• Korea Journal of Hospital Management
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• v.27 no.1
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• pp.31-42
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• 2022

Purposes: This study aims to investigate the changes in the length of stay and medical expenses by the impact of the admission decided by patients or their family. Methodology: The analysis was conducted using data from elder patients aged 65 or older who have used admission services more than once from year 6(2012) to year 12(2017) of the Korean Medical Panel Data(KOWEPS). The statistical analysis was performed through the Chi-square test, mean difference analysis, and generalized estimation equation analysis. Findings: Compared to the patients who used admission services decided by doctors, those who used admission services decided by patients or their family had a longer length of stay and a lower daily medical expense. Practical Implications: Inappropriate admission decided by patients or their family can increase the risk of hospital-acquired infections, impairing the health of elderly patients, and has a negative impact on the efficiency of health resources. Therefore, it is necessary to prevent and properly manage inappropriate admission decided by patients or their family

• Journal of Digital Convergence
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• v.11 no.4
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• pp.351-359
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• 2013

This study was conducted to investigate the factors that affect the length of stay in hospital for schizophrenic patients. Of the data from the in-depth injury patient surveillance system, the final subject included 2,239 patients with schizophrenia in their final diagnosis. Using SPSS 18.0, a hierarchical regression analysis was performed by sequentially entering the explanatory variables by setting sociodemographic characteristics, discharge characteristics and hospital characteristics as explanatory variables and the length of stay in hospital as a dependent variable. The findings showed that the sociodemographic characteristics had the highest explanatory power and the explanatory power changed when the explanatory variable of the hospital characteristics was added, as opposed to the discharge characteristics. Male, type-1 medicaid, Chungcheong-do and the number of beds were found to be the factors that mostly affect the length of stay. Since this study used the secondary data, it has a limitation in terms of additional variables that could better explain the length of stay for schizophrenic patients. Nevertheless, it has an implication in that it investigated a large scale of data on a national level. For the effort of reducing the length of stay, it is suggested that an effort should be made at the national level, by focusing more on the hospital characteristics as well as the individual characteristics of patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.3
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• pp.1234-1243
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• 2011

Our study was carried out to develop the severity-adjustment model for length of stay in hospital for community-acquired pneumonia so that we analysed the factors on the variation in length of stay(LOS). The subjects were 5,353 community-acquired pneumonia inpatients of the Korean National Hospital Discharge In-depth Injury Survey data from 2004 through 2006. The data were analyzed using t-test and ANOVA and the severity-adjustment model was developed using data mining technique. There are differences according to gender, age, type of insurance, type of admission, but there is no difference of whether patients died in hospital. After yielding the standardized value of the difference between crude and expected length of stay, we analysed the variation of length of stay for community-acquired pneumonia. There was variation of LOS in regional differences and insurance type, though there was no variation according whether patients receive their care in their residences. 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 Preventive Medicine and Public Health
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• v.43 no.6
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• pp.523-534
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• 2010

Objectives: We assessed impact of performance reporting information about the readmission rate, length of stay and cost of hip hemiarthroplasty. Methods: The data are from a nationwide claims database, National Quality Improvement Project database, of Health Insurance Review & Assessment Service in Korea. From January 2006 to April 2008, we received information of length of stay, readmission within 30 days, cost of 22 851 hip hemiarthroplasty episodes. Each episodes has retained the diagnoses of comorbidities and demographics. We used time-series analysis to assess the shifting of patients selections, between high volume (over 16 operations in a year) and low volume institutions, after performance reporting (December 2007). The changes of quality (readmission, length of stay) and cost were evaluated by multilevel analysis with adjustment of patient's factors and institutional factors after performance reporting. Results: As compared with the before performance reporting, the proportion of patients who choose the high volume institution, increased 3.45% and the trends continued 4 months at marginal significance (p = 0.059). After performance reporting, national average readmission rate, length of stay were decreased by 0.49 OR (95% CI=0.25 - 0.95) and 10% (${\beta}$=-0.102, p<0.01) and cost was not changed (${\beta}$=-0.01, p=0.27). The high volume institutions were more decreased than low volume in length of stay. Conclusions: After performance reporting, readmission rate, length of stay were decreased and the patient selections were marginally shifted from low volume institutions to high volume institutions.

• Quality Improvement in Health Care
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• v.10 no.1
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• pp.42-56
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• 2003

Background : The purpose of this study is to investigate the influencing factors on the length of emergency department stay of patients with acute myocardial infraction. Methods : we reviewed medical records of all patients who were Hospitalized with acute myocardial infraction from March 1, 2002 to February 28, 2003. Results : The average length of stay in the emergency room of the subjects was 182.74 minutes. After the emergency room treatment, 48.1% of the subjects were transferred to intensive care unit. The hospitalization through emergency room mostly took place in the office hours. There were more patients on Monday. The influencing factors on the length of stay in the emergency room of patients with acute myocardial infraction were emergency room arrival time which was classified in seasons, treatment hours of specialized doctors, medical care insurance and required time of radiologic examination. Conclusion : In order to reduce the length of emergency room stay, it might be an available solution secure enough spaces, facility, and staff of the radiologic test only for the patients of the emergency room. And the effective use of emergency facility and space, establishment of standardized treatment guideline, and provision of emergency treatment support system are also needed.

• Health Policy and Management
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• v.29 no.4
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• pp.445-453
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• 2019

Background: This study is to investigate the association between the distribution of multimorbidity and length of stay and medical expenses among inpatients in a municipal hospital to achieve an integrated care setting. Methods: We used the exploratory factor analysis and the generalized estimating equation model to analyze the data from patients living in the northeast region of Seoul, who were hospitalized from January 2017 to December 2017 in a municipal hospital. Results: As a result of the factor analysis, seven types of multiple chronic diseases were classified. Among the elderly patients admitted to municipal hospitals, the burden of medical expenses was mainly influenced by the length of stay (B=310,719, p-value <0.0001), not the type of disease (all not significant). Length of stay were mainly due to psychiatric illness (factor 1: B=4.323, p-value <0.0001) related to the brain and metabolic diseases (factor 2: B=2.364, p-value=0.003). Conclusion: This study showed that the medical expenses of the elderly patients were largely due to prolonged hospitalization, not multimorbidity. Therefore, it is necessary to develop an integrated care paradigm strategy cope with the multimorbidity of the elderly in the community and to alleviate the socio-economic burden.

• Safety and Health at Work
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• v.14 no.2
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• pp.229-236
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• 2023

Background: In workers with moderate to severe work-related traumatic brain injury (wrTBI), this study aimed to investigate the effect of the timing of rehabilitation therapy initiation on the length of hospital stay and the factors that can influence this timing. Methods: We used data obtained from the Republic of Korea's nationwide Workers' Compensation Insurance. In the Republic of Korea, between the years 2010 and 2019, a total of 26,324 workers filed a claim for compensation for moderate to severe wrTBI. Multiple regression modeling was performed to compare the length of hospital stay according to the timing of rehabilitation therapy initiation following wrTBI. According to the timing of the initiation of rehabilitation therapy following TBI, the proportions of healthcare institutions that provided medical care during each admission step were compared. Results: The length of hospital stay for workers who started rehabilitation therapy within 90 days was significantly shorter than that for workers who started rehabilitationment were first admitted to tertiary hospitals. Approximately 39% of patients who received delayed rehabilitation treatment were first admitted to general hospitals, and 28.5% were first admitted to primary hospitals. Conclusions: Our findings demonstrate the importance of early rehabilitation initiation and that the type of healthcare institution that the patient is first admitted to after wrTBI may influence the timing of rehabilitation initiation. The results of this study also emphasize the need to establish a Worker's Compensation Insuranceespecialized rehabilitation healthcare delivery system.

• Journal of Korea Entertainment Industry Association
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• v.14 no.6
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• pp.201-208
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• 2020

The purpose of this study was to analyze the claim data of Health Insurance Review & Assessment Service to determine what factors affected the length of stay in patients aged 65 and older and undergoing total knee arthroplasty due to the principal diagnosis of gonarthrosis by the type of medical institutions. As a result of making an analysis, gender, age, medical security type, severity, residential area and the number of sickbeds were identified as the factors that influenced the length of stay in each type of medical institutions. At this point in time when an increase in the elderly population triggered by population aging and another subsequent increase in medical expenses put a heavy strain on household and national economy, it's necessary to consider how to shorten the length of stay and how to ensure the efficient management of sickbeds based on the findings of this study. In addition, this study is of significance in that it could be used as basic data on quality life-care for elderly patients by the introduction of a systematic management system geared toward lessening patient burden for medical expenses.

• Journal of Korean Biological Nursing Science
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• v.17 no.1
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• pp.28-36
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• 2015

Purpose: This study examined the effects of music therapy on pain, anxiety and length of stay of patients undergoing laparoscopic hysterectomy in the postanesthesia care unit (PACU). Methods: Sixty patients who received laparoscopic hysterectomy under general anesthesia from a PACU in a university hospital located in Cheonan city participated in this study. The experimental group (n=30) was offered the option to listen to their preferred music by using MP3 players and headphones for 30 minutes. The control group (n=30) received routine postoperative nursing care. Visual analogue scale was used to measure participants' pain and anxiety, length of stay in the PACU was examined by using their medical records. Data were collected from December 2013 to February 2014 and analyzed by descriptive statistics, ${\chi}^2$-test, Fisher's exact test, and independent t-test using SPSS version 21.0. Results: The result showed that the level of post-operative pain (t=2.44, p=.018), anxiety (t=2.37, p=.021), and the length of stay in PACU (t=3.06, p=.004) significantly decreased in the experimental group as compared to the control group. Conclusion: This study indicated that music therapy with the patients' preferred music showed positive effects. Therefore, it can be used as a therapeutic intervention for postoperative pain management of patients with laparoscopic hysterectomy.

• International Journal of Human Ecology
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• v.10 no.1
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• pp.87-98
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• 2009

This study examines the socio-cultural readjustment of the Korean students returning from overseas study at an early age. For this study 259 returnee students from elementary through high school completed a questionnaire which covered aspects such as school adjustment and re-acculturative stress in relationship to gender, grade, number of parents accompanying the students overseas, length of overseas stay, age of return, length of stay in Korea, and the acculturative stress experienced in a host culture. The findings indicate that re-acculturative stress level of returnee students is higher than the level of the acculturative stress, and that the two are positively related. Hierarchical multiple regression analyses reveal the grade and acculturative stress of returnee students as a significant predictor of school adjustment. The length of overseas stay and acculturative stress significantly predicted the re-acculturative stress level. The acculturative stress significantly affected both school adjustment and re-acculturative stress of returnee students back in Korea.