Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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A study on the variation of severity adjusted LOS on Injry inpatient in Korea

손상입원환자의 중증도 보정 재원일수의 변이에 관한 연구

  • Kim, Sung-Soo (Dept. of Medical Information Management, Asan Medical Center) ;
  • Kim, Won-Joong (Dept. of Health Policy & Management, InJe University) ;
  • Kang, Sung-Hong (Dept. of Health Policy & Management, InJe University)
  • 김성수 (서울아산병원 의료정보관리팀) ;
  • 김원중 (인제대학교 보건행정학과) ;
  • 강성홍 (인제대학교 보건행정학과)
  • Received : 2011.04.28
  • Accepted : 2011.06.09
  • Published : 2011.06.30
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Abstract

In order to analyze the variation in length of stay(LOS) of injury inpatients, we developed severity-adjusted LOS model using Korean National Discharge In-depth Injury Survey data of Center for Disease Control. Appling this model, we calculated predicted values and, after standardizing LOS using the differences from the actual values, analyzed the variation in LOS. Major factors affecting severity-adjusted LOS of injury inpatients were found to be severity, surgery(or no surgery), age, injury mechanism and channel of hospitalization. Result of analysis of the differences between the actual values and predicted values adjusted by decision tree model suggested that there were statistically significant differences by hospital size(number of beds), type of insurance and location of institution. In order to reduce the variation in LOS, efforts should be exerted in developing nationwide treatment protocol, inducing medical institutions to utilize it, and furthermore systematically evaluating it to reduce the variation continually.

손상입원환자의 재원일수 변이요인을 분석하기 위해 질병관리본부의 퇴원손상환자 자료를 이용하여 재원일수 중증도 보정모형을 개발하였다. 이 모형을 적용, 보정값을 산출하고 실측값과의 차이를 이용하여 재원일수를 표준화한 후 재원일수의 변이를 분석하였다. 입원손상환자의 중증도 보정 재원일수에 영향을 미치는 주요 요인은 중증도, 수술유무, 연령, 손상기전, 입원경로 등으로 나타났다. 의사결정나무 모형에 의하여 재원일수의 보정값을 산출하여 실측값과의 차이를 분석한 결과 병원규모(병상수)별, 보험유형별, 기관 소재지별로 통계적으로 유의한 차이가 있는 것으로 나타났다. 따라서 재원일수의 변이를 줄이기 위해 국가차원에서 진료행위프로토콜을 개발하여 의료기관에서 이를 활용하도록 유도하고, 더 나아가 이를 체계적으로 평가하여 지속적으로 노력하여야 할 것이다.

Keywords

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