• Title/Summary/Keyword: the length of stay

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Imported Malaria over Fifteen Years in an Inner City Teaching Hospital of Washington DC

  • Yeruva, Sri Lakshmi Hyndavi;Sinha, Archana;Sarraf-Yazdy, Mariam;Gajjala, Jhansi
    • Parasites, Hosts and Diseases
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    • v.54 no.3
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    • pp.261-264
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    • 2016
  • As endemic malaria is not commonly seen in the United States, most of the cases diagnosed and reported are associated with travel to and from the endemic places of malaria. As the number of imported cases of malaria has been increasing since 1973, it is important to look into these cases to study the morbidity and mortality associated with this disease in the United States. In this study, we would like to share our experience in diagnosing and treating these patients at our institution. We did a retrospective chart review of 37 cases with a documented history of imported malaria from 1998 to 2012. Among them, 16 patients had complicated malaria during that study period, with a mean length of hospital stay of 3.5 days. Most common place of travel was Africa, and chemoprophylaxis was taken by only 11% of patients. Travel history plays a critical role in suspecting the diagnosis and in initiating prompt treatment.

The Adequacy of Laparoscopic Appendectomy for Simple and Perforated Appendicitis in Children (소아에서 단순형 및 천공형의 급성 충수염에 대한 복강경하 충수절제술 적용의 적합성 연구)

  • Kim, Mee-Ra;Chung, Jae-Hee;Kim, Eung-Kook;Song, Young-Tack
    • Advances in pediatric surgery
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    • v.10 no.2
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    • pp.127-130
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    • 2004
  • Appendectomy is the most common emergency surgical operation in children. The laparoscopic treatment of pediatric appendicitis is controversial, particularly in complicated cases. The purpose of this study is to evaluate laparoscopic appendectomy (LA) and open appendectomy (OA) for simple and perforated appendicitis (SA, PA) in children. A total of 188 patients, operated from January 1992 to September 2003, were reviewed. Ninety-one patients underwent OA (65 SA and 26 PA) and 97 had LA ( 67 SA, 30 PA). There was one conversion of LA to OA in PA. Operative time for LA was longer for OA in PA (55.8 vs. 45.7 min; p=0.0467). Recovery of bowel movement, diet starting time, length of hospital stay for LA were significantly shorter than those for OA. Postoperative complication rate was not different between LA and OA in each group. Laparoscopic appendectomy is a safe and effective method for both simple and perforated appendicitis.

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Reclassification of healthcare utilization of inpatients to estimate the demand for long-term care services (현 입원의료이용량의 급성기진료 및 장기요양 서비스 재분류)

  • 장혜정;김창엽;윤석준
    • Health Policy and Management
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    • v.11 no.3
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    • pp.31-45
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    • 2001
  • With an economic development and epidemiologic transition, the burden of disease due to chronic diseases and accidents is increasing. However, in most of developing countries, long-term care facilities are not available, therefore acute care facilities should provide both acute and long-term care services. It is also true in Korea. The demand for long-term care services needs to be estimated to establish the adequate supply system of health resources. This article introduces the reclassification methodology of inpatients' healthcare utilization to acute and long-term care services. All discharged patients from hospitals for one month were analyzed. The distribution of inpatients' hospital days were fitted to Chi-squared distribution by ICD disease categories, and they were grouped in five clusters. For each cluster, the lower and upper limit of classification criteria to acute and long-term care services were chosen. Summarizing all hospital days corresponding to acute and long-term care respectively, 24 to 28 percent of inpatient services fumed out to be long-term care services. The study results are consistent with those of the existing studies. They can be used practically in the allocation of long-term care resources.

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Factors Influencing Relocation Stress Syndrome in Patients Following Transfer from Intensive Care Units (중환자실 환자의 일반 병동 전실 시 스트레스 영향요인)

  • Park, Jin-Hee;Yoo, Moon-Sook;Son, Youn-Jung;Bae, Sun-Hyoung
    • Journal of Korean Academy of Nursing
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    • v.40 no.3
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    • pp.307-316
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    • 2010
  • Purpose: The purpose of this study was to identify the levels of relocation stress syndrome (RSS) and influencing the stress experienced by Intensive Care Unit (ICU) patients just after transfer to general wards. Methods: A cross-sectional study was conducted with 257 patients who transferred from the intensive care unit. Data were collected through self-report questionnaires from May to October, 2009. Data were analyzed using the Pearson correlation coefficient, t-test, one-way ANOVA, and stepwise multiple linear regression with SPSS/WIN 12.0. Results: The mean score for RSS was $17.80{\pm}9.16$. The factors predicting relocation stress syndrome were symptom experience, differences in scope and quality of care provided by ICU and ward nursing staffs, satisfaction with transfer process, length of stay in ICU and economic status, and these factors explained 40% of relocation stress syndrome (F=31.61, p<.001). Conclusion: By understanding the stress experienced by ICU patients, nurses are better able to provide psychological support and thus more holistic care to critically ill patients. Further research is needed to consider the impact of relocation stress syndrome on patients' health outcomes in the recovery trajectory.

Study on the Medical Cost of Patients Visited by Referral Center: Focusing on the Patient in Gastroenterology (진료의뢰센터 경유환자의 진료비 영향요인에 관한 연구: 소화기내과 환자를 중심으로)

  • Choi, Young-Doo;Lee, Kwang-Soo;Hong, Sang-Jin
    • The Korean Journal of Health Service Management
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    • v.6 no.2
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    • pp.101-109
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    • 2012
  • This study purposed to analyze the differences of cost, length of stay, and number of visits between patients who referred from clinics to a general hospital and patients who directly visit a general hospital. Study sample included 402 patients (177 patients who were not referred from clinics, 225 patients who referred from clinics) who visited the Dept. of Gastroenterology in a university hospital in Daejeon from January to June in 2007. Cost and patients' information were collected from Hospital Information System and medical record. SPSS v.12.0 was used for the statistical analysis. Multiple regression analysis found that for inpatients, location variables and malignant tumors of digestive organs had a significant influence on cost variable. For outpatients, a referring hospital type and visiting month had significant influences on total cost, and sex and visiting month (February) had significant relationship with number of visit. The study results help to understand the differences of patient care depending on whether they were referred from clinics or not. Hospital managements could use the results for marketing purposes, and it could provide valuable information for increasing the competitiveness of hospital in a given market.

Frailty assessed by the electronic frailty index and its impact on health outcomes in older adults with chronic diseases: a systematic review (전자허약지수(electronic frailty index)를 활용한 만성질환 노인의 허약평가와 건강결과 간의 관계: 체계적 고찰)

  • Jung-Wook Shin;Min-Young Yu;Youn-Jung Son
    • Journal of Korean Biological Nursing Science
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    • v.25 no.4
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    • pp.229-242
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    • 2023
  • Purpose: The electronic frailty index (eFI), which is derived from electronic health records, has been recommended as screening tool for frailty due to its accessibility and ease of use. The objective of this systematic review was to identify the prevalence of frailty assessed by the eFI and its influence on health outcomes in older adults with chronic diseases. Methods: We searched PubMed, Embase, Web of Science, CINAHL, SCOPUS, Cochrane, Google search, and nursing journals in Korean from January 2016 to December 2022. Results: Twelve studies were analyzed. The eFI score, based on routine clinical data, was associated with adverse health outcomes. The most frequent outcome studied was mortality, and the eFI was associated with increased mortality in nine studies. Other outcomes studied included hospitalization, length of stay, readmission, and institutionalization in relation to hospital care usage, and cardiovascular events, stroke, GI bleeding, falls, and instrumental activities of daily life as health conditions. Conclusion: Early identification of frailty in older adults with chronic diseases can decrease the burden of disease and adverse health outcomes. The eFI has a good discriminative capacity to identify frail older adults with chronic diseases.

Impact of public releasing of hospitals' performance on acute myocardial infarction outcomes (병원의 급성심근경색증 진료 결과 공개의 효과)

  • Eun, Sang Jun;Kim, Yoon;Lee, Eun Jung;Jang, Won Mo
    • Quality Improvement in Health Care
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    • v.17 no.1
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    • pp.69-78
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    • 2011
  • Objectives : The purpose of this study was to determine whether the published AMI report card could reduce in-patient mortality, 7-day after discharge mortality, and length of stay (LOS). Methods : Interrupted time-series intervention analysis was used to evaluate the impact of the report card for AMI care quality in November 2005 in terms of risk-adjusted in-patient mortality, risk-adjusted 7-day after discharge mortality, and DRGs case-mix LOS using the claim data of Health Insurance Review and Assessment Service. Results : Public disclosure of AMI care quality decreased risk-adjusted in-patient mortality and DRGs case-mix LOS by 0.00050% per month and 0.042 days per month respectively, however there was no effect on risk-adjusted 7-day after discharge mortality. Patterns of effect of public disclosure on AMI outcomes were a fluctuating pattern on risk-adjusted mortalities and a pulse impact for 1 month on DRGs case-mix LOS. Conclusions : We found the public disclosure of AMI care quality had decreasing effects on risk-adjusted in-patient mortality and DRGs case-mix LOS, but the size of the effect was marginal.

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Effect of Intravenous Patient Controlled Analgesia for Postoperative Pain in Adult Tonsillectomy (성인에서 편도적출술후 정맥내 동통자가조절법에 의한 동통조절 효과)

  • 정필섭
    • Korean Journal of Bronchoesophagology
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    • v.4 no.2
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    • pp.171-176
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    • 1998
  • Postoperative pain following tonsillectomy remains a significant obstacle to speedy recovery and smooth convalescence. Inadequate analgesia causes poor oral intake and influences the length of hospital stay and ability to return to normal activity. Patient Controlled Analgesia (PCA) is a method of analgesia adminstration that consists of a computer driven pump with a button that the patient may press to adminster a small dose of analgesic drug. The aim of this study was to examine whether Intravenous Patient Controlled Analgesia (IV-PCA) can reduce postoperative pain after tonsillectomy. The 100 patients undergoing tonsillectomy with general anesthesia were divided into two groups. The PCA group patients (n=80) received a mixture of nalbuphine and ketorolac by Walkmed PCA infusor during first 48 postoperative hours. In control group (n=20), the patients received oral acetoaminophen (Tyrenol) regularly and tiaprofenic acid (Surgam) intramuscularly on a p.r.n basis. Analgesic efficacy was evaluated with visual linear analogue scale (VAS) and the adverse effects were evaluated with 4 point scale. The patients of PCA group had less pain than those of control group. The adverse effects in the PCA group were nausea and vomiting. This study suggests that IV-PCA may be safe and effective method of pain control after adult tonsillectomy and is better accepted than oral or intramuscular pain medications.

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Study on Feasibility as Culinary Tourism Resources of Head Families (Jongga) - With a Chungjae Gwonbeol Jongga Familiarization Tour Participants - (종가의 음식관광자원 가능성 연구 - 충재 권벌종가 팸투어 참가자 대상으로 -)

  • Choi, Jia;Lee, Eun-Joo
    • Journal of the East Asian Society of Dietary Life
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    • v.25 no.5
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    • pp.752-764
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    • 2015
  • The main objective of this study was to investigate how Jongga and its cuisine is perceived by Koreans and foreign tourists and develop Jongga culinary culture for culinary tourism. Chungjae Jongga was chosen since it is one of the most famous Jongga in South Korea. In-depth personal interviews were performed with Koreans and foreign tourists. Interviews were performed to provide deeper insights into comments and subject matters. Most tourists selected "having lunch at Jongga" as the most distinctive part of the tour. To develop the experience at Jongga as a culinary destination, questionnaires were created to study eight areas: satisfaction, expectations as a tourist at Jongga, most impressive part of tour, preference of food serving style, length of stay, price range, things to be improved, and role of food guide. This study will help Jongga to improve food as a culinary tourist's attraction and ultimately heighten the value of Jongga. Perceptions toward Jongga and its cuisine were generally positive, but the quality of service and lack of organization in establishments were perceived to be negative factors.

Analysis of Healthcare Quality Indicator using Data Mining and Decision Support System

  • Young M.Chae;Kim, Hye S.;Seung H. Ho
    • Proceedings of the Korea Inteligent Information System Society Conference
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    • 2001.01a
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    • pp.352-357
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    • 2001
  • This study presents an analysis of healthcare quality indicators using data mining for developing quality improvement strategies. Specifically, important factors influencing the inpatient mortality were identified using a decision tree method for data mining based on 8,405 patients who were discharged from the study hospital during the period of December 1, 2000 and January 31, 2001. Important factors for the inpatient mortality were length of stay, disease classes, discharge departments, and age groups. The optimum range of target group in inpatient healthcare quality indicators were identified from the gains chart. In addition, a decision support system was developed to analyze and monitor trends of quality indicators using Visual Basic 6.0. Guidelines and tutorial for quality improvement activities were also included in the system. In the future, other quality indicators should be analyze to effectively support a hospital-wide continuous quality improvement (CQI) activity and the decision support system should be well integrated with the hospital OCS (Order Communication System) to support concurrent review.

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