• Acute and Critical Care
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• 제33권4호
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• pp.230-237
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• 2018

Background: Socioeconomic status (SES) is closely associated with health outcomes, including mortality in critically ill patients admitted to intensive care unit (ICU). However, research regarding this issue is lacking, especially in countries where the National Health Insurance System is mainly responsible for health care. This study aimed to investigate how the SES of ICU patients in South Korea is associated with mortality. Methods: This was a retrospective observational study of adult patients aged ${\geq}20$ years admitted to ICU. Associations between SES-related factors recorded at the time of ICU admission and 30-day and 1-year mortalities were analyzed using univariable and multivariable Cox regression analyses. Results: A total of 6,008 patients were included. Of these, 394 (6.6%) died within 30 days of ICU admission, and 1,125 (18.7%) died within 1 year. Multivariable Cox regression analysis found no significant associations between 30-day mortality after ICU admission and SES factors (P>0.05). However, occupation was significantly associated with 1-year mortality after ICU admission. Conclusions: Our study shows that 30-day mortality after ICU admission is not associated with SES in the National Health Insurance coverage setting. However, occupation was associated with 1-year mortality after ICU admission.

• 보건행정학회지
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• 제26권1호
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• pp.4-11
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• 2016

Background: Hospital admissions for ambulatory care sensitive conditions (ACSCs), which are widely used as an indicator of poor access to primary care, can be used as an efficiency indicator of healthcare use in countries providing good access to health care. Korea, which has a national health insurance (NHI) system and a good supply of health care resources, is one such country. To quantify admission rates of ACSC and identify characteristics influencing variation in Korean health care institutions. Methods: By using NHI claims data, we computed the mean ACSC admission rate for all institutions with ACSC admissions. Results: The average ACSC admission rate for 4,461 institutions was 1.45%. Hospitals and clinics with inpatient beds showed larger variations in the ACSC admission rate (0%-87.9% and 0%-99.6%, respectively) and a higher coefficient of variation (7.96 and 2.29) than general/tertiary care hospitals (0%-19.1%, 0.85). The regression analysis results indicate that the ACSC admission rate was significantly higher for hospitals than for clinics (${\beta}=0.986$, p<0.05), and for private corporate institutions than public institutions (${\beta}=0.271$, p<0.05). Conclusion: Substantial variations in ACSC admission rates could suggest the potential problem of inefficient use of healthcare resources. Since hospitals and private corporate institutions tend to increase ACSC admission rates, future health policy should focus on these types of institutions.

• 한국간호교육학회지
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• 제14권1호
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• pp.12-19
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• 2008

Purpose: This study was performed to explore the effects of an admission-education program on knowledge, self-efficacy, self-care and glucose control in type 2 diabetes patients. Method: A single group pre-post test design was used. Twenty-one patients participated in this program during 6 days which consisted of education and practice about exercise, diet, self-care and prevention of complications. Variables at baseline, 3 months, and 6 months were measured. Results: Knowledge level, self-care level and self-efficacy were significantly increased over time after the admission-education program. The $HbA_1C$ level and glucose level in urine were significantly decreased over time after the admission-education program. Conclusion: The admission-education program can increase levels of knowledge, self-care, self-efficacy and decrease glucose levels. Therefore, this admissioneducation program was shown to have a positive effect on the management of diabetes.

• 보건행정학회지
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• 제5권2호
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• pp.18-34
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• 1995

To clarify the relationship between the medical supply(medical persons and goods) and the use of bed, the author has made comparison among OECD 24 countries. Per Capita Bed-days can be divided into Average Length of Stay and Admission Rate, and these three variables were regressed upon both In-patient Care Beds of all medical institutions including acute somatic, psychiatric, special, nursing homes and other long-term care and Share of Total Health Employment in Total Employment. The result of regression analysis shows a statistically significant positive relationship between In-patient Care Beds and Average Length of Stay, and negative relationship between Share of Total Health Employment and Admission Rate. In addition to Ordinary Least Square(OLS) estimation, amended Bounded Influence Estimation(BIE) was also made to adjust the influence of outliers. Japan shows a very large number of In-patient Care Beds and a very low Share of Total Health Employment, and this medical situation is judged to have close relation to her long Average Length of Stay and low Admission Rate.

• 임상간호연구
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• 제21권3호
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• pp.293-308
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• 2015

Purpose: This study aimed to develop nursing practice standards of hemodialysis care according to admission types. Methods: The standards were developed in four phases. Phase 1: The preliminary standards of hemodialysis care were developed based on literature review and evaluation of professional experts. Phase 2: Content validity was evaluated by 34 professional experts and the standards were modified and revised. Phase 3: Clinical validity was evaluated by 212 hemodialysis nurses. Expert group validated and verified the final outcome. Phase 4: Final standards of hemodialysis care according to admission types were developed. Results: The standard of hemodialysis care for out-patients included 5 standards, 9 contents, 43 nursing activities. The standard for in-patients included 6 standards, 10 contents, 50 nursing activities. The standards for critical patients included 4 standards, 10 contents, 43 nursing activities. There were differences in nursing activities according to admission type. Time required to meet the standards were different according to admission types. Conclusion: The findings of this research demonstrated that the time required for hemodialysis care and appropriate number of nurse would be different according to admission types. Different nursing workload according to admission type of hemodialysis patients need to be considered in allocating nursing manpower.

• 성인간호학회지
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• 제13권2호
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• pp.291-304
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• 2001

The purpose of this study was to develop Intensive Care Unit (ICU) admission and discharge criteria that would lead to the appropriate utilization of ICU resources and nursing services. For this study, a conceptual framework was developed through a review of the literature. Then in order to identify the overall health condition of patients in the ICU, and to draw up preliminary criteria, the medical records of 58 patients who were admitted to the ICU of Y Medical Center in Seoul between March, 1999 to February, 2000 of were analyzed. Two expert validity tests were done for the preliminary criteria for admission and discharge with 21 patients over 18 years of age who were admitted patients and for 12 patients who were discharged between May 30, 2000 and June 5, 2000 a clinical validity test was also done. After this process, the final admission and discharge criteria were developed. The results of this study are summarized as follows: 1. After a review of the literature, there were 9 categories for admission criteria cardiologic, gastrointestinal, neurologic, endocrine, post-op care of major surgery, vital signs, laboratory values, and a category of miscellaneous items. Discharge criteria had 3 categories which were vital signs, laboratory values, and a category of miscellaneous items. 2. From the medical records of the 58 patients who were admitted to the ICU, 45 items for preliminary criteria for admission and 17 for discharge were identified. 3. The two expert validity tests showed that of the 45 items 29 admission items received over 75 percent agreement. The 16 admission items which received less than 75 percent agreement were revised or deleted from the admission criteria. Of the 17 discharge items, 11 had over 75 percent agreement and 6 less then 75 percent agreement. These were revised or deleted from the discharge criteria. 4. In the clinical validity test, 14 admission items showed more than 75 percent agreement and 11 discharge items more than 83 percent agreement. 5. The final criteria consisted of 29 items for admission and 11 items for discharge. Since patients being considered for admission to the ICU have complex problems, there is a need to make the decision based on more than a single issue. This tool will insure that the ICU nursing care and treatment resources are appropriately used by allowing a multi-professional health team to make admission and discharge decisions.

• Journal of Acupuncture Research
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• 제19권2호
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• pp.201-210
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• 2002

Objective : The aim of this study was to assess the effects of admission care on Bell's palsy by case control study. Method : 27 patients who diagnosed as Bell's palsy were shared 13 inpatients group treated by early admission care, and 14 outpatients group. They were equally treated with acupuncture, herb medicine and western medicine. The groups were evaluated by Yanagihara,s unweighted grading system at pre-treatment, after 5 days, after 10 days and after 15 days. Results : The Yanagihara,s scores of 2 groups showed stastically significant improvement in comparison with pre-treatment. In improvement index after treatment, the Yanagihara,s scores of 2 groups increased but were not stastically significant the difference. Conclusion : These results provided that the admission care may not be a valuable treatment for Bell's palsy. Further study is needed to evaluate the effect of early admission care on Bell's palsy.

• 대한한방부인과학회지
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• 제32권3호
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• pp.57-72
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• 2019

Objectives: This study aims to assess the maternal characteristics and changes of body among patients who received Korean medicine postpartum care compared to pre-study. Methods: From January 1, 2018 to February 28, 2019, we included 31 postpartum patients who had body composition analysis at admission and discharge among 34 patients who received postpartum care in ${\square}{\square}$ University Hospital. We used SPSS 21.0 for window to test for statistical significance. Results: The average age, weight, and caesarean section rate increased compared to previous study. The average period of postpartum care has decreased. After postpartum care, abdominal circumference, body weight and Body Mass Index (BMI) was significantly decreased, but not as much as pre-study. The coefficient of determination was derived to predict the effects of postpartum care and calculated as "$Abdominal\;circumference\;change=2.745+0.593{\times}admission\;period$", "$weight\;change=0.214+0.345{\times}admission\;period$" and "$BMI\;change=0.198+0.120{\times}admission\;period$". Conclusions: Compared to previous study, as the maternal age increased and admission period decreased, the weight loss after childbirth decreased. It is necessary to provide individual treatment through coefficient of determination.

• 간호행정학회지
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• 제5권3호
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• pp.415-424
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• 1999

The purpose of this study was to estimate the population requiring nursing home services for frail elders who received home care nursing services. This study identified the need of nursing home services and the proportion of elders over 60 years of age requiring nursing home services according to the admission eligibility including items with intensity of home care nursing services and the criteria for screening of patients requiring home care nursing services. In this study, survey research design was conducted. A total of 49 home care nurses were collected. They were asked to assess the need of nursing home services based on items with intensity of home care nursing services and the criteria for screening of patients requiring home care nursing services. Using secondary data analysis from the survey on 'The Evaluation of Home Care Nursing Service Program in 1994 in Korea', the proportion of elders requiring nursing home services was estimated. The estimated numbers and proportion of frail elders requiring nursing home services were 169 (86.2%) aged persons among community dwelling elders based on admission eligibility. However, the proportion of aged persons was 68% using the only criteria for screening of patients requiring for screening home care nursing services.

• 의료법학
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• 제15권2호
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• pp.317-343
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• 2014

In order to account for whether a doctor should indemnify damages resulted from violation of duty of care, the fact that a doctor violated duty of care, that damages were incurred, and the link between violation of duty of care and damages incurred, respectively, should be verified. So even though a doctor violated duty of care to patients, he or she will not bear the responsibility to indemnify damages unless it is not verified. If a doctor's negligence in medical practices is assessed that obviously unfaithful medical practice far exceeds the limit of admission of a patient, it will not go against people's general perception of justice or law and order to constitute a medical malpractice itself as an illegal action that will require liabiliy for damage. However, when the limit of admission is set too low, a patient's benefit and expectation of proper medical treatment can be violated. In contrast, if the limit of admission is set high, it can leave too little room for doctors' discretion for treatments due to a bigger risk of indemnification for damages. Thus, a reasonable balance that can satisfy both benefit and expectation of patients and doctors' right to treatment is needed.