• Title, Summary, Keyword: 재입원

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Consumption Values on the Intention to Re-use on Geriatric Hospitals (노인요양병원 재이용 의사에 영향을 미치는 소비가치 요인)

  • Kwon, Jin
    • The Journal of the Korea Contents Association
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    • v.13 no.12
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    • pp.921-930
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    • 2013
  • Objective: After introduction of the Elderly Long Term Care Insurance, number of geriatric hospitals increased greatly. However, few studies were conducted on the satisfaction of the patients of the geriatric hospitals especially on the intention to reuse geriatric hospitals. Methods: The current study modified Sheth's consumption value model, useful for the development of an effective marketing strategy for geriatric hospitals, and tested it in Korean circumstances. The survey was conducted at two municipal hospitals and three private hospitals in Seoul and Gyeonggi Province between August 1 and September 30 of 2012. Data were collected from 472 inpatients who are 60 years or older. The structured research tool was developed and distributed. Factor analysis and hierarchical logistic regression analysis were conducted using SPSS(version 14.0) Results: The result of the research suggested that the satisfaction on rehabilitation services, which is a functional value, among the consumption values was the strongest factor on the intention to reuse geriatric hospitals. Impression of high-end luxury, reliability of care, and outside locus of control on health followed. Conclusion: It is recommended that geriatric hospitals ought to improve rehabilitation programs, facilities, and equipments and enhance kindness of staff to encourage intention to reuse geriatric hospitals.

Construction of Medical Episode Data using National Health Insurance Service Data (국민건강보험청구 자료를 이용한 진료에피소드 자료 구축)

  • Pak, Hae-Yong;Pak, Yun-Suk
    • Journal of Convergence for Information Technology
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    • v.9 no.9
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    • pp.195-200
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    • 2019
  • The purpose of this study is to analyze the characteristics of National Health Insurance claim data and to construct a pilot medical episode data considering it. In this study, the trends of respiratory disease (ICD10: J00-J99) cardiovascular disease (ICD10: I00-I99) from the day of onset of treatment to re-admission after admission were confirmed in Seoul, and the largest decrease was observed when the no-treatment period was 0 day. The data reduction rate when the no-treatment period is 0 day is judged to be due to the monthly separation claim of the health insurance claim data. Also, the result that there is a tendency of monthly separation request according to the type of medical treatment. Through this study, we constructed epidemic data for the pilot medical treatment considering the characteristics of the claim data of health insurance, and based on this, it can be used as a data processing method for calculating basic epidemiological information.

A Case of Vascular Ring Associated with Tracheitis Due to Type b Haemophilus influenzae (헤모필루스 인플루엔자 기관염이 확인되면서 진단된 혈관륜 1례)

  • Kim, Su Hyun;Chung, Yoon Sook;Oh, Sung Hee;Kim, Nam Su;Kim, Hyuck
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.261-266
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    • 2002
  • Vascular ring, originating from abnormal regression of the aortic arch during fetal life, can cause prolonged and recurrent respiratory symptoms and dysphagia when the diagnosis is delayed. We report a 4 month old girl with vascular ring, who had been treated for persistent respiratory symptoms including stridor, wheezing, and dyspnea soon after birth. Initially her respiratory symptoms were thought to be due to bronchiolitis, for which respiratory syncytial virus was confirmed by immunofluorescent staining. Her clinical course was again complicated with tracheitis and pneumonia due to Haemophilus influenzae type b. The possibility of anatomical anomaly was investigated when it was felt to be difficult to insert a suction catheter deep down through a endotracheal tube which was placed for adequate ventilatory management. A three-dimensional chest CT revealed a vascular ring consisting of a double aortic arch. For 5 months following surgery, her respiratory symptoms have slowly been improving. She developed another episode of pneumonia which was milder than the one which occurred before the surgery.

Carcinoma of Esophagus Developing at the Site of Lye Stricture (부식성 식도염에 의한 협착부에 발생한 식도암)

  • 김종훈;김중강;백준기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • pp.10.4-10
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    • 1979
  • The cause of esophageal cancer is still unknown in the majority of patients, but pre-existing diseases of esophagus related to the development of cancer were reported by many authors: e.g. lye stricture, achalasia, Plummer-Vinson syndrome, dietary and alocholic habbits etc. Recently the authors had experienced one case of esophageal cancer with complaint of dysphagia, developing at the site of lye stricture, which was diagnosed by the esophagogram and esophagoscopic biopsy.

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Lateral Thoracic Expansion Surgery for Jeune's Syndrome (Jeune 증후군 환아에게 시행한 외측 흉벽 확장술)

  • Kim Joon Bum;Moon Il Hong;Choi Byung Min;Lee Kee Hyoung;Choi In Cheol;Park Seung Il
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.38 no.12
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    • pp.873-877
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    • 2005
  • Jeune's asphyxiating thoracic dystrophy is a rare, complex malformation with a broad spectrum of clinical expression. The degree of chest wall deformity is the most important prognostic factor and the only part which is correctable. A 11 month-old male infant was diagnosed as having Jeune's syndrome and received right side lateral thoracic expansion surgery. But because respiratory distress symptom was sustained postoperatively, we performed left side procedure 3 months after the initial operation. Respiratory distress symptom got worse after fracturing the left titanium plate which was inserted to fix the expanded thoracic wall and reimplantation was performed. The patient was discharged 6 months after the initial operation. He was readmitted and received ventilator care for respiratory failure and died 10 months after the initial operation.

Utilization of Medical Assistance Patients in Nursing Hospital (의료급여환자의 요양병원 이용에 관한 연구)

  • Lee, Yong-Jae
    • The Journal of the Korea Contents Association
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    • v.17 no.5
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    • pp.366-375
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    • 2017
  • The purpose of this study is to analyze the use of hospital, hospitalization, medical service, discharge and power of medical care patients who are concerned about moral hazard. We conducted focus group interview with 3 medical care patients and their families and 5 workers who had worked for more than 4 years in a nursing hospital. The main results and implications are as follows. First, admission to nursing hospitals was mostly based on the linkage between the medical institutions and the competition to attract the patients rather than the choice of the patients. Second, the main cause of the long-term hospitalization of medical assistance patients was the lack of social protection measures such as absences of residence and care giver, although there are factors that cause moral hazard such as low self-pay. Third, most of the patients were in need of treatment, but they were admitted to the hospital even though their needs were not higher than those of the health insurance patients. Fourth, the rehabilitation service is the mainstay of the medical service of the nursing hospital, and the roles of nursing staff and care givers are important. Fifth, medical care patients are paying medical expenses for nursing hospitals due to cost of living and family support, but they are exempted from the hospital expenses or the burden of their own expenses in the hospital. Sixth, public institutions and social welfare institutions have not managed continuously since commissioning patients to nursing hospitals and have neglected the connection with community services after discharge.

Trial of a Synthetic Absorbable Staple Line Reinforcement for Preventing Recurrence after Performing Video-assisted Thoracoscopic Bullectomy for the Treatment of Primary Pneumothorax (일차성 기흉 치료에서 흉강경 기포 절제술 시 재발 방지를 위한 Staple Line 보강재 사용)

  • Park, Jae-Hong;Yoo, Byung-Ha;Kim, Han-Yong;Hwang, Sang-Won;Kim, Myoung-Young
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.42 no.3
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    • pp.337-343
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    • 2009
  • Background: Postoperative recurrence is a major problem after performing video-assisted thoracic surgery for the treatment of primary pneumothorax. This study was designed to evaluate the efficacy and safety of a bioabsorbable staple line reinforcement (GORE $SEAMGUARD^{(R)}$) for preventing recurrence after bullectomy. Material and Method: From January 2000 to December 2004, 300 patients underwent video assisted thoracoscopic surgery for the treatment of primary penumothorax. 143 patients were treated with bioabsorbable staple line reinforcement (Group A) and 142 patients were treated with stapling of the bullae (Group B). Mechanical pleural abrasion was performed in all the patients. The operating time, the duration of the indwelling chest tube, the length of the hospital stay and the number of recurrences after operation were compared between the groups. Result: No operative deaths occurred. The conversion rate to an open procedure was 5% (15/300). Comparison with these groups (Group A versus Group B) showed the following results: the operating time ($49.6{\pm}25.6$ vs $51.8{\pm}30.4$ minutes, respectively, p=0.514), the duration of an indwelling chest tube ($5.8{\pm}2.5$ vs $7.2{\pm}3.3$ days, respectively, p<0.005), the hospital stay ($10.9{\pm}4.3$ vs $12.5{\pm}4.3$ days, respectively, p<0.005) and the number of recurrences (14 (9.8%) vs 10 (7.0%), respectively, the over all rate: 8.4% p=0.523), and the mean follow up period. ($48.1{\pm}36.6$ vs $36.5{\pm}24.4$ months, respectively). Conclusion: There were advantages to use synthetic absorbable staple line reinforcement over the usual method for the treatment of primary pneumothorax in regard to the duration of an indwelling chest tube and the hospital stay, but here was no significant difference between the groups for postoperative recurrence.

Factors Affecting Quality of Nursing Services and Intention to Revisit as Perceived by Hospitalized Patients and Nurses in Medium Sized Urban Hospitals (일 지역 중소 종합병원 입원환자와 간호사가 지각한 간호서비스 질과 의료기관 재이용 의도에 영향을 미치는 요인)

  • Kim, Ki Sook;Ha, Eun Ho
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.2
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    • pp.103-114
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    • 2009
  • Purpose: The purpose of this study was to investigate factors which affect the quality of nursing services and intention to revisit as perceived by hospitalized patients and nurses in medium sized urban hospitals. Methods: The SERVQUAL scale, a measurement of overall nursing services and intention to revisit a medical institution, was used. The sample consisted of 223 patients and 239 nurses from four medium sized hospitals in I city. Frequencies, t-test, One-way ANOVA, Pearson correlation coefficient and Stepwise method regression were used to analyze the data. Results: For expectation, nurse and patient perceptions were similar, but for performance, patient perception was significantly higher than nurse perception for five factors. The factors affecting intention to revisit the hospital were those recommending, satisfaction with medical and nursing services. Conclusion: The findings indicate that differences between expectations and performance for both patients and nurses need to be reduced in order to elevate patient satisfaction. A precondition for intention to revisit and increased satisfaction is the development of marketing strategies as well as intervention programs in nursing.

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Association Between Unplanned and Planned Readmissions in an University Hospital (비예정과 예정된 재입원 환자들간의 관련 요인 분석)

  • Oh, Hyonh-Joo;Yu, Seung Hum
    • Quality Improvement in Health Care
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    • v.4 no.2
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    • pp.242-259
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    • 1997
  • This study describes associated factors of readmission of 213 inpatients from an university hospital in Seoul. This retrospective study reviewed medical records of patients who discharged from a hospital stay for general diseases between 1 August 1995 and 31 October 1995, Cases were 68 discharge patients with an unplanned readmission within 30 days of discharge from an index stay. And the other cases are 145 patients who had more than two discharges and didn't have an unplanned readmission within 30 days. Logistic regression model was analyzed and the results were as follows; 1. duration of readmission, rate of unpayed, room, path, and risk of disease were more likely to be readmitted unexpectedly than the expected readmission patients. 2. early readmission, low risk condition group, and inadquateness of discharge plann for patients had unplanned radmissions rather than planned readmissions. Therefore, discharge planning education to health care provider is required and assessement of discharge planning should be evaluated. Readmissions are usually for related problems that arose during the original hopitaliztion and caused cost problems. Especially the unplanned readmissions are frequently preventable. Ultimately, models for readmissions can serve as a valuable clinical tool for target high-risk patients and older patients and with this kind of tools we can reduce hospital readmissions and maintain high-quality of inpatient care.

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A Refeeding Syndrome in the Treatment of Anorexia Nervosa Complicated by Spontaneous Gastric Rupture (자발적 위천공을 동반한 신경성 식욕부진 환자의 재급식 증후군 치험 1예)

  • Song, Eun-Jeong;Lee, Kyung-Hun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.51-56
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    • 2009
  • We report a rare case of gastric perforation in a 13-year-old boy with anorexia nervosa. He was admitted to our hospital with the chief complaint of body weight loss. He had lower abdominal pain after 2 days. An abdominal CT revealed diffuse peritonitis. At laparotomy, the stomach was dilated and perforated. Postoperatively, the patient suffered from malnutrition. We monitored electrolytes, minerals, and fluids closely before and during the initiation of feedings to prevent morbidity and mortality associated with refeeding syndrome. We present an extremely rare complication that relates to this phenomenon, describing an acute gastric dilatation that led to gastric necrosis and perforation through an unusual mechanism in an extremely anorectic teenager during hospitalization for refeeding.

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