• Quality Improvement in Health Care
• /
• v.2 no.2
• /
• pp.56-71
• /
• 1996

Background : Review of readmissions in health care facilities is necessary from the viewpoint of both economic concerns and quality considerations. To identify the characteristics, factors, and causes of multiple admissions in comparison with single admissions is essential for both providers and payers in order to assure quality care and efficient use of medical resources. Methods: All discharges from an university hospital in 1993 were analyzed, and the characteristics of multiple admissions were identified and were compared with those of single admissions by using the data bases of the discharge abstract and billing for reimbursement. Medical records of patients readmitted within 6 days after the previous discharge were reviewed to identify the reasons for such prompt readmission. Statistical analysis between groups of patients were performed by using SPSS. Result : The mean age was higher in multiple admissions than those of single admissions, and the average length of stay was longer in multiple admissions than in single admissions. The hospital cost per day is higher in single admissions while the cost per case is higher in multiple admissions. More than half of readmissions occurred within one month after the preceding discharges. Above 15% of the readmission within 6 days after the preceding discharges seemed to have close relationship with quality of care provided during the preceding hospitalization. The death rate of the patients readmitted within 6 days was the highest in comparison with multiple admissions and single admissions. Conclusion : Potential preventable readmissions should be reduced by identifying characteristics of multiple admissions, especially unplanned readmission, and by applying some interventions such as standard predischarge assessment or careful follow-up care after discharge for high risk readmission groups. As the results of these efforts, health care facilities could achieve quality improvement in medical care, and effective use of hospital resources.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.15 no.6
• /
• pp.3832-3840
• /
• 2014

The rapidly aging population is also increasing the number of dementia patients rapidly. Studies have revealed the early signs of slowing progress. Therefore, dementia patient safety, continuous care, daily living, and health care are becoming more important. In this paper, a smart home care system using smart phones and Bluetooth communication technology was used to monitor the state of dementia patients of based on the results of grading dementia, health care of the dementia patients at home and provide for the safety of the system using motion sensors and gas leak sensors to respond to various emergency situations, such as fire, gas leak protection, and loitering. Using this system, the patient can stay longer in their home due to the nature of Korean culture before admission, while reducing the family's economical, physical and psychological burden and allowing the consultation of specialists through the system by building a database of individuals and providing professional service and specialty care referral agencies through the link.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.13 no.6
• /
• pp.2672-2679
• /
• 2012

The study was done to provide basic data of medical quality evaluation after developing the comorbidity disease mortality measurement modeled on the severity-adjustment method of AMI. This study analyzed 699,701 cases of Hospital Discharge Injury Data of 2005 and 2008, provided by the Korea Centers for Disease Control and Prevention. We used logistic regression to compare the risk-adjustment model of the Charlson Comorbidity Index with the predictability and compatibility of our severity score model that is newly developed for calibration. The models severity method included age, sex, hospitalization path, PCI presence, CABG, and 12 variables of the comorbidity disease. Predictability of the newly developed severity models, which has statistical C level of 0.796(95%CI=0.771-0.821) is higher than Charlson Comorbidity Index. This proves that there are differences of mortality, prevalence rate by method of mortality model calibration. In the future, this study outcome should be utilized more to achieve an improvement of medical quality evaluation, and also models will be developed that are considered for clinical significance and statistical compatibility.

• Journal of Life Science
• /
• v.20 no.8
• /
• pp.1214-1220
• /
• 2010

Imipenem-resistant bacteria were isolated from clinical specimens taken from hospitalized patients in Suncheon, Korea. Fifty-four isolates were phylogenetically analyzed based on 16S rRNA gene and gyrB gene sequence comparisons. Isolates were affiliated with Pseudomonas aeruginosa (30 strains; 55.6%), Acinetobacter baumannii (21; 38.9%), Enterobacter hormaechei (2) and Pseudomonas putida (2). Twenty-two isolates produced metallo-$\beta$-lactamase (MBL); 12 Acinetobacter baumannii strains, 7 Pseudomonas aeruginosa strains, 2 P. putida strains and 1 Enterobacter hormaechei strain. Antibiotic susceptibility of the isolates was determined using the disc diffusion method and Vitek system. Strains producing metallo-$\beta$-lactamase (type IMP & VIM) were more resistant to antibiotics ceftazidime, aztreonam, amikacin and gentamicin than to strains producing OXA and SHV type of $\beta$-lactamase.

• Health Policy and Management
• /
• v.26 no.1
• /
• pp.39-50
• /
• 2016

Background: This study examined patient and hospital factors related to long-stay admissions in long-term care hospitals (LTCHs) among older people in Korea. Methods: We analyzed health insurance claims data, entitlement data, and institutional administrative data from the National Health Insurance Service databases between 2010 and 2012. At the patient level, we compared characteristics of patients staying in LTCHs for over 180 days (the long-stay group) with those staying in LTCHs for less than 90 days during a calendar year. At the hospital level, we examined the general characteristics and staffing levels of the top 10% of hospitals with the highest proportion of patients whose length of stay (LOS) was 180+ days (the hospitals with long-stay patients) and compared them with the top 10% of hospitals with the highest proportions of patients whose LOS was less than 90 days (hospitals with shorter-stay patients). Results: The long-stay group accounted for about 40% of all LTCH patients. People in the group were more likely to be women, aged 80+, living alone, and experiencing more than two health conditions. Compared to the hospitals with shorter-stay patients, those with long-stay patients were more likely to be occupied by patients with behavior problems and/or impaired cognition, owned by corporate or local governments, have more beds and a longer period of operation, and deliver services with lower staffing levels. Conclusion: This study found long-stay older people in LTCHs and those in LTCHs with high proportions of long-stay older patients had several distinct characteristics compared to their counterparts designated in this study. Patient and hospital characteristics need to be considered in policies aiming to resolve long-stay admissions problems in LTCHs.

• Clinical and Experimental Pediatrics
• /
• v.48 no.2
• /
• pp.174-177
• /
• 2005

Purpose : We evaluated children with Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) in terms of epidemiology and clinical characteristics. Methods : A total of 424 medical records of children with HSP admitted to The Catholic University of Korea, Daejeon St. Mary's Hospital, from 1987 to 2003 were retrospectively analyzed. Results : The mean annual number of cases was $25.1{\pm}7.9$ and no one year showed an outbreak. There was a steady number of patients throughout the year with a decrease during the summer season. The male-to-female ratio was 1.3 : 1 with the median age of the patients being 6-years-old. The age distribution showed a peak at age 6 in a bell-shaped distribution curve. Purpura was noted in 100 percent of the patients, gastrointestinal involvement in 53.8 percent, joint involvement in 40.8 percent, and renal involvement in 18.9 percent. Nephrotic syndrome occurred in 1 percent of all patients. Conclusion : The epidemiologic and clinical features of HSP were similar to those of other regions in Korea and foreign nations, irrespective of time.

• The Journal of the Korea Contents Association
• /
• v.15 no.6
• /
• pp.346-357
• /
• 2015

Purpose: This descriptive study was to examine uncertainty and performance of infection control in the VRE patients' caregivers. Methods: The participants were 82 caregivers who involved with the VRE patients care in D tertiary hospital in D metropolitan city. Data were analyzed with number, percentage, t-test, and ANOVA using SPSS/Win 21.0. Results: The participants' uncertainty was 56.99 and performance of infection control was 35.09. Performance of infection control was significantly different by age (F=121.38, p<.001), education (F=102.77, p<.001), relationship with the patient (F=17.80, p<.001), hours of caring per day (t=3.14, p=.002), and type of family (t=-8.65, p<.001). There was a significant negative correlation between participants' uncertainty and performance of infection control (r=-.96, p<.001). Conclusion: The results of the study will be used to develop nursing intervention program and standard protocol for infection control for the VRE patients' caregivers.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.12 no.1
• /
• pp.126-129
• /
• 2008

목적: 방사성옥소 치료 환자들은 주의 사항이나 식이요법 등을 지키는 것에 대한 어려움과 3~4일간의 격리 치료기간 동안의 막연한 불안감을 느끼는 등의 심리적, 신체적 부담감을 가지고 있다. 본 과에서는 방사성옥소 치료의 예약과 치료병실에 대한 표준지침서를 개발하여 환자들에게는 정확하고 쉬운 정보를 제공하여 막연한 불안감을 해소하고 치료 업무에 종사하는 종사자들에게는 통일된 정보를 제공하여 업무효율을 향상시키는 효과와 치료 병실의 환경개선을 통한 환자의 심리적 안정감을 찾는데 주력하고자 본 연구를 시작하였다. 대상 및 방법: 2006년 9월부터 2007년 2월까지 치료병실에 입원한 환자를 대상으로 치료환자의 치료 일정, 주의사항, 저옥소 식단과 치료병실의 표준 진료 지침서를 개발하고 치료 병동의 간호사와 협력하여 치료병실의 환경을 개선하여 환자에게 적용하였다. 결과: 방사성옥소 치료의 특성상 환자는 치료가 결정되는 순간부터 치료과정에 대한 이해도 부족과 치료병실 생활에 대한 불안감을 느끼게 되므로 치료 시 사용되는 일정 및 주의사항, 저옥소 식단의 표준지침서를 개발하여 환자 치료병실 개선과 치료병실에서의 표준지침서를 개발하고 사용하였다. 결론: 치료에 따른 진료지침서와 병실 환경을 개선 후 치료에 대한 환자의 이해도 및 치료병실에서의 생활이 예전과 비교해서 많이 향상 되었고 치료의 과정을 설명하는 예약 시에도 많은 도움이 되고 있다. 이러한 치료과정의 규격화 하는 작업들은 본원뿐 아니라 치료병실이 있는 병원의 치료환경을 개선하는데 도움이 될 것이라고 사료된다.

• Journal of Hospice and Palliative Care
• /
• v.19 no.4
• /
• pp.283-291
• /
• 2016

Over the past decade, hospice and palliative care in Japan have progressed rapidly under the national policies supported by the Cancer Control Act. The numbers of palliative care units/inpatient hospices, hospital palliative care teams, and clinics with a home hospice function have been steadily increasing. The increasing numbers of physicians, nurses, and pharmacists have been certified as specialists in palliative care by national associations. Collaborative efforts have been made to standardize and disseminate educational programs and training opportunities in undergraduate, postgraduate, and continuing medical education. Research activities in Japan have markedly contributed to the growing body of evidence, especially in the fields of terminal delirium, terminal dehydration, palliative sedation, care for dying patients, prognostication, communication, psycho-oncology, and regional palliative care programs. This review focuses on major palliative care settings, specialty, national associations, education, and research in palliative care in Japan.

• Korean Journal of Acupuncture
• /
• v.33 no.4
• /
• pp.176-182
• /
• 2016

Objectives : This study was designed to analyze the characteristic of heart rate variability(HRV) changes between Deficiency Pattern and Excess Pattern in Stroke Patients admitted to the hospital. Methods : We measured heart rate variability of stroke patients who were admitted to the Department of Korean Internal medicine, Stroke and Neurological Disorders Center from February 1, 2015 to May 30, 2016. We recruited a total of 28 stroke patients and heart rate variability tests were performed on the first day of admission, 2weeks after admission, and 4 weeks after admission. Results : VLF and LF/HF ratio significantly increased over time in Deficiency Pattern group compared with those in the Excess Pattern group. Conclusions : This results suggest that the parasympathetic function of Deficiency Pattern group is lower than that of the Excess Pattern group, resulting in imbalance of the autonomic nervous system.