품질경영학회지 (Journal of Korean Society for Quality Management)

  • 제39권3호
  • /
  • Pages.391-399
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  • 2011
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  • 1229-1889(pISSN)
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  • 2287-9005(eISSN)
한국품질경영학회 (Korean Society for Quality Management)
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관상동맥우회술 시행환자의 중증도 보정 재원일수 변이에 관한 연구

The Variation Factors of Severity-Adjusted Length of Stay in CABG

  • Kim, Sun-Ja (Asan Medical Center) ;
  • Kang, Sung-Hong (Department of Health Policy and Management, Inje University) ;
  • Kim, Won-Joong (Department of Health Policy and Management, Inje University) ;
  • Kim, Yoo-Mi (Department of Health Policy and Management, Sangji University)
  • 투고 : 2011.07.20
  • 심사 : 2011.09.26
  • 발행 : 2011.09.30
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초록

Our study was carried out to analyze the variation factors of severity-adjusted length of stay(LOS) in coronary artery bypass graft(CABG). The subjects were 932 CABG inpatients of the Korean National Hospital Discharge In-depth Injury Survey from 2004 through 2008. The data were analyzed using $x^2$ test and the severity-adjusted model was developed using data mining technique. The results of the study were as follows: male(71.1%), older than 61 years of age(61.6%), more than 500 beds(92.8%) and admitting via ambulatory care(70.0%) appeared to have higher rate than otherwise. In-hospital mortality of CABG inpatients was 2.8%. In addition, 46.4% of the patients received their care in other residence. The angina pectoris(45.6%) was found to be the highest in principle diagnosis, followed by chronic ischemic heart disease(36.9%) and acute myocardial infarction(12.0%). We developed severity-adjusted LOS model using the variables such as gender, age and comorbidity. Comparison of adjusted values in predicted LOS revealed that there were significant variations in LOS by location of hospital, bed size, and whether patients received the care in their residences. The variations of LOS can be explained as the indirect indicator for quality variation of medical process. It is suggested that the severity-adjusted LOS model developed in this study should be utilized as a useful method for benchmarking in hospital and it is necessary that national standard clinical practice guideline should be developed.

키워드

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