• Title, Summary, Keyword: 재입원

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A study on the Hospital dropout of Discharged patients Using Data Mining (데이터마이닝 기법을 이용한 퇴원환자 이탈연구)

  • Ham, S.W.;Kim, E.Y.
    • Proceedings of the KAIS Fall Conference
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    • pp.405-406
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    • 2009
  • Introduction : 최근 의료기관 내 진료비 정산으로 인한 전산화사업이 적극 추진되면서 각 의료기관은 생성된 자료의 목적과는 무관하게 대량의 자료를 지니고 있으면서도 병원경영과 관련하게 자료를 활용하고 있지 못하다.Objectives : 병원 입원환자의 데이터를 분석하여 입원환자의 이탈요인을 파악하여 이탈을 방지하고 지속적인 의료서비스를 제공할 수 있도록 하고자 한다. Method : 본 연구는 일개병원을 퇴원환자를 대상으로 2006년 1월 1일~2007년 12월 31일 동안의 퇴원환자 데이터를 기반으로 연구되었다. 퇴원환자 38,359명의 병원데이터 베이스를 기반으로 동일 연구기간 외래 누적데이터 375,659건의 외래환자 데이터와 비교하여 퇴원환자 중 재입원 예약 및 외래진료 예약 부도여부를 비교하는 후향적 연구를 수행하였다. 2008년 1월 1일 기준 재입원 예약 및 외래진료 예약부도 발생여부를 기준으로 계속진료환자 그릅과 이탈환자그룹을 생성하였다. 중복을 제거한 총 대상은 3,503명이였다. Discussion :본 연구에서 얻어진 결과를 기초로 퇴원환자의 이탈률이 높은 환자그룹을 집중 관리하여 이탈을 방지하고 관심을 갖고 향후 잠재적 이탈 고객을 다시 유입할 수 있는 많은 방안들이 마련되어야 할 것이다.

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Convergence Analysis of Risk factors for Readmission in Cardiovascular Disease: A Machine Learning Approach (의사결정나무분석을 이용한 심혈관질환자의 재입원 위험 요인에 대한 융합적 분석)

  • Kim, Hyun-Su
    • Journal of Convergence for Information Technology
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    • v.9 no.12
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    • pp.115-123
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    • 2019
  • This is descriptive study to 2nd analysis data KNHANES IV-VI about risk factors of readmission among patients with cardiovascular disease. Among the total 65,973 adults, 1,037 with angina or myocardial infarction were analyzed. The analysis was conducted using SPSS window 21 Program and CHAID decision tree was used in the classification analysis. Root nodes are economic activity(χ2=12.063, p=.001), children's nodes are personal income(χ2=6.575, p=.031), weight change(χ2=12.758, p=.001), residential area(χ2=4.025, p=.045), direct smoking(χ2=3.884, p=.031). p=.049), level of education(χ2=9.630, p=.024). Terminal nodes are hypertension(χ2=3.854, p=.050), diabetes mellitus(χ2=6.056, p=.014), occupation type(χ2=7.799, p=.037). We suggest that the development and operation of programs considering the integrated approach of various factors is necessary for the readmission management of cardiovascular patients.

Comparison of Health Behaviors and Health Indices According to Percutaneous Coronary Intervention in Patients with Chest Pain -Analysis of Nursing Information Chart and Electronic Medical Record- (흉통환자의 관상동맥중재술 시행 여부에 따른 건강행위 및 건강지표 비교 - 간호정보조사지와 전자의무기록 분석-)

  • Kweon, Mi-Soo;Lee, Sook-Jeong
    • The Journal of the Korea Contents Association
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    • v.19 no.12
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    • pp.279-288
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    • 2019
  • The purpose of this study was to compare the health behaviors and health indices according to whether a percutaneous coronary intervention(PCI) was performed due to chest pain. This is a secondary data analysis study of nursing information questionnaires and electronic medical records of 247 chest pain patients in a hospital from January 2010 to December 2017. The participants were divided into non-PCI and PCI groups, and the health behaviors, blood pressure, and blood lipid levels were collected at the first hospital admission and re-admission. Collected data were analyzed using SPSS 24.0. As a result of the study, smoking and lipid levels were significantly healthier than the participants in PCI group during re-hospitalization. Non-PCI group had a high risk of smoking despite the high risk of coronary artery stenosis. It was found that continuous integrated management to promote health behavior is needed. The significance of this study was to identify the importance of health behavior in patients with the risk of cardiovascular disease.

A Comparison of Factors Affecting Hospital Revisit Intention in Comprehensive Nursing Care Unit and General Care Unit (간호·간병통합서비스병동과 일반병동환자의 병원재이용의사 영향요인 비교)

  • Lee, Ji-Su;Lee, Ji-Won
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.4
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    • pp.73-81
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    • 2020
  • This study compared nursing service satisfaction and revisit intention of comprehensive nursing care unit and general care unit patients and confirmed the impact of nursing service satisfaction on revisit intention. We used data from 201 survey questionnaires collected from four general hospitals located in B-metropolitan area. Data were collected from Jun 1 to 30, 2019. The data were analyzed using x2-test, t-test, ANOVA, Scheffé test, Pearson's Correlation Coefficient, and Stepwise multiple regression. The results show that nursing service satisfaction was significantly higher in patients admitted to the comprehensive nursing care unit than in the general care unit. There was a significant correlation in increased nursing service satisfaction being associated with increased revisit intention. Among subcategories of nursing service satisfaction, Empathy and Tangibles were cited by 56% of the comprehensive nursing care unit and 40% of the general care unit. As a result of this study, it is necessary to prepare a nursing system that can continuously monitor nursing service satisfaction in order to increase hospital revisit intention and expand the implementation of a comprehensive nursing care unit system.

The Effect of General Hospital Inpatient's Perceived Service Quality on Satisfaction and Customer Loyalty (종합병원 입원환자가 인지하는 의료서비스 품질이 고객만족도 및 충성도에 미치는 영향)

  • Kang, Cheon-Kook
    • The Journal of the Korea Contents Association
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    • v.17 no.12
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    • pp.617-627
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    • 2017
  • The purpose of this study was to investigate the effect of medical service quality perceived by general hospital inpatients on satisfaction and loyalty. Data were collected and analyzed through questionnaires of 310 hospitalized patients in general hospital in Gyeonggi-do. The main results of this study are as follows. First, the effect of medical service quality on satisfaction was statistically significant in procedural procedure, hospital life (doctor, nurse), employee friendliness, hospital environment and service satisfaction(p <.001). Second, the effect of medical service quality on loyalty was statistically significant in hospitalization (nurse), hospitalization (doctor), hospital environment and service loyalty(p <.05). Finally, the effect of inpatient satisfaction on loyalty was found to have a significant effect on satisfaction(p <.001). The higher satisfaction with medical service quality affects the loyalty, and it is an important factor in future re-hospitalization and recommendation of hospital to others. Therefore, management should establish policies on quality of medical service to improve the satisfaction and loyalty of hospitalized patients. It should be reflected.

Factors Influencing Readmission of Home Ventilator-Assisted Children (가정용 인공호흡기 장착 아동의 재입원 영향 요인)

  • Kim, Mi-Hwa;Kim, Hee-Soon;Park, June-Dong
    • Child Health Nursing Research
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    • v.18 no.1
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    • pp.9-18
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    • 2012
  • Purpose: This study was conducted to analyze factors affecting readmission of children with home ventilator care. Methods: To collect patient data, a retrospective chart review was done of medical records of children admitted between June 1, 2007 and May 31, 2010 at one children's hospital located in Seoul. During that period 30 children were discharged with a home ventilator. Results: Twenty-one of these children had a total of 63 readmissions during the study period, averaging 2.1 readmissions per child with a mean duration of hospitalization of 7.4 days. Children with nasogastric tubes were more frequently readmitted (t=7.232, p=.012) and duration of hospitalization was significantly longer (t=4.761, p=.038). Children who had cardio-pulmonary comorbidity were more frequently readmitted and had longer hospitalization than children without comorbidity (t=5.444, p=.027). When home ventilator assisted children were admitted via emergency room, they were hospitalized longer (t=14.686, p=<.001). Cardio-pulmonary morbidity and readmission via ER explained 38.1% of variation for readmission. Feeding method explained 15.0% of variation in length of hospitalization. Conclusion: The results suggest that health care providers must give individualized education on home ventilator care to parents with children who are at risk for readmission due to cardio-pulmonary comorbidities, nasogastric tube, or readmission via ER.

A Study on the Identification of Risk Factors for unplanned Readmissions in a University Hospital (계획되지 않은 재입원에 대한 위험요인분석)

  • Hwang Jeong Hae;Rhee Seon Ja
    • Journal of Korean Public Health Nursing
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    • v.16 no.1
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    • pp.201-212
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    • 2002
  • This study was designed to identify the risk factors of unplanned readmission in a university hospital. The six-month discharge information from January to June, 2000 in a tertiary university hospital was used as a source of data through the medical record and hospital information system. To increase the effect of comparison. the data were collected by sampling 192 couples (384 patients) of unplanned readmission group through the matching by its disease groups, sex, and age. The accuracy of prediction for unplanned readmission was analyzed by constructing the predicted model of unplanned readmission through the logistic regression. The study results are as follows. The conditional logistic regression analysis was performed with nine variables at the significance level 0.05 through univariate analysis including residence, days after discharge, initial admission route, previous admission, transfer to special care unite, hospital stay days, medical care expenses, special cares, and laboratory and imaging services. As a result, the closer the patients live in Seoul and Gyeong-in area (Odds ratio=2.529, p=0.003), the shorter the days after discharge was (Odds ratio=0.600, p=0.000), and the more frequent admission rate was (Odds ratio=2.317, p=0.004), the more unplanned readmission was resulted. Also, the accuracy of prediction for data classification of this regression model showed $70.3\%$(032+83/306).

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Arthroscopic Management for Pyogenic Arthritis with Positive Culture in the Knee Joint (배양 검사로 증명된 화농성 슬관절염의 관절경적 치료)

  • Baek, Seung-Hoon;Kim, Se Sik
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.167-174
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    • 2012
  • Purpose: The purpose of this study is investigation of clinical and functional outcomes in homogeneous group with positive culture after arthroscopic management for pyogenic knee arthritis and analysis of factors affecting those outcomes. Materials and Methods: Thirty-two patients with positive culture after arthroscopic management were included. Mean follow-up period was 41.6 months. Clinical evaluation included death related to infection, recurrence, time to normalize erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), duration of administration of intravenous antibiotics and readmission. Radiographic evaluation was performed according to Kellgren and Lawrence. The prevalence of total knee arthroplasty was investigated and functional evaluation included modified Lysholm, Tegner activity and Korean version of the Western Ontario and McMaster Universities (K-WOMAC) score. Results: Staphylococcus aureus was identified in 21 patients. Time to normalize ESR and CRP was 78.0 and 67.6 days, respectively. Two patients died while there were six recurrences and five readmissions. Rate of recurrence was significantly high in patients with chronic renal failure (P=0.034) and incidence of readmission was associated with higher radiographic grade of osteoarthritis and rate of reoperation (P=0.032 and P=0.006, respectively). At the final follow-up, radiographic grade worsened in 21 patients and was associated with those at first visit. Five arthroplasties were performed. Average modified Lysholm score, Tegner activity score and K-WOMAC score were 53.5, 2.7, 44.2 points, respectively. Conclusion: The severity of osteoarthritis on final radiographs was associated with those at first visit. Patients with higher grade of osteoarthritis at first visit showed higher incidence of readmission and those with chronic renal failure demonstrated higher chances of recurrence.

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The Relation of Communication Types of Nurses, Satisfaction on Nursing Services and Intent to Revisit the Hospital Perceived by Patients Admitted to Comprehensive Nursing Care Service (간호·간병통합서비스를 이용한 입원환자가 인식한 간호사의 의사소통유형, 간호서비스 만족도 및 병원재이용 의도의 관계)

  • Kim, So-Yeong;Kim, Won-Dong;Lee, Sun-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.321-331
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    • 2017
  • This study was conducted to identify communication types of nurses, satisfaction with nursing services and intent to revisit the hospital by hospitalized patients, and to investigate factors influencing intent to revisit the hospital at a time of expansion of comprehensive nursing care service. The subjects consisted of 123 hospitalized patients in sixgeneral hospitals with more than 100 beds in Gyeongsangnam-do. Data were collected by a self-report questionnaire from July 1 to July 30, 2017. The collected data were analyzed by t-test, ANOVA, Pearson's correlation coefficients, and hierarchical regression. There were significant differences in intend to revisit the hospital depending on age(F=9.83, p<0.001), gender(t=-3.82, p<0.001), marital status(t=2.24, p=0.028), education(F=11.92, p<0.001) and days of hospitalization(F=7.81, p<0.001). Intent to revisit the hospital indicated a significantly positive correlation between informative(r=0.609, p<0.001) and affiliative(r=0.536, p<0.001) communication types and satisfaction with nursing services(r=7.97, p<0.001), as well as a significantly negative correlation with authoritative communication types(r=-0.356, p<0.001). Factors influencing intent to revisit the hospital were informational communication type(${\beta}=0.38$, p=0.003) and satisfaction with nursing services(${\beta}=0.84$, p<0.001). Based on these findings, it is necessary to develop various educational programs and conduct systematic education to facilitate effective communication between nurses and patients in order to improve the quality of nursing service and satisfaction of patients admitted to comprehensive nursing care services.

Clustering according to Inpatients' Opinion on Hospital Foodservice and Analyzing Inpatient Response to Foodservice Qualify and Revisit Intention by the Cluster: In Case of S Hospital (입원환자의 급식서비스 인식에 따른 고객 군집화 및 군집별 급식서비스 질 평가, 재이용 의도 분석: S병원을 대상으로)

  • Lee, Hae-Young;Chang, Seung-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.10
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    • pp.1491-1497
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    • 2006
  • The purpose of this study was to analyze the relationship among inpatients' perceptions of foodservice quality, satisfaction and revisit intention. Questionnaires were hand-delivered to 350 inpatients and a total of 230 questionnaires were usable (response rate 65.7%), Statistical data analysis was completed using the SPSS Win 11.0 for descriptive analysis, independent t-test, $x^2$ test and k-means cluster analysis. The results of this study can be summarized as follows: The average score of overall importance of meal service in medical service was 4.25 out of 5.0, yet the score of overall quality of meal service and value had lower than importance score. A helpfulness to medical treatment (3.48), bringing customer happiness (3.18), overall satisfaction for foodservice (3.66), satisfaction based on expectation before discharge (3.53) and offering foodservice apt to hospital reputation (3.40) were measured as expressions of satisfaction. As a result of clustering analysis, two clusters were classified and named as affirmative opinion group and negative one. Expectation for four factors of foodservice quality between two groups had no significance. But affirmative opinion group had significantly higher score than negative one in perception and satisfaction. Affirmative customers' intention to revisit in the near future was evaluated as high in both considering general medical service (4.04) and reflecting meal service level (3.84).