• Title/Summary/Keyword: the length of stay

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Short-term clinical outcomes of late preterm infants (후기 조산아들의 단기 임상적 결과)

  • Na, Ji Youn;Park, Narimi;Kim, Eun Sun;Lee, Hyun Ju;Shim, Gyu Hong;Lee, Jin-A;Choi, Chang Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong Il;Choi, Jung-Hwan
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.303-309
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    • 2009
  • Purpose : To identify the short-term clinical outcomes of late preterm infants and to test the hypothesis that late preterm infants have more clinical problems during the early postnatal period than term infants. Methods : One hundred late preterm infants [gestational age (GA) $34^{+0}$-$36^{+6}$ weeks] and the same number of term infants (GA $37^{+0}$-$41^{+6}$ weeks) were randomly selected from 289 late preterm infants and 825 term infants born in the Seoul National University Bundang Hospital between January 2007 and December 2007, and their electronic medical records were reviewed and analyzed. Results : Compared to term infants, late preterm infants had significantly more medical problems such as temperature instability (odds ratio [OR] 8.7), hypoglycemia (OR 17.5), intravenous fluid infusion (OR 10.2), evaluation for sepsis (OR 9.4), respiratory problems (OR 7.5), apnea and bradycardia (OR 8.6), phototherapy for jaundice (OR 3.6), and feeding intolerance (OR 10.0). Hospital stay was also significantly longer in late preterm infants. Conclusion : Late preterm infants had significantly more medical problems and increased length of hospital stay compared to term infants. More attention should be given to caring for these late preterm infants in newborn nursery during the early postnatal period.

Trend of Medical Care Utilization and Medical Expenditure of the Elderly Cohort (노인 코호트의 의료이용 및 입원진료비 변화 추이 -공.교 의료보험 대상자를 대상으로-)

  • Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.2 s.57
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    • pp.437-461
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    • 1997
  • Because of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 30 years, the life expectancy of the Korean people has lengthened considerably and as a result, the number of the elderly has markedly increased. Such an increase of the number of aged population brought about many social, economic, and medical problems which were never seriously considered before. This study was conducted to assess the trend of medical care utilization and medical expenditure of the elderly. The data of each patient in the study were taken from computer database maintained for administrative purpose by the Korea Medical Insurance Corporation. The study population was 132,670 who were 60 years old or more and registered in Korean Medical Insurance Corporation from 1989 to 1993. The study subjects were predominantly female(56.3%) and 10,000-20,000 Won premium group(50.6%). The following are summaries of findings : The total increase of the number of inpatient cases was 40.5% from 1989 through 1993. The average annual increase was 3.7% in inpatient medical expenditures per case, 4.4% in inpatient medical expenditures per day and 0.08% in length of stay per case from 1989 through 1993. Cataract was the most prevalent disease of 10 leading frequent diseases in all ages from 1989 through 1993. The case mix in 1993 compared to 1989 revealed that cataract and ischemic cerebral disease were increased whereas essential hypertension and pulmonary tuberculosis were decreased . The average annual increase of medical expenditures was 3.8% in general hospitals, 6.3% in hospitals and 2.4% in clinics. From 1989 through 1993, medical expenditures used by high-cost patients accounted for about 14% to 20% of all expenditures for inpatient care, while they represented less than 2.5% of the elderly population. Time series analysis revealed that total medical expenditures and doctor's fee for inpatient will be progressively increased whereas drug expenditures for inpatient will be decreased. And there will be no change in length of stay. Based on the above results, the factors increasing medical cost and utilization should be identified and the method of cost containment for the elderly health care should be developed systematically.

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The Relationship between Medical Service Quality and Managerial Performance in General Hospitals (종합병원의 의료서비스 품질수준과 경영성과 간의 관계)

  • Ryu, Chung-Kul;Yang, Dong-Hyun
    • Korea Journal of Hospital Management
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    • v.11 no.4
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    • pp.82-103
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    • 2006
  • The purpose of this study is to analyse statistically the relation between medical service quality and managerial performance. And then the way of analysis is the regression analysis that independent variable is service quality, dependent variable is the volume of revenue, the number of patients and the rate of beds utility, and dummy variable is the number of beds, ownership and region. The sample hospitals were the 113 hospitals on general hospitals more than 300beds which were consisted of 20 public hospitals, 41 corporate hospitals and 52 college hospitals, and also distributed 67 hospitals on big city and 46 hospitals other city. The sample hospitals were selected from the Korean Hospital Association and the data of the year 2003 and 2004. The collected data was analyzed using the SPSSWIN 10.0 version, and the study hypothesis was tested using regression analysis. The findings of this study are summarized as follows. First, as a result of analysing hypothesis 1. In the study of the relationship between the service quality and the revenue, it was verified that the more service quality in last year became the more revenue in the year. But the dummy variable, ownership and region, rarely related to hospital revenue. Therefore it means that the more service quality is connected to the more revenue on the large number of beds hospitals. Second, as a result of analysing hypothesis 2 & 3. In the study of the relationship between the service quality and the number of patients, it was verified that the more service quality in last year became the more outpatients in the year. But there was no verified to inpatients. It seems to be the reason why a hospital has operated the fixed number of beds approved by the public office. So there are no free to expand beds according to the number of inpatients as much as inpatients are increasing. Third, as a result of analysing hypothesis 4 & 5. In the study of the relationship between the service quality and the rate of beds utility, it was verified that the more service quality in last year became the shorter of average stay of length in the year. Especially it has influenced much more on a hospital which was the large number of beds, the corporate and the college, but the region. But it was denied that the more service quality became the more the beds turnover. As a result of this study, it shows that the service quality in the last year has importantly influenced on a hospital managerial performance in the year. Estimating the service quality of each hospital, most patients have selected the hospital they want. And the hospital need to keep the number of patients for the proper management. So this result of the study means that a hospital must improve the service quality for keeping efficient management.

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The Major Factors Influencing on the Financial Performance of the Profit and Loss-Making Hospitals - With Cases of the Provincial Hospitals - (흑자 및 적자병원의 경영성과요인 -지방공사의료원을 중심으로-)

  • Jung, Yoon-Suk;Jung, Key-Sun;Choi, Sung-Woo;Jung, Soo-Kyung;Lee, Chang-Eun
    • Korea Journal of Hospital Management
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    • v.6 no.2
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    • pp.138-155
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    • 2001
  • This study was designed to find out the factors which influence on the financial performance of the hospital. Out of 32 provincial hospitals which were established by the government, 10 hospitals were selected as sample hospitals. Ten hospitals were divided into two groups(5 hospitals each), one of which was profit-making and the other loss-making. The criteria in selecting profit or loss-making hospitals was net profit to total revenue. The major finding of the study was as follows; 1. Whether or not a hospital had specialized in certain departments was proved to be the major factor influencing on the financial performance. Three out of five profit-making hospitals could harvest following results by operating specific departments. (1) Man powers needed for the operation of specific departments were 14.6 persons per 100 bed, which was only 1/7 of the general hospital. (2) The number of doctors has not increased in proportion to the increase of the number of beds. (3) Ratio of total revenue to MD.'s payroll expenses of the profit-making hospitals was 75.0% higher than the loss-making hospitals. (4) The average length of stay of specific department was very long(388.1 days). However, the specific departments were found to have contributed much to the financial performance because the occupancy rate of such departments was very high(94.5%). 2. The headcount per 100 bed of the profit-making hospitals was 23.9 persons(24.0%) less than the loss-making hospitals and the ratio of payroll expenses to total revenue 15.1% less. 3. Averagel revenue per specialist of the profit-making hospitals was 100 million(25.1%) more than loss-making hospitals and the ratio of total revenue to MD's payroll expenses of profit-making hospital was 75.0% higher. 4. Profit-making hospitals have introduced new systems or renovation in 36 fields, such as incentive payment system, utilization of contracted man powers, change of the payroll structure of the nurses, specialization in certain departments, etc; however, loss-making hospitals introduced only 25 new systems or renovations. These kind of renovation could not be achieved without the cooperation of the labor union and the strong will of the top management. Therefore, it could be said that the labor union of the profit-making hospitals seems to have been very cooperative compared with that of loss-making hospitals.

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A Study on the Nursing Needs and Service Satisfactory of Users in the Post-Partum Care Center (산후조리원을 이용한 산모의 간호요구 및 만족도)

  • Jung, Hyun
    • Women's Health Nursing
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    • v.5 no.2
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    • pp.222-229
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    • 1999
  • These days, as the society has been in the trends of highly industrialized and the family has been downsized, there is remarkably increasing number of women who follow occupation. These changes have made it more difficult for the family to help post-partum mother, which had been performed in side of house. By the help of social believe that during at least 1 month after childbirth professional nursing program is indispensable for both maternity protection and physical-mental recuperation, now many post-partum care centers for post-partum mother have been in operation. Although these post-partum care center have in use for a long time, no study was performed before this study on the same subject. Data were analyzed using by SAS. The results of study are as follow : 1. The general features of the user of the post-partum care center. The predominant band of user's age is extended from 26 to 30. The users are mainly housewives and they are in higher level of incomes and educations. As for the feature of delivery methods, they performed the normal spontaneous vaginal delivery method by 58.0% and the Caesarean operation method by 42.0%. As for the sexuality for babies, 59.3% of infants are male, and 40.7% are female. The highest delivery order of users is first and admission after 1-3days delivery is highest. 2. The results for the investigation into the actual condition of the post-partum care center are as follow : About the main reason for entrance of the post-partum care center was found to be the needs for the better nursing programs for recuperation after childbirth. This demands are also supported by their husbands. The average length of stay in the post-partum care center is 17.6 days and the besides promised expense ; powdered milk, milk-suckers, disposable dippers, skin cares, body shape cares, entrophics, injections. The post-partum have private rooms for mother and infants. Over the half of average expense is 229 million won. They are paying accessory fees the post-partum care center have similar step organization : the nurses, the skin carers, the cleaners. Mostly both ways of feeding powdered milk and breast feeding are in use, and mother's milk is preserved in the night time to be given to infant by nurse in charge. 3. The results of the investigation on users' nursing demand to the post-partum care center and satisfaction are as follow : The ranking order of nursing demand of mothers who used the is that ; infant care demands, environmental demands, emotional and mental care demands, education and training demands. As much as 70% of the respondents have dissatisfaction in nursing program, The ranking order of service satisfaction of mothers who used appears to be higher following order ; satisfaction in infant care demand, satisfaction in physical nursing demand, satisfaction in emotional and mental nursing demand, satisfaction in education and training demand, satisfaction in environment nursing demand. The results of pearson correlation. between nursing demand and service satisfaction of mothers who used are found to be relative noticeable in the level of 0.05. only infant care. The 61.7% of the women who used the post-partum care center. are responding that they will reuse the same post-partum care center again.

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A Comparative Study on Medical Utilization between Urban and Rural Korea (도시 농촌간 의료이용 수준의 비교분석)

  • Joo, Kyung-Shik;Kim, Han-Joong;Lee, Sun-Hee;Min, Hye-Young
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.311-329
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    • 1996
  • This study was designed to compare the level of medical utilization between the urban and rural areas of Korea and to explain the differences between the two regions. Data from the National Health Interview Survey performed by the Korean Institute of Health & Social Affairs in 1992 were used for this study utilizing a sample size of 21,841 people. The level of medical utilization such as the number of physician visits and the number of hospital admissions was compared between the regions with ANOVA. Various determinants for medical use were also compared by univariate analysis. Statistical models which included enabling factors, predisposing factors, need factors and region were constructed for bivariate analysis in order to further elucidate the level of medical utilization. The results were as follows: 1. There was greater medical use, both in terms of physician visits and inpatient care in the rural areas in spite of insufficient health resources. The particular reasons for higher medical utilization in rural areas were attributed to a higher number of initial physician visits as well as a longer the length of stay per hospital admission. Therefore, indicators representing the degree of met need (utilization/need) showed no significant difference between rural and urban areas in spite of the fact that the medical need is larger in rural areas. 2. Use of public health facilities received a significant portion of physician visits in the rural area. The government's effort to enhance primary health care through health centers, health subcenters and the nurse practitioner's post in rural areas has contributed to the increase of access to medical care in the rural areas. 3. There were some differences in the socio-demographic characteristics between two regions ; There were more elderly people over the age of 65: unstable marital status, less education and lower incomes also characterized the rural areas. Therefore, among rural people, there were more predisposing factors for medical use. Additionaly, need factors such as poor self-reported health status and high morbidity level were also high in the rural area. 4. In contrast it was learned that, the supply of health resources was mostly concentrated in the urban areas except for public health facilities. Therefore, geographical access to medical care was lower in the rural area both in terms travel time and travel cost. 5. The coefficient of the region variable was insignificant in the regression model which controlled the supply factor only. However, utilization was significantly higher in urban areas if the model included predisposing factors and need factors in addition to the supply factor. The results were interpreted as rural people have greater medical needs.

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Current Status of Pediatric Critical Care in Korea: Results of 2015 National Survey

  • Yoon, Jong-seo;Jhang, Won Kyoung;Choi, Yu Hyeon;Lee, Bongjin;Kim, Yoon Hee;Cho, Hwa Jin;Eun, Byung Wook;Kim, Jintae;Kim, Kyung Won;Cho, Joongbum;Shin, Hong Ju;Ryu, Jeong Min;Chung, Jae Hee;Yoo, Young;Huh, June;Park, Seong Jong;Park, June Dong;Korean Society of Pediatric Critical Care Medicine
    • Journal of Korean Medical Science
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    • v.33 no.49
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    • pp.308.1-308.10
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    • 2018
  • Background: The aim of this study was to describe the structure, organization, management, and staffing of pediatric critical care (PCC) in Korea. Methods: We directed a questionnaire survey for all Upper Grade General Hospitals (n = 43) in Korea in 2015. The first questionnaire was mainly about structure, organization, and staffing and responses were obtained from 32 hospitals. The second questionnaire was mainly about patients and management. Responses to second questionnaire were obtained from 18 hospitals. Results: Twelve from 32 Upper Grade General Hospitals had pediatric intensive care units (PICUs) and 11 of them had the PICU which was exclusive for children. Total number of PICU beds in Korea was 113. The ratio of the number of PICU beds to the number of children was 1:77,460 in Korea and this ratio is lower than that of other developed countries. The mean number of beds in the PICUs was $9.4{\pm}9.3$ (range, 2-30). There were 16 medical doctors who were assigned for PCC and only 5 of them were full time pediatric intensivists. In the 18 Upper Grade General Hospitals that responded to the second questionnaire survey, there were 97 patients in the PICUs with an average number of $5.7{\pm}7.2$ (range, 0-22) on the survey day. The mean age of the patients was $3.4{\pm}5.6$ years. The mean length of hospital stay was $82{\pm}271days$. The mean Pediatric Risk of Mortality score III was $9.4{\pm}7.8$ at the time of admission to the PICUs. Conclusion: There is a considerable shortage of PICU beds compared to those in developed countries. In addition, the proportion of PICUs with PCC specialists is much lower than those in the US and European countries.

Characteristics of Injured Pregnant Women by the Traffic Accidents (교통사고로 수상한 임산부의 특성)

  • Kim, Duk-Hwan;Cho, Young-Duck;Kim, Jung-Youn;Yoon, Young-Hoon;Lee, Sung-Woo;Moon, Sung-Woo;Choi, Sung-Hyuk
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.132-138
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    • 2012
  • Purpose: Trauma is one of the major causes of maternal and fetal mortality, and the most common cause of maternal trauma is a traffic accident. In Korea, data about traffic accidents in pregnant women are not widely collected and classified so far. Hence, we studied and analyzed the characteristics of injured pregnant women by the traffic accidents. Methods: From January 2002 to August 2011, pregnant women who were in traffic accidents visiting Emergency Department were studied. Pregnancy out come and the degree of the damage were determined through the retrospective analysis of the medical records. Results: The pregnant women who visited after traffic accidents were total 204 patients. Among them, 176 patients had no complication related to the traffic accidents, 28 patients had complications. The incidence of the complications in the 3rd trimester pregnants was statistically significant higher than that in the other trimesters. The analysis based on the mechanism shows more complications in the pedestrian injury. In the survey by the type of the vehicles, the complications from the trauma associated with a car had lower incidence. The patients arrived at the emergency center by walking had greater numbers than who arrived by an ambulance in the groups occurred the complications. The patients suffered complications who complained pain in trunk especially in abdomen and pelvis than in extremities and complained vaginal discharge, and those showed a statistically significant greater incidence. Conclusion: When pregnant women were injured by the traffic accidents, the factors related to the poor pregnant prognosis were trimester of pregnancy, means of visiting the emergency center, trauma mechanism, and complaining symptoms. Therefore, these factors may be used as a prognostic tool to predict an incidence of complications, length of hospital stay and rate of complications and can be used to plan for treatments.

Analysis on Gender Characteristics Expressed in Male and Female Costume During the Ancient Greek Age (그리스 시대의 남성복과 여성복에 표현된 젠더(gender) 특성 분석)

  • Yi, Myoung-Hee;Choi, Yoonmi
    • Journal of the Korean Society of Costume
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    • v.63 no.4
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    • pp.84-100
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    • 2013
  • Ancient Greece was a patriarchal society that distinguished gender roles between men and women. Although their costumes were composed of simple rectangular fabric without any technical complications in itself, the Greeks did try to express gender differences in their clothing. The final look of the Greek costume was dependent on the way the cloth draped onto its wearer as well as the wearer's identity. Greeks costume could just be seen as a rectangular fabric when it was not draped on a person's body. The purpose of this study is to examine how the gender differences were expressed in the ancient Greek drapery costume, which was made by using a completely different technical process, compared with the modern tailored costume. There are four elements of the costume that give the costume its formative shape, which are the wearer's body, the rectangular fabric (material as the first formative costume), the way the fabric is draped, and the final appearance as the second formative costume (the relationship between the wearer's body and the costume) and this study analyzes these elements individually. It is intended to analyze the gender characteristics and how each element appears in a different way from the perspective of Structuralism, an analytical method that considers a phenomenon as a total sum of the elements. Literature research was conducted and representative sculpture, painting and pottery, were used between the Archaic Period (B.C. 800~500) and the Classical Period (B.C. 500~323). The results show that the gender differences appear in each formative element of costume: First, the body was distinguished by the ancient Greek custom. The man's nudity was accepted while the woman's body was concealed. Second, in regards to the first formative costume, which was the rectangular fabric, men's were made with thick high quality wool because their involvement in outdoor activities meant that they needed clothes to stay warm, while the women wore clothes made of thin wool or hemp cloth, because their most of their activities were at home. Third, the way to drape the fabric shows the gender differences by changing the length of the clothing and its design ; men's short khiton was practical for big movement and at the same time the clothing exposed the man's body. The woman's doric khiton diversified its decoration by the size of the apotigma and by using the belt. Finally the second formative costume reflected the Greeks' social distinction between a man's body and a woman's body. The man's costume naturally exposed the man's body. On the other hand, the woman's long costume has a variety of shapes on the ground, that concealed her lower body, while the ornamental function was more accentuated than the man's costume. The gender differences expressed in Greek costume fundamentally reflected the point of view of the male and female body and their social roles in society.

The Effect of Depression and Self-efficacy on the Quality of Life (요양병원 입원노인의 우울과 자아효능감이 삶의 질에 미치는 영향)

  • Kwag, Sung-Won;Sim, Kyoung-Bo;Roh, Heo-Lyun;Kim, Dong-Hyun
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.1
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    • pp.23-31
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    • 2018
  • Objective : Purpose of this study was to investigate the effect of depression and self - efficacy on the quality of life of the elderly hospitalized in a nursing hospital and to suggest a new direction for improving the quality of life of the elderly. Methods : The target was 212 senior citizens who were hospitalized at a nursing hospital located in K city in North Gyeongsang Province. The questionnaire was structured by adding the characteristics of the subjects, the Korean Senior Depression Index (GDS-K), the Self-effective Index (WHQOL-BRFA), and the World Health Organization's Life-Enhanced scale. coded using SPSS ver.18, the depression, self-efficiency, and quality of life differences according to the general characteristics (t-test, ANOVA), and Self-efficacy, depression, and the correlation coefficient between quality of life and A multI-sentence analysis to see the impact of depression and self-efficacy on the quality of life. Results : Self - efficacy and depression according to subject characteristics were different according to length of stay, and quality of life was different in religion. The correlation between depression, self - efficacy, and quality of life of admitted elderly showed statistically significant negative correlation (p <.01) with depression in both the quality of life and self - efficacy sub - variables. The depression and the self - efficacy of the elderly had the greatest effect on the quality of life. The variables were depression (${\beta}=-.328$), social efficacy (${\beta}=.248$), and physical efficacy (${\beta}=.193$). Conclusion : In order to improve the quality of life of the elderly, it will be necessary to provide and develop medical care services that reduce depression and improve self - efficacy (physical and social).