through length of stay in hospital were observed an we analyzed the increase of hospital revenues per bed for the shortening of length of stay. The results of the analysis were as follows: 1. The average length of stay by dept. was 11.0 in dept. of internal medicine. 12.4 in dept. of general surgery, 7.1 in dept. of gynecoloty, 6.8 in dept. of pediatrics, 26.1 in dept. of nervous surgery, 21.6 in dept. of orthopedic surgery, 25.5 in dept. of plastic sersury, 7.6 in dept. of ophthalmology, 7.1 in dept. of E.N.T, 8.1 in dept. dermatoloty, 9.0 in dept. urology. 2. The trend of daily medical fees of in-patients was the highest from the first day to the third day. Because most necessary examination and various treatment or operation took place in these period. 3. The estimative model for medical fees by the length of stay at each clinical department was inferred. 4. The increased revenue per bed by shortening the length of stay was calculated by the estimative model. Shortening one day would increase 305,999 thousand won in dept. of internal medicine 232,138 thousand won in dept. of general surgery., 177,795 thousand won in dept. of gynecology medicine, 69,031 thousand won in dept. of pediatrics 360,381 thousand won in dept. of nervous surgery 211.339 thousand won in dept. of orthopedic surgery, 100,249 thousand won in dept of plastic surgery, 10,569 thousand won in dept. of ophthalmology -814,122 thousand won in dept. of E.N.T, 1,582 thousand won in dept. of dermatology, -5,821 thousand won in dept. of urology. It is expected that they can improve their profitability by shortening the length of stay of the in-patients.

• Korea Journal of Hospital Management
• /
• v.23 no.3
• /
• pp.52-62
• /
• 2018

This study aims to analyze the factors affecting in-hospital complication and length of stay in elderly patients with total knee arthroplasty. A total of 8,224 inpatients over 65 years old were selected from the national old inpatient sample data which was produced by Health Insurance Review and Assessment Service in 2016. STATA 12.0 was performed using frequency, chi-square test, t-test, ANOVA and multiple linear and logistic regression analysis. Analysis results show that ages(over 85), Charlson Comorbidity Index, district(metropolitan) for general hospitals and gender, district, beds(100-199) for hospitals are significantly influenced in-hospital complication. Statistically significant factors affecting the length of stay are gender, insurance type, depression, district, bed(300 over) for general hospitals and gender, type of insurance, Charlson Comorbidity Index, depression, district, beds(200-299) for hospitals. Based on these findings, the factors affecting in-hospital complication and length of stay were different depending on the type of medical institution. Accordingly, policymakers should analyze the differences in care behavior depending on the type of medical institution and expand policy and financial support to resolve them.

• Journal of Internet of Things and Convergence
• /
• v.3 no.2
• /
• pp.21-32
• /
• 2017

This study is a descriptive investigation for understanding factors influencing the length of stay in the postanesthesia care unit of elderly patients. Retrospective investigation was conducted on 300 patients aged 65 or older among those who had received an operation under general anesthesia and treated in postanesthesia care unit of hospital C located in Gyeonggi-do, from January 1 to December 31, 2014. The patients' average postanesthesia care unit stay was found to be 48.4 minutes and the 30-59 minute section accounted for the highest part with 58.0%. The postanesthesia care unit stay time according to intra-operative factors showed significant differences depending upon muscle relaxants, transfusion, ABGA, body temperature and total hours under anesthesia. Concerning the post anesthesia care unit stay length according to post-operative factors, significant differences were observed depending upon complications, PCA device, and circulatory drug use. In order to find out factors influencing the post anesthesia care unit stay length, the multiple regression analysis was conducted. As a result, the circulatory drug use and intra-operative lower body temperature were found to have an effect on the post anesthesia care unit stay length with the total explanatory power of 13%. Based on these findings above, it is deemed helpful to carefully monitor factors related to the post anesthesia care unit stay length and provide swift response accordingly for shorter post anesthesia care unit stay time of elderly general anesthesia patients.

• Health Policy and Management
• /
• v.5 no.2
• /
• pp.18-34
• /
• 1995

To clarify the relationship between the medical supply(medical persons and goods) and the use of bed, the author has made comparison among OECD 24 countries. Per Capita Bed-days can be divided into Average Length of Stay and Admission Rate, and these three variables were regressed upon both In-patient Care Beds of all medical institutions including acute somatic, psychiatric, special, nursing homes and other long-term care and Share of Total Health Employment in Total Employment. The result of regression analysis shows a statistically significant positive relationship between In-patient Care Beds and Average Length of Stay, and negative relationship between Share of Total Health Employment and Admission Rate. In addition to Ordinary Least Square(OLS) estimation, amended Bounded Influence Estimation(BIE) was also made to adjust the influence of outliers. Japan shows a very large number of In-patient Care Beds and a very low Share of Total Health Employment, and this medical situation is judged to have close relation to her long Average Length of Stay and low Admission Rate.

• Journal of Preventive Medicine and Public Health
• /
• v.44 no.1
• /
• pp.48-55
• /
• 2011

Objectives: The purpose of this study was to examine the impact of Diagnosis-Related Group (DRG)-based payment on the length of stay and the number of outpatient visits after discharge in for patients who had undergone caesarean section. Methods: This study used the health insurance data of the patients in health care facilities that were paid by the Fee-For-Service (FFS) in 2001-2004, but they participated in the DRG payment system in 2005-2007. In order to examine the net effects of DRG payment, the Difference-In-Differences (DID) method was adopted to observe the difference in health care utilization before and after the participation in the DRG payment system. The dependent variables of the regression model were the length of stay and number of outpatient visits after discharge, and the explanatory variables included the characteristics of the patients and the health care facilities. Results: The length of stay in DRG-paid health care facilities was greater than that in the FFS-paid ones. Yet, DRG payment has no statistically significant effect on the number of outpatient visits after discharge. Conclusions: The results of this study that DRG payment was not effective in reducing the length of stay can be related to the nature of voluntary participation in the DRG system. Only those health care facilities that are already efficient in terms of the length of stay or that can benefit from the DRG payment may decide to participate in the program.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.24 no.4
• /
• pp.433-442
• /
• 2018

Purpose: This study was performed to investigate the factors affecting postoperative pain and length of hospital stay of liver transplantation donors. Methods: This is a retrospective study using the Electronic Medical Records (EMR) of 91 patients operated on at a tertiary hospital in Seoul, Korea in 2016. The collected data were analyzed using descriptive statistics, t-test, Mann-Whitney U test and Kruskal-Wallis test, Spearman's rank correlation, and multiple regression analysis. Results: The average age of the donors was $35.7{\pm}12.2$ years, and all donors were family members. PCA was applied for control pain in all patients, and 40.7% of PCA-related side effects were observed. The average length of hospital stay was $9.24{\pm}2.52$ days. The factors influencing the length of hospital stay were operative methods, pain control methods, and postoperative complications. The length of hospital stay was 1.29 days shorter if donors had no complication, 1.43 days shorter when only PCA was used, and 1.19 days shorter when laparoscopic resection was performed (Adjusted $R^2=0.17$, F=4.67, p<.05). Conclusion: The results of this study can be used as basic data for practical and effective postoperative nursing education and intervention of living liver donors.

• The Journal of the Korea institute of electronic communication sciences
• /
• v.9 no.2
• /
• pp.203-209
• /
• 2014

The purpose of this study was to analysis of influence between of private health insurance and length of stay with cervical and lumbar simple sprain patients at Ubiquitous medical environment. They were diagnosed as having sprain of cervical and lumbar spine without neurological symptoms in hospitals and clinics from July 1, 2010 to February 29, 2012. This study was t-test, ANOVA and multiple regression analysis. The results were when the number of private health insurance was input as an independent variable, the subjects had one or two accidental insurances(${\beta}$=2.731, P=0.013), length of stay in beds was longer than they had no accidental insurance and when they had more than three ones(${\beta}$=4.991, P=0.000), length of stay was significantly longer. This study has a meaning in that it is domestic practical study which identified relationships between entry of private health insurance and length of stay.

• The Korean Journal of Health Service Management
• /
• v.8 no.4
• /
• pp.47-55
• /
• 2014

The purpose of this study was to analyze the differences in the outcome for CABG according to whether hospitals provided heart related surgeries. The 2011 National Inpatient Sample (NIS) and inpatient quality indicator principles from the Healthcare Research and Quality (AHRQ) were used for analysis. Hospitals were divided into three groups according to the surgeries they provided. The length of stay and in-hospital deaths were adjusted for the differences in risks. ANOVA was performed to examine the differences for the risk-adjusted in-hospital mortality rate and risk-adjusted length of stay among the three groups. The analysis results showed that hospitals providing CABG, PTCA, and PHS had lower risk-adjusted in-hospital mortality rates or similar risk-adjusted lengths of stay compared to those of hospitals providing only CABG. However, the three groups did not have statistically significant differences in outcome indicators. Another study will be needed with a larger sample.