• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.10
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• pp.354-362
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• 2017

Due to population aging and westernized lifestyle, ischemic heart diseases are increasing, and Korea has one of the highest lengths of stay for ischemic heart diseases. Since the increase in the length of stay is a major cause of the increase in medical expenses, it is necessary to prepare a plan to manage the length of stay. Accordingly, this study was conducted to identify the factors influencing the length of stay of ischemic heart disease, and provide the elementary resources necessary for the management of the length of stay. The study subjects were 566 ischemic heart disease patients of a tertiary hospital. As the result of the study, first, the number of inpatients with chest pain as the chief complaint was the largest. Second, the average length of stay was 4.89 days, and the length of stay varied depending on the type of ischemic heart disease. Third, the age of over 75 years, diabetes, and dyspnea were the factors increasing the length of stay. Therefore, for management of adequate length of stay for ischemic heart disease, it is important to prevent the progression of illness through blood sugar control for ischemic heart disease patients with diabetes. Also, it is necessary to prepare a system where patients can visit hospitals as fast as possible if they have any symptoms.

• Journal of Digital Convergence
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• v.18 no.1
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• pp.257-263
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• 2020

This study was conducted to improve the quality of National Health Policy by analysing the effects of sociodemographic characteristics, Medical institutions characteristics and characteristics of Admission-Discharge on the length of stay in hospital for schizophrenic patients from the data of Health Insurance Review & Assessment Service. The subjects were 4,692 patients who were diagnosed with schizophrenia as main diagnosis from the data records of HIRA-NIS 2016. Regression analysis was performed to evaluate the effect on the length of stay. Sociodemographic characteristics, hospital characteristics and characteristics of Admission-Discharge were used as explanatory variables and length of stay in hospital was used as a dependent variable. The result of study showed that female, age, medical aid, the kind of hospital, gangweon-do and with mental disease were found to be the factors that affect the length of stay. The significance of this study is to use the public data for evaluating factors that affect the length of stay in hospital for schizophrenic patients. But this study did not consider disease severity, so further study is needed for evaluation of the effects of factors on the length of stay according to disease severity.

• The Journal of the Convergence on Culture Technology
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• v.9 no.3
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• pp.137-143
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• 2023

This study was conducted to analyze factors affecting the length of stay in children with injuries by determining relationships between length of stay and characteristics of children(aged 0 to 12) with injuries. 7,804 patients aged 0 to 12 who participated in the Korea Nation Hospital Discharge In-Depth Injury Surveys, got a diagnosis of sequelae of injuries and of other consequences of external causes(S00-T98), and were discharged between 1 January 2016 and 31 December 2020 were investigated. A frequency analysis, independent samples t-test, and ANOVA were performed. Also, to identify factors affecting the length of stay, a regression analysis was performed. The average length of stay for the patients investigated in this study was 5.5 days. The length of stay for school-age children(aged 7 to 12) and children who had either public or private coverage was higher than that for preschoolers(aged 0 to 6) and children who didn't have public or private coverage, respectively. The length of stay for children admitted to a hospital in a rural area(Jeolla-do or Gyeongsang-do) was higher than that for children admitted to a hospital in a metropolitan area and the length of stay for children admitted to a hospital that had 100-299 hospital beds was relatively long. However, children who first visited a hospital for outpatient care stayed relatively short in hospital and children who had been burned or injured in traffic crashes stayed relatively long in hospital. Children who got a secondary diagnosis and had a principal procedure or who died after being discharged were in hospital for a long time. The findings of this study shall be useful, as they identified characteristics related to the length of stay for Korean children with injuries and factors that determine the length of stay for those children by analyzing the national dataset, or more specifically, the data from the Korea National Hospital Discharge In-Depth Injury Surveys. The risk of child injuries can be easily reduced by taking actions to prevent them and providing safety education programs. The present study has provided essential baseline data for the provision of aggressive care for child injuries and the establishment of a range of policies for child injury prevention.

• Health Policy and Management
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• v.34 no.1
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• pp.78-86
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• 2024

Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

• The Korean Journal of Health Service Management
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• v.8 no.4
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• pp.13-24
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• 2014

This study analyzes the effects of hospital caseload on medical charges and length of stay for inpatients. Hospital caseload, representing the level of concentration of patients, was measured with the Internal Herfindal Index for three diagnosis related group (DRG) codes (appendectomy, operations on anus, and operations on uterus and adnexa). Ordinary least squares regression was used for analysis. Results showed that medical charges per inpatient and average length of stay significantly differed with respect to hospital concentration indices, and that hospital caseload was inversely related to operational performance for appendectomy and operations on uterus and adnexa. The significant negative relationship between concentration index and length of stay may decrease the total medical charges. The results imply that the expansion of the DRG payment system to hospitals will have a negative influence on their gross sales.

• Journal of the Korea Convergence Society
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• v.2 no.4
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• pp.53-58
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• 2011

This Study is to propose the resonable management for cancer patients by identifying correlation among the treatment, their length of hospital stay and medical charges. Research subjbject is 144 patient that breast cancer, uterine cancer and Family Medical patients of inpatients in K University Hospital in Korea during six month, from January 1, 2010 to June 30, 2010. The analysis shows that the emergecy is superior range thag outpatient because each of them has 97.9%, 2.1% by looking at the path to admission. And the age of 40-49 is the higest group by age. When matrix components of breast cancer patients, principal component is composed of two axes. Factors associated with the first component appeared correlations between all variables without the age. Following results, this study is considered similar types of disease or treatments are need to introduce the DRG.

• Journal of the Korea Convergence Society
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• v.9 no.8
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• pp.77-85
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• 2018

Dementia among the diseases occurring in the old age is recognized as a disease to be solved at the national level and systematic management is being carried out. However, the awareness and response of the mild cognitive disorder, which is the middle stage of normal aging and dementia, are insufficient and social costs are increasing every year. The subjects of the study were 303 hospitalized patients whose primary diagnosis was mild cognitive impairment (F067) in a nursing hospital located in one district in 2016. The number of days of hospitalization was shorter in autumn and longer in winter or in hospital discharge. The cost of treatment for patients with mild cognitive impairment is lower in autumn and higher in winter or in 'discharge' of medical treatment results. The total cost of medical treatment was high in the winter by season in the ADL 6-12 and ADL 13-20 groups. Difference in the cost of medical treatment according to the characteristics of medical treatment, the medical expenses were the highest when the number of corporal disease was 5 ~ 8. In the medical treatment results, the ADL 6-12 point group and the ADL 13-20 point group had high medical expenses in 'continue'. Considering the clinical characteristics of mild cognitive impairment and considering that 10-15% of the patients with mild cognitive impairment progress to dementia every year, early detection and treatment of mild cognitive impairment is an effective and potentially important task for reducing potential social and dementia patients.

• Korea Journal of Hospital Management
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• v.15 no.2
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• pp.15-26
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• 2010

Stroke is a high-risk disease. The future of the medical environment is that the proportion of elderly population is increasing, the average life expectancy is being increased, while the fatal rate of stroke will be low. These situation will due to the financial burden on medical insurance. The most important factor that affects on the medical costs of stroke patients is the length of stay. In this study the mean length of hospital for stroke stay was 21.81days(37.97days for intracerebral hemorrhage, 18.89 days for cerebral infarction). The payment per case of stroke was 6.86 million won(12.6 million won for intracerebral hemorrhage, 5.72 million won for cerebral infarction). The payment per case of intracerebral hemorrhage was 2.2 times more than that of cerebral infarction. The payment in the day of hospitalization was the highest and until the second day medical costs was high. After the third day medical costs tended to decline, after that seemed to show an almost constant level. The length of hospital stay was found to be the most important determinant of inpatient charges for stroke. Accordingly rational management of the length of stay will be beneficial to health care consumers, providers, states.

• The Korean Journal of Health Service Management
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• v.11 no.1
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• pp.91-105
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• 2017

Objectives : This study analyzed the differences in length of stay(LoS), total hospital charges(THC), and cost of rehabilitation(CoR) between two types of stroke patients, intracerebral hemorrhage(ICH) and cerebral infarction(CI). Factors associated with these differences were also assessed. Methods : Data were obtained from the 2011 National Inpatient Sample data of Health Insurance Review and Assessment Service. We used propensity score matching to match the characteristics of the two types of stroke patients, and conducted a regression analysis to analyze their associations. Results : The differences between THC, LoS, and CoR by stroke and hospital types were shown. Each type of hospital showed different results. Conclusions : A rapidly aging population will accelerate the number of stroke patients requiring effective management. Studies evaluating healthcare utilization of stroke patients will provide evidence for both healthcare resources allocation and healthcare policy decisions.

• Journal of Preventive Medicine and Public Health
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• v.27 no.4 s.48
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• pp.793-805
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• 1994

Investigating the existence of volume-outcome relationships for specific disease groups relates directly to the policy issue of whether, and how, specific inpatient services should be regionalized. This study examined whether medical costs and lengths of stay as outcomes were affected by changes in volume within hospitals. Based on the claims data obtained from National Federation of Medical Associations, each six disease categories from medical and surgical conditions were selected and 29,720 cases from 1,266 hospitals were analyzed. Main findings of the research can be summarized as follows: 1. Analyzing volume and cost per case relationship, tonsillectomy class 1, hernia procedure class 0, appendectomy and cesarean section class 0,1 in surgical conditions showed negative relationship significantly. In cases of medical conditions, costs per case in respiratory neoplasm class 2, COPD class 1, 2, digestive malignancy were also related to volume negtively. 2. Comparing volume with length of stay per case, lens procedure class 0, hernia procedure class 0, appendectomy class 0,1, cesarean section class 1 in surgical conditions showed negative relationships significantly. In medical conditions, volume of respiratory neoplasm class 2, COPD class 1,2, digestive malignancy class 0 were associated with negatively. 3. Within same disease categories, changes in cost and length of stay per case to volume were more remarkable in severe cases. These results suggested a significant inverse relationship between disease cases and cost, length of stay per case as outcome variables.