• Title/Summary/Keyword: the length of stay

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Influencing Factors on Family Stress, Family Meaning and Family Adaptation in Families with High Risk Neonates (고위험 신생아 가족의 스트레스, 가족의미 및 적응에 영향을 미치는 요인)

  • Lee, Joung-Ae;Park, In-Sook;Moon, Young-Sook;Lee, Nam-Hyeong
    • Journal of Korean Academy of Nursing
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    • v.37 no.4
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    • pp.431-441
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    • 2007
  • Purpose: The purpose of this study was to identify the relationship among family stress, family meaning and family adaptation of families with high risk neonates. Method: The date was collected on the basis of self- report questionnaires (August 2004 to March 2005); Tow-hundred twelve parents, who had high risk neonates in C hospital's neonatal intensive care unit, participated on request. Results: Family sense of coherence, family meaning, social support, family stress, marital communication and patient condition had a significant, direct effect on family adaptation. Family cohesion, religion, confidence in the health professional, and length of stay had a significant, direct effect on family meaning. Conclusion: The results of this study suggest the consequences associated with high risk neonates may be alleviated by a family support intervention designed to improve parental communication skills as well as to maintain family cohesiveness. Medical care could also encourage more emotional support of parents towards their neonate.

Changes in Japan Healthcare System and New Directions of Hospital Management (일본 의료시스템의 변화와 병원 경영의 새로운 방향)

  • Inoue, Takahiro;Hada, Masashi;Yuzawa, Atsuko;Lee, Sei-Hoon;Kwon, Young-Dae
    • Korea Journal of Hospital Management
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    • v.13 no.4
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    • pp.101-118
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    • 2008
  • Japanese national health expenditure was 8.0% of GDP in 2004, and it was lower than average of OECD countries. But it has increased rapidly in recent years. Japan has relatively many acute care beds and high-price medical equipments, and the average length of stay is long. Japanese government is trying healthcare reform to contain healthcare expenditure, increase the efficiency of management and improve the quality of healthcare. As healthcare policies for hospitals such as DPC (Diagnosis Procedure Combination) for acute care beds, reduction of long-term care beds, and functional differentiation and liaison among healthcare institutions are implemented, the number of hospitals in financial difficulties is increasing. The serious situation urges hospitals to adapt to changes and search new directions of management. They need to establish and implement appropriate positioning strategy, and increase management efficiencies. Korean healthcare system has similarities with Japanese in many aspects. The recent reform and changes in Japanese healthcare system and hospitals give suggestions to Korean hospitals as to how they can prepare for environmental changes and improve management.

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Parent Satisfaction with Inpatient Hospital Services in Children's Hospitals (아동전문병원 입원환아 부모의 병원서비스 만족도)

  • Jeong Yong Sun;Kim Jin-Sun
    • Child Health Nursing Research
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    • v.11 no.3
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    • pp.273-281
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    • 2005
  • Purposes: The purposes of this study were to evaluate parent satisfaction with inpatient hospital services in children's hospitals and to identify variables related to parent satisfaction. Method: A descriptive correlation study was conducted. Parents of 165 children who were inpatients in two children's hospitals participated in the study. Data were collected using structured questionnaire at the time of discharge. For statistical analysis, t-test, ANOVA, and Pearson correlation analysis were used. Results: The highest parent satisfaction domain was nursing service, and the lowest parent satisfaction domain was hospital service and accommodations. Parents were less likely to be satisfied with hospital facilities, equipment, noise and cleaning and less likely to be satisfied with the lack of information they received and with the lack of communication with health care professionals. Parents with longer length of stay and with older children reported higher satisfaction than their counterparts. Moreover, parent satisfaction was related to their intention to revisit and related to intention to recommend this surveyed hospital over others. Conclusions: Efforts to improve parent satisfaction in children's hospital service and accommodation are needed to improve the quality of health care. Communication by health care professionals with parents and a partnership between parents and health care professionals are necessary to improve quality of care.

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Factors Determining Children's Private Health Insurance Enrolment and Healthcare Utilization Patterns: Evidence From the 2008 to 2011 Health Panel Data

  • Shin, Jawoon;Lee, Tae-Jin;Cho, Sung-il;Choe, Seung Ah
    • Journal of Preventive Medicine and Public Health
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    • v.48 no.6
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    • pp.319-329
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    • 2015
  • Objectives: Parental socioeconomic status (SES) exerts a substantial influence on children's health. The purpose of this study was to examine factors determining children's private health insurance (PHI) enrolment and children's healthcare utilization according to PHI coverage. Methods: Korea Health Panel data from 2011 (n=3085) was used to explore the factors determining PHI enrolment in children younger than 15 years of age. A logit model contained health status and SES variables for both children and parents. A fixed effects model identified factors influencing healthcare utilization in children aged 10 years or younger, using 2008 to 2011 panel data (n=9084). Results: The factors determining children's PHI enrolment included children's age and sex and parents' educational status, employment status, and household income quintile. PHI exerted a significant effect on outpatient cost, inpatient cost, and number of admissions. Number of outpatient visits and total length of stay were not affected by PHI status. The interaction between PHI and age group increased outpatient cost significantly. Conclusions: Children's PHI enrolment was influenced by parents' SES, while healthcare utilization was affected by health and disability status. Therefore, the results of this study suggest disparities in healthcare utilization according to PHI enrollment.

Factors Associated with Central Venous Catheterization in Cancer Patients (암환자의 중심정맥관 삽입 예측요인)

  • Park, Jeong-Yun;Park, Yeon-Hwan
    • Asian Oncology Nursing
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    • v.11 no.1
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    • pp.1-8
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    • 2011
  • Purpose: The purpose of this study was to identify the types of venous access devices (VAD) for cancer patients and investigate the factors related to the insertions of central venous catheter (CVC) in cancer patients. Methods: The subjects were 379 cancer patients. A retrospective review of all patients who were discharged from a cancer unit from November 1st to 21st in 2008 was done using a structured questionnaire. Results: A total of 82 CVC (21.6%) was inserted among 379 patients for administering anticancer therapy. There were statistically significant differences in age, length of stay (LOS), cumulative LOS, medical department, history of CVC insertion, cancer category, and albumin level between patients using peripheral intravenous (IV) catheters and CVC. In addition, factors influencing the use of CVC were LOS (odds ratio [OR]=0.286, confidence interval [CI]=1.043-1.124), history of CVC insertion (OR=3.920, CI=0.128-0.637), albumin level (OR=1.010, CI=1.879-8.179), cumulative LOS (OR=1.010, CI=1.001-1.018), and hematological diseases (OR=4.863, CI=2.162-10.925). Conclusion: We found that central venous catheterization for anticancer therapy was minimal even though CVC was safe and effective device for IV access. It is necessary to develop a strategy to use VADs efficiently and timely for cancer patients.

Health related behavior patterns and associated factors among marriage immigrant women using latent class analysis (잠재계층분석을 활용한 결혼이주여성의 건강관련행동 군집유형과 영향요인)

  • Cho, Wonsup;Yoo, Seunghyun;Kim, Hyekyeong
    • Korean Journal of Health Education and Promotion
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    • v.32 no.5
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    • pp.17-31
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    • 2015
  • Objectives: This paper aims to identify the health related behaviors patterns and its associated factors among marriage immigrant women in Korea, and discusses their application to health promotion strategies. Methods: The study participants were 7,591 immigrant wives in Gyeonggi province who participated in health examinations conducted by the Korea Association of Health Promotion in 2011-2013. The participants completed self-administered questionnaires on sociodemographics, psychological characteristics, health status and health care factors, and health related behaviors. Results: A 3-latent-class model of health behaviors was identified related to 'lack of physical activity', 'abnormal diet', and 'not experienced medical check-up': 'high risk class', 'middle risk class', and 'low risk class'. Most of the participants belong to 'middle risk class'. Country of origin, age, length of stay, number of children, work status, health insurance status, and unmet health care needs were associated with problematic health behaviors in middle risk health behavior class. Conclusions: Health promotion and intervention programs for marriage immigrant women and their family members need to consider the health behavior patterns of physical inactivity, abnormal diet and no medical check-up and develop multiple behavior intervention with pre-existing program modification.

Usefulness of Shock Index to Predict Outcomes of Trauma Patient: A Retrospective Cohort Study

  • Kim, Myoung Jun;Park, Jung Yun;Kim, Mi Kyoung;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.32 no.1
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    • pp.17-25
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    • 2019
  • Purpose: We investigated how prehospital, emergency room (ER), and delta shock indices (SI) correlate with outcomes including mortality in patients with polytrauma. Methods: We retrospectively reviewed the medical records of 1,275 patients who visited the emergency department from January 2015 to April 2018. A total of 628 patients were enrolled in the study. Patients were divided into survivor and non-survivor groups, and logistic regression analysis was used to investigate independent risk factors for death. Pearson coefficient analysis and chi-square test were used to examine the significant relationship between SI and clinical progression markers. Results: Of 628 enrolled patients, 608 survived and 27 died. Multivariate logistic regression analysis reveals "age" (p<0.001; OR, 1.068), "pre-hospital SI >0.9" (p<0.001; OR, 11.629), and "delta SI ${\geq}0.3$" (p<0.001; OR, 12.869) as independent risk factors for mortality. Prehospital and ER SIs showed a significant correlation with hospital and intensive care unit length of stay and transfusion amount. Higher prehospital and ER SIs (>0.9) were associated with poor clinical progression. Conclusions: SI and delta SI are significant predictors of mortality in patients with polytrauma. Moreover, both prehospital and ER SIs can be used as predictive markers of clinical progression in these patients.

Factors associated with the self-rated health of married immigrant women in South Korea. (국내 결혼이주여성의 주관적 건강상태에 영향을 미치는 요인)

  • Chae, Duckhee;Kang, Kyeong Hwa
    • Journal of Korean Public Health Nursing
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    • v.35 no.2
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    • pp.224-238
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    • 2021
  • Purpose: This study aimed to identify factors associated with the self-rated health of married immigrant women in South Korea. Methods: Data, collected in August 2018, were derived from the 2018 National Multicultural Family Survey. Study subjects were 9,230 married immigrant women. Data were analyzed using logistic regression. Results: Of the study subjects, 23.2% rated their health as poor. Results showed that individual factors (age, ethnic affiliation, duration in South Korea, and depressive symptoms); social and community networks (relationship with spouse, parenting efficacy, Korean proficiency, perceived discrimination, social support, and social activities); and living and working conditions (life satisfaction and unmet heath needs) were associated with health. Married immigrant women in their 50s or older, living in Korea for more than 15 years, experiencing depressive symptoms, low life satisfaction, and having unmet health needs were especially at high risk of poor health. Conclusion: More detailed health policy that considers age, length of stay, and country of origin. To prevent the rapidly deteriorating health of married immigrant women after middle age, mental health support should be given priority, and systematic improvement is needed to increase accessibility healthcare services.

Diagnostic Laparoscopy and Laparoscopic Diverting Sigmoid Loop Colostomy in Penetrating Extraperitoneal Rectal Injury: A Case Report

  • Jo, Young Goun;Park, Yun Chul;Kang, Wu Seong;Kim, Jung Chul;Park, Chan Yong
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.216-219
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    • 2017
  • Laparoscopy has been one of the most effective modalities in various surgical situations, although its use in trauma patients has some limitations. The benefits of laparoscopy include cost-effectiveness, shorter length of hospital stay, and less postoperative pain. This report describes diagnostic laparoscopy and laparoscopic diverting sigmoid loop colostomy in penetrating extraperitoneal rectal injury. A 41-year-old male presented with perineal pain following penetrating trauma caused by a tree limb. Computed tomography showed air density in the perirectal space and retroperitoneum. As his vital signs were stable, we performed diagnostic laparoscopy and confirmed no intraperitoneal perforation. Therefore, laparoscopic diverting sigmoid loop colostomy was performed. He was discharged without any complications despite underlying hepatitis C-related cirrhosis. Colostomy closure was performed 3 months later.

Feeding Desaturation and Effects of Orocutaneous Stimulation in Extremely Low Birth Weight Infants (초극소 저체중 출생아에서 수유 시 산소포화도 저하와 구강자극 요법의 효과)

  • Choi, Hae-Won;Park, Hye-Won;Kim, Hee-Young;Lim, Gi-Na;Koo, So-Eun;Lee, Byong-Sop;Kim, Ai-Rhan;Kim, Ki-Soo;Pi, Soo-Young
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.193-200
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    • 2010
  • Purpose: Feeding desaturation is a common problem among preterm infants which can result in prolonged hospital stays, longterm feeding difficulties and growth delay. The purpose of this study was to identify the characteristics of premature infants with feeding desaturation and to examine the effect of orocutaneous stimulation on oral feeding. Methods: During the first phase of this study, 125 extremely low birth weight infants were reviewed retrospectively. Characteristics between infants with feeding desaturation (n=34) and those without feeding desaturation (n=91) were examined. During the second phase, 29 infants recruited from March, 2009 to May, 2010 were subjected to orocutaneous stimulation. The results of orocutaneous stimulation were compared to a control group (n=81). Results: The first phase of the study revealed that extremely low birth weight infants with feeding desaturation were significantly lower in gestational ages at birth, and had lower 5 minute apgar scores, more gastroesophageal refluxes and bronchopulmonary dysplasia. Infants without feeding desaturation reached full enteral feeding significantly earlier and showed shorter duration of hospital stay. At the second phase, infants in the intervention group showed shorter days to achieve initiation of bottle feeding, shorter days in achievement of full bottle feeding, last episodes of feeding desaturation and length of hospital stay compared to the control group of similar characteristics. Conclusion: Orocutaneous stimulation among extremely low birth weight infants results in earlier achievement of full bottle feedings without episodes of feeding desaturation hence shortens the length of hospital stay.