• 한국콘텐츠학회논문지
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• 제13권8호
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• pp.314-323
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• 2013

본 연구의 목적은 건강보험심사평가원에서 제공한 2009년 환자표본자료를 이용하여 병원의 환자집중도 수준과 분만환자의 평균재원일수와의 관계를 분석하는 것이다. 병원에 내원한 분만환자의 집중도는 DRGs(Diagnosis Related Groups)를 이용하여 생성된 내부허핀달지수를 이용하여 측정하였다. 통계분석에서는 병상 수, 분만환자 수, 100병상 당 의사 수, 100병상 당 간호사 수 같은 병원의 구조변수를 통제변수로 사용하였고, 분만환자의 평균재원일수는 종속변수로 사용하였다. 연구에서 분만환자의 집중화에 따른 재원일수 변이의 분석을 위해 모형 1에서는 병원의 모든 입원환자들 중 분만입원환자의 집중화정도를 분석하였고, 모형 2에서는 모든 산부인과 관련 환자들 중 분만입원환자의 집중화정도를 분석하였다. 분석결과 환자집중도는 두 모형 모두 평균재원일수와 통계적으로 유의하지 않았으며, 분만환자 수와 병상 수에서 통계적으로 유의하였다. 분만환자 수 변수는 평균재원일수와 음의 상관관계를 보였고, 병상 수는 양의 상관관계를 보였다. 연구결과는 병원에 내원한 분만환자의 집중도 지수 보다는 분만환자 수가 평균재원일수에 유의한 영향을 주는 것으로 나타났으며, 환자 수는 병원에서 진료의 효율성을 향상시키는데 기여한다고 볼 수 있다.

• 한국멀티미디어학회논문지
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• 제22권7호
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• pp.804-814
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• 2019

The patient's waiting time and length of stay have been reported as a factor decreasing their satisfaction in the hospital, especially in developing countries. This paper focuses on modeling hospital's outpatient department workflow in a developing country and optimizing the patient waiting time as well as total length of stay. By using discrete-event simulation, many alternative scenarios have raised, such as adding more working time, altering human resources, and adjusting the staff's responsibility, those scenarios will be examined to explore better settings for the hospital. The results show that possible to achieve a 9.6% reduction in patient total length of stay and it could be accomplished without adding more resources to the hospital.

• 보건행정학회지
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• 제28권2호
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• pp.178-185
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• 2018

Background: We investigated association between introduction of the diagnosis-related groups (DRG) system for anal operation and length of stay. Also, we investigated how it is different among hospitals with longer length of stay and among hospitals with shorter length of stay before introduction of the DRG system. Methods: We used data from Health Insurance Review and Assessment which were national health insurance claim data. Total 13,111 cases of anal surgery cases were included which were claimed by hospitals since July 2012 to June 2014. Two-level multivariable regression was conducted to analysis the association between length of stay and characteristics of hospital and patient. Results: Before introducing DRGs, the average length of stay was 5.41 days. After introducing DRGs, average length of stay was decreased to 3.92 days. After introducing DRGs, length of stay has decreased (${\beta}=-1.0450$, p<0.0001) and it was statistically significant. Among hospitals which had short length of stay (shorter than mean of length of stay) before introducing DRGs, effect of introducing DRGs was smaller (${\beta}=-0.4282$, p<0.0001). On contrary, among hospitals which had long length of stay (longer than mean of length of stay) before introducing DRGs, effect of introducing DRGs was bigger (${\beta}=-1.8280$, p<0.0001). Conclusion: Introducing DRGs was more effective to hospitals which had long length of stay before introducing DRGs.

• Child Health Nursing Research
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• 제18권1호
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• pp.43-52
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• 2012

Purpose: The purpose of this study was to provide basic data for suitable neonate blood glucose maintenance by investigating and analyzing the blood glucose level of post cardiovascular surgery neonates in the ICU for the effect of blood glucose levels on the following outcomes; ICU stay, hospital stay, mechanical ventilation time, morbidity, and mortality. Methods: The participants were 143 neonates in the ICU after having had cardiovascular surgery. The design for this study was an investigation of the blood glucose levels of the neonates and retrospective analysis of patient outcomes according to blood glucose level. Results: The results for the neonate groups showed that the factors of hospital stay, ICU stay, mechanical ventilation time and mortality, for the group with a blood glucose level over 140 mg/dL were longer and higher than for the group with blood glucose of less than 100 mg/dL or the group between 100-139 mg/dL. Conclusion: The results of this study indicate that when caring for neonates after cardiovascular surgery, it is important to recognize the influence of blood glucose levels on patient outcomes like hospital days, ICU stay, length of time on mechanical ventilation and mortality. Further, care guidelines for neonates' glucose level management need to be developed.

• 성인간호학회지
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• 제23권1호
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• pp.87-99
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• 2011

Purpose: The study was designed to identify the factors that influence the length of stay of elderly people in the recovery room. Methods: The design of the study was descriptive correlation. The subjects were 196 general anesthesia patients. The data were analyzed by SPSS/WIN 17.0 program. Results: The average length of stay in the recovery room was 62.62 minutes. The length of stay in the recovery room was influenced by age (27.50%); number of diseases (12.97%) and albumin level (6.75%). Other related post operative factors (30.98%) were abnormal ABGA, shivering, PAR score, pain, arrhythmia, amount of bleeding, cardiovascular complication, hypertension and delirium. Those factors explained 78.2% out of the total variance of the length of stay. The strongest effector was the abnormal ABGA (${\beta}$=.226) and then shivering (${\beta}$=.222). Conclusion: The influencing factors should be assessed and monitored for the aged before and after surgery. Further research is needed to find the exact factors for ICU transfer elderly from recovery room and emergency surgery target.

• 한국직업건강간호학회지
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• 제28권2호
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• pp.104-113
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• 2019

Purpose: This study aimed to investigate the factors affecting general hospital nurses' intention to stay in their jobs. Methods: A descriptive research design was used with a convenience sample of 286 nurses. Data were collected from March 15 to April 14, 2017using self-reported questionnaires and analyzed by descriptive statistics, t-test, analysis of variance, Pearson's correlation coefficient, and multiple regression analysis using the SPSS/WIN 21.0 program. Results: The mean scores for intention to stay, resilience, and emotional labor were 5.28 out of 8, 57.40 out of 100, and 3.23 out of 5, respectively. Intention to stay was positively correlated with overall career (r=.30), workplace (r=.18), shift work (r=-.20), position (r=.28), salary (r=.13), job satisfaction (r=.51), hospital satisfaction (r=.46), and resilience (r=.41). Factors influencing the intention to stay were job satisfaction and resilience, which explained 28% of the variance. Conclusion: Overall career, job satisfaction, and resilience are critical factors affecting general hospital nurses' intention to stay. Based on the findings of this study, efforts to improve nurses' job satisfaction and resilience should be implemented to mitigate the loss of this expert group among healthcare professionals.

• 가정간호학회지
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• 제7권1호
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• pp.58-72
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• 2000

This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

• 문화기술의 융합
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• 제9권3호
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• pp.137-143
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• 2023

이 연구는 어린이(0-12세)손상 환자의 특성에 따른 재원일수의 관계를 규명하여, 어린이손상 환자 재원일수에 미치는 요인을 분석하고자 시행하였다. 조사대상은 퇴원손상심층조사 자료에서 2016년 1월1일부터 2020년 12월31일 까지 퇴원한 환자 중 0-12세 이하이며, 주진단이 손상 및 사고의 외인(S00-T98)인 환자 7,804명이었다. 분석은 빈도 분석 및 독립표본 t-검정, ANOVA 검정을 실시하였다. 재원일수에 영향을 미치는 요인을 알아보고자 회귀분석을 시행하였다. 연구대상자의 평균재원일수는 5.5일 이었다. 학령기(7-12세)기 아동이 학령전기(0-6세)보다 재원일수가 길었으며, 진료비 지불방법이 의료급여 및 기타보험 환자가 재원일수가 길었다. 의료기관 소재지가 수도권보다 비수도권(전라도, 경상도)일 때, 병상규모가 100-299병상인 경우 재원일수가 길었다. 내원경로는 외래인 경우 재원일수가 짧았고, 손상기전이 운수사고, 화상인 경우 재원일수가 길었다. 부진단이 있고, 주수술을 시행한 경우 재원일수가 길었으며, 퇴원후 방향이 사망인 경우 재원일수가 길게 나타났다. 이 연구는 전국 단위 자료인 퇴원손상심층조사 자료를 이용하여 우리나라 어린이 손상환자의 재원일수의 특성 및 결정요인을 파악하였다는 점에서 의의를 갖는다. 또한, 안전교육 및 예방 활동만으로도 발생을 줄일 수 있는 어린이 손상의 관련 요인 대한 적극적인 치료와 다양한 예방정책 마련을 위한 기초 자료를 제공했다는 점에서 의의가 있다.

• Journal of Preventive Medicine and Public Health
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• 제27권4호
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• pp.807-814
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• 1994

This study is to find out changes in medical practice at a university hospital before and after covering intraocular lens (IOL) from the health insurance benefit. The coverage started on March 1, 1993 and a total of 596 cases who were discharged from July 1 to December 31, 1992 and 580 cases who were discharged from July 1 to December 31, 1993 were analyzed. Since the standard reimbursement scheme was changed from March 1, 1993, the charges for 1992 were transformed into 1993 scheme. Major findings are as follows: Average length of stay was statistically significantly decreased from 8.24 days in 1992 to 6.86 days in 1993. Charges except IOL has been statistically significantly decreased from 501,000 Won in 1992 to 444,000 Won in 1993. Charges for drugs and injection have been reduced. However, charge per day for them was not much different. This is due to decrease in length of stay. Charges for laboratory tests and radiologic examination were quite the same. Charges which are not covered by the insurance remained the same. The revenue of the hospital was reduced as expected. However, the hospital reduced the length of stay and increase the turnover rate In order to compensate the potential loss of revenue due to the difference of reimbursement between the out-of-pocket expense and the insurance coverage. By introducing the IOL benefit in the insurance, the insured pays less, hospital generates more revenue through shortening the hospital stay, and the total medical care cost becomes less nationwidely.

• Journal of Chest Surgery
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• 제56권1호
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• pp.16-22
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• 2023

Background: Postoperative air leaks after pulmonary resection prolong the duration of chest drainage and the length of hospital stay. One of the many treatment options is bedside pleurodesis using various agents. This study evaluated the feasibility of an early intervention to stop postoperative air leaks with either autologous blood or a 50% glucose solution. Methods: We retrospectively reviewed 323 patients who underwent bedside pleurodesis between January 2017 and March 2022. Sixty-four patients received autologous blood patch pleurodesis, and 36 were treated with a 50% glucose solution after pulmonary resection. The primary endpoints were the total postoperative tube indwelling time, post-pleurodesis tube indwelling time, and hospital stay. A propensity score-matched analysis was performed. Results: In the autologous blood patch pleurodesis and 50% glucose solution groups, the mean initiation timing of postoperative pleurodesis were 2.06±1.62 and 3.28±1.56 days, the mean duration of the tube indwelling time after surgery was 6.58±3.02 and 6.42±4.92 days, and the mean duration of the tube indwelling time after pleurodesis, it was 4.53±3.10 and 3.11±4.80 days, respectively. In addition, the total length of hospital stay was 9.11±5.42 and 7.83±4.75 days in the autologous blood patch pleurodesis and 50% glucose solution groups, respectively. Conclusion: Early postoperative air leak cessation with autologous blood patch pleurodesis or 50% glucose solution pleurodesis is a feasible procedure with acceptable outcomes that effectively shortens the hospital stay.