• Journal of Hospice and Palliative Care
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• v.21 no.1
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• pp.23-32
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• 2018

Purpose: Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in U.S. hospitals. We examine hospital cost trends and the impact of palliative care utilization on the use of life-sustaining procedures in this population. Methods: Retrospective nationwide cohort analysis was performed using National Inpatient Sample (NIS) data from 2005 and 2014. We examined the receipt of both palliative care and intensive medical procedures, defined as systemic procedures, pulmonary procedures, or surgeries using the International Classification of Diseases, 9th revision (ICD-9-CM). Results: We used compound annual growth rates (CAGR) to determine temporal trends and multilevel multivariate regressions to identify factors associated with hospital cost. Among 77,394,755 hospitalizations, 79,314 patients were examined. The CAGR of hospital cost was 5.83% (P<0.001). The CAGRs of systemic procedures and palliative care were 5.98% and 19.89% respectively (each P<0.001). Systemic procedures, pulmonary procedures, and surgeries were associated with increased hospital cost by 59.04%, 72.00%, 55.26%, respectively (each P<0.001). Palliative care was associated with decreased hospital cost by 28.71% (P<0.001). Conclusion: The volume of systemic procedures is the biggest driver of cost increase although there is a cost-saving effect from greater palliative care utilization.

• Korean Journal of Agricultural and Forest Meteorology
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• v.20 no.3
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• pp.233-242
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• 2018

This study explored the richness patterns of vascular plant species and evaluated the effects of the climatic and habitat variables on the observed patterns along elevational gradients on the Mt. Baekhwa, South Korea. Plant data were recorded from 70 plots and a total of 187 plant species with 78 woody and 109 herbaceous species were recorded along two study transects, the Banyasa and Bohyunsa transects, on the Mt. Baekhwa. A total of 154 plant species with 66 woody and 88 herbaceous species and 131 plant species with 58 woody and 73 herbaceous species were recorded along the Banyasa and Bohyunsa transects, respectively. We used simple ordinary least squares regression model, multi-model inference and variation partitioning to analyze the relative contribution of climatic and habitat variables on the elevational richness patterns. Species richness pattern for vascular plants along the Banyasa transect monotonically decreased with elevation, whereas plant species richness showed reversed hump-shaped pattern along the Bohyunsa transect. Although the elevational patterns of species richness for vascular plants were different between the both transects, habitat variables are more important predictors than climatic variables for the elevational patterns of plant species richness along our study transects on the Mt. Baekhwa. These results indicate that elevational diversity patterns of vascular plants may be different even between nearby elevational transects in a mountain ecosystem but the diversity patterns may be controlled by same drivers.