• Title/Summary/Keyword: Hospitalized

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Association of Higher Continuity of Primary Care with Lower Risk of Hospitalization among Children and Adolescent Patients (어린이와 청소년 환자에서 일차의료의 지속성과 입원 위험도의 관련성)

  • Choi, Yong-Jun;Kang, Sung-Hyun;Kim, Yong-Ik
    • Health Policy and Management
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    • v.18 no.1
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    • pp.85-107
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    • 2008
  • This study aims to describe levels and distribution of the continuity of primary care among children and adolescent patients who are 2-19 years old, and analyze the effects of it on the risk of hospitalization. Study population was 2-19 year old child and adolescent patients as of 2002, who had more than three ambulatory care visits in the years of 2002-3 and whose most frequent provider was the primary care practices (189,660 persons). Association of levels of primary care with the risk of hospitalization was evaluated using multiple event survival analysis. Outcome variables were whether the patient had hospitalized or not, and whether the patient had hospitalized due to ambulatory care-sensitive conditions or not. Multiple event survival analysis revealed statistically significant association of the levels of primary care with the risk of hospitalization. Hazard ratio was 1.34 [1.27-1.41] at the medium level of continuity and 1.47 [1.39-1.55] at the lower level where outcome variable was whether the patient had been hospitalized or not. Hazard ratios were 1.35 [1.21-1.50] at the medium level of continuity and 1.60 [1.44-1.78] at the lower level, where outcome variable was whether the patient been had hospitalized due to ambulatory care-sensitive conditions or not. This study produced some evidences on the benefits of continuity of care, which will in turn support the introduction of personal doctor registration program in the future.

Influence of Social Support and Illness Perception on Depression among Hospitalized Older Adults Prior to Discharge from an Acute Care Hospital (퇴원을 앞둔 노인 환자의 사회적 지지와 질병지각이 우울에 미치는 영향)

  • Yeom, Jeung Heui;Shin, Yong Soon
    • Korean Journal of Adult Nursing
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    • v.29 no.3
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    • pp.246-255
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    • 2017
  • Purpose: This study was designed to identify factors affecting depression among hospitalized older adults prior to discharge from an acute care hospital. Methods: This descriptive study included adults aged 65 or older who were hospitalized in a general hospital in Seoul, Korea. Depression was measured by the Short Form Geriatric Depression Scale and illness perception was evaluated by the Brief Illness Perception Questionnaire. Social support was examined using the Perceived Geriatric Social Support Scale. Data were collected from August 25 to October 12, 2015. Data analysis included descriptive statistics, independent t-test, Kruskal-Wallis test, Pearson's correlation coefficient, and hierarchical multiple regression. Results: Among a total of 120 participants, 57 patients (47.5%) experienced depression. Mean depression score was $7.37{\pm}3.67$. Depression was associated with illness perception (r=.53, p<.001), social support (r=-.19, p=.043), number of admission due to the recurrence (r=.31, p=.001), and time to recognize discharge plan (r=.25, p=.044). In hierarchical multiple regression, illness perception (${\beta}=.45$, p<.001) and time to recognize discharge plan (${\beta}=.21$, p=.039) were predictors of depression (F=7.68, p<.001, Adjusted $R^2=.38$). Conclusion: The findings of this study suggest that management of illness perception and timely notice of discharge are important to reduce depression in hospitalized elderly patients.

Mortality, Length of Stay, and Cost Associated with Hospitalized Adult Cancer Patients with Febrile Neutropenia

  • Chindaprasirt, Jarin;Wanitpongpun, Chinadol;Limpawattana, Panita;Thepsuthammarat, Kaewjai;Sripakdee, Warunsuda;Wirasorn, Kosin;Sookprasert, Aumkhae
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1115-1119
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    • 2013
  • Background: Febrile neutropenia (FN) is a serious complication following chemotherapy and is associated with significant mortality and financial expenditure. The aim of this study was to evaluate risk factors for longer length of stay (LOS) and mortality and cost of treatment among hospitalized adults with cancer who developed febrile neutropenia in Thailand. Materials and Methods: Information on illness of inpatients and casualties came from hospitals nationwide and from hospital withdrawals from the 3 health insurance schemes in fiscal 2010. The data covered 96% of the population and were analyzed by age groups, hospital level, and insurance year schemes in patients with febrile neutropenia. Results: A total of 5,809 patients were identified in the study. The mortality rate was 14%. The median LOS was 8.67 days and 69% of patients stayed for longer than 5 days. On bivariate analysis, age, cancer type, and infectious complications (bacteremia/sepsis, hypotension, fungal infections, and pneumonia) were significantly associated with longer LOS and death. On multivariate analysis, acute leukemia and infectious complications were linked with longer LOS and death significantly. The median cost of hospitalized FN was THB 33,686 (USD 1,122) with the highest cost observed in acute leukemia patients. Conclusions: FN in adult patients results in significant mortality in hospitalized Thai patients. Factors associated with increased mortality include older age (>70), acute leukemia, comorbidity, and infectious complications.

The Statistical Study of 84 Traffic Accident Patients hospitalized in Oriental Medical Hospital (한방병원에 입원한 교통사고 환자 84례에 대한 통계적 고찰)

  • Park, Tae-Yong;Lee, Jeong-Han;Ko, Youn-Seok;Woo, Young-Min;Song, Yong-Sun;Shin, Byung-Cheul
    • The Journal of Korea CHUNA Manual Medicine
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    • v.6 no.1
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    • pp.31-40
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    • 2005
  • Objectives : The purpose of the study was to find out the characteristic of patients admitted in Oriental Medical Hospital We to traffic accident and to promote the superiority of oriental medical treatment on the sequelae. Methods : 84 inpatients were analyzed statistically according to medical charts, hospitalized from January 1, 2003 to December 31, 2004. Results and Conclusions : By gender, males accounted for 38.1%, while females 61.9%. By age, most incidences occurred in the forties (25%), thirties (22.6%) and twenties (16.6%) in order. With regard to the interval from occurrence of accidents to hospitalization, 26 cases (31%) were found to be hospitalized 41 days after the accidents, followed by 21 cases (25%) in $11{\sim}20$ days and 17 cases (202%) in $1{\sim}2$ days. Most cases tumed out to be minor injuries with 40 patients from cervical sprain (47.6%) and lumbar sprain (37%). The mean duration of hospitalization was $36.58{\pm}48.30$ days Inpatients of paralysis of extremities (sequelae of ICH) numbered the longest stay $(121.00{\pm}75.57\;days)$, cervical sprain that recorded $11.28{\pm}6.52$ days hospitalized. Most of inpatients were treated with acupuncture(100%), moxibustion, cupping therapy (97.6%) and herbal medication(96.4%), chuna Manipulation therapy was chosen selectively with sprain, HIVD.

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A study of hospitalized patients' knowledge and practice of oral health (일부 입원환자의 구강보건지식과 구강관리실천에 관한 연구)

  • Noh, Eun-Mi
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.3
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    • pp.247-258
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    • 2007
  • This study intended to provide the basic data for developing the educational materials of the preventive measures of dental diseases and of the improvement method of oral health by examining hospitalized patients' knowledge and practice of oral health. It had a survey for 253 hospitalized patients in D General Hospital located in Ulsan from August 10, 2006 to September 10, 2006. The participants were requested to write down an answer to each question. In relation to the knowledge and practice of oral health, 15 questions were prepared respectively and 5-point scale was employed. The study results were as follows: 1. 53.8% of the participants were females and 25.3% was in the ages of 30~39, 44.7% was high school graduates and 26.1% had professional jobs. 41.9% was hospitalized for less than 5 days. 2. The participants' average knowledge of oral health was $3.79{\pm}0.88$ and their average practice was $3.15{\pm}0.98$, which tells that they knowledge oral health, but they are negligent at practicing it. 3. Female patients showed higher knowledge of oral health than males, and the patients in the ages of 30~39 showed the highest knowledge(pE0.05). In terms of the practice of dental health, younger patients showed higher points. The higher their educational and economic background were, the higher their knowledge and practice of oral health were. In addition, the patients involved in office works or public serves showed higher knowledge and practice too(pE0.05).

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Analysis of Utilization and Expenses of Medical and Oriental Medical Care Services in a Designated Rural Areas (군보건소의 진료제공량 및 양·한방 진료비 분석)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.17 no.1
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    • pp.17-24
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    • 1992
  • The medical care insurance system has been adopted in rural areas in 1988, since then, the utilization of medical care services has increased rapidly in rural areas. The government has restructured the 15 health centers, which are located in remoted rural areas and these 15 health centers were strengthend to provide the curative care to the residents in order to meet the curative can demand of the residents. Besides the reorganization of the health centers, the government has implemented the oriental medical care demonstration project at the health center in a designated rural areas. This study was aimed to analyze the utilization and expenses of medical and oriental medical care services in a designated rural areas. Number of annual visits of residents to health centers in 1991 showed slightly decreased compared with that in 1989. However number of annual visits to the hospitalized health centers was an increase of 49.3%~64.5%. Regarding the coverage of curative care for the residents in rural areas, the hospitalized health centers are functioning more effective than that of health center. Expenses per case of medical care rendered by health center was lower than that of oriental medical care, while the expenses of the medical care was quit higher than that of oriental medical care in the hospitalized health centers. According to the above mentioned study results, the hospitalized health centers were more effective and suitable to provide a curative care to the residents than the health centers, and also the oriental medical care could be needed to be provided by public health network in the near future.

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Elderly Sleep Pattern and Disturbing Factors Before and After Hospitalization (노인환자의 입원 전ㆍ후 수면양상과 수면장애요인에 관한 연구)

  • 김미영;조성희;이상미;정수정;박경숙
    • Journal of Korean Academy of Nursing
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    • v.29 no.1
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    • pp.61-71
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    • 1999
  • Sleep is a necessity for survival. Disruption of sleep leads to numerous adverse physiological and psychological consequences. These could be particularly undesirable for older patients, who are subject to many additional factors. But there is limited research related to hospitalized elderly in Korea. The purpose of the study is to explore sleep patterns and disturbing factors of before and after hospitalization, in order to present basic information regarding elderly sleep to develop nursing intervention. The sample consisted of 32 elderly men and women between the ages of n and 87 years. Data collection was done from September to November 1997. Measures of sleep patterns and related factors were obtained from self-reported sleep questionnaires. Analysis of data was done by use of t-test, paired t-test, ANOVA, and Pearson Correlation Coefficient. The results of this study were summarized as follows : 1. In comparision between before and after admission of their sleep pattern, “sleep onset” tends to be delayed and nocturnal sleep time was significantly reduced. So, hospitalized elderly reported less total sleep time than before admission. 2. Regarding the sleep disturbing factors, medication(hypnotics ; 37.5%), physiological factor (snoring ; 59.4%) environmental factor (pillow ; 78.1%), emotional factor(anxiety related to disease ; 37.5%), and illness factor(fatigue ; 34.7%) were reported. 3. Significant differences in gender were found. Men had more disturbances in sleep than women owing to difficulty in falling a sleep and lack of nocturnal sleep. Women consumed more sleep inducing drugs. Significant increase was reported in napping during the day with increasing age. 4. Significant differences between good sleepers and poor sleepers were found for the following variables : nocturnal sleep time, total sleep time, bed time, sleep onset latency time, sleep latency time after nocturnal awakening, time spent in bed upon arousal, environmental factors, and emotional factors. In conclusion, it was found that the quantity and quality of sleep were significantly altered in hospitalized elderly, but adequate strategies for better sleep were not practiced. Further research is needed to develop Intervention strategies to promote sleep and to prevent sleep problems.

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The effects of psychological factors on elderly of depression scale and Electroephalography

  • Kang, Byeong-Woo;Jung, Mi-Hyun;Cho, Byung-Jun
    • Journal of the Korea Society of Computer and Information
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    • v.21 no.12
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    • pp.157-163
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    • 2016
  • Purpose : This study purposed on the understanding of psychology in the elderly women using depression scale and electroephalography. The subjects were thirty elderly women in geriatric care hospital. All participants were elderly women over 65 years old. The subjects signed up with informed consent and they were divided into a normal elderly group, an exercise elderly group and a hospital elderly group. They were randomly assigned with 10 persons. Methods : The study instruments were Geriatric Depression Scale(GDS) and Poly-G-I. Brain wave activity was measured by 'power spectrum analysis' of TeleScan program. Statistic analysis consisted of average, standard deviation, One-way ANOVA and post-hoc Tukey using SPSS 21.0 version. The significance was set at .05. Results : Depression scale results showed that the exercise elderly group were $10.60{\pm}5.36$ points which was the lowest among the three groups. The Normal elderly group was $16.20{\pm}5.59$, and the hospitalized elderly group was $16.70{\pm}6.76$ points. There was no significant difference between the normal elderly group, exercise elderly group and hospitalized elderly group. The hospitalized group showed statistical difference in relative theta power in the area of Fp1, F3, F4, T3, P3 as compared to the normal elderly group and the exercise elderly groups. There was no significant difference between relative beta power and relative gamma power in three groups. Conclusion : Geriatric depressed scale showed no significant difference in each group. This is indicated in the mental problems associated with depression. This indicates a higher level of depression in the hospitalized elderly women, more than in the normal elderly women and exercise elderly women groups.

A Study on the Empathy of Pediatric nurses (아동간호사의 공감정도에 관한 연구 -간호사와 입원아동 어머니를 대상으로-)

  • Park Eun Sook;Suk Min Hyun;Jung Kyung Sook
    • Child Health Nursing Research
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    • v.3 no.2
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    • pp.142-153
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    • 1997
  • Empathy is an essential factor for establishing therapeutic relationship. Especially for pediatric nursing, the nurses need to know how to perceive children's feeling and thought and to express her understanding about them affectively. So, empathy is considered as an important concept in pediatric nursing. This study was attempted to measure the empathic ability of pediatric nurses by pediatric nurses and mothers of hospitalized children. The subject of this study consisted of 83 pediatric nurses and 106 mothers of hospitalized children in 4 hospitals in Seoul and 1 hospital in Kyung-Gi. Data were collected from Jan. 14 to Feb. 6, 1997, by the questionnair method. The instrument for this study was the Empathic Construct Rating Scale : ECRS(60-item, 5 point scale). Data were analyzed by descriptive statistics, t-test and ANOVA. Results of this study are summarized as follows 1. Pediatric nurses perceived their empathic ability to be moderately high (Mn=3.71). The level of perceived empathic ability of the pediatric nurses showed no significance by general characteristics. 2. The mothers of hospitalized children perceived nurses' empathic ability to be moderate(Mn=3.27). The level of perceived nurses' empathic ability of the mothers of hospitalized children showed significant differences by the experience of hospitalization of the children and the age of the mothers. 3. The perceived nurses' empathic ability of the mothers was significantly low than of the pediatric nurses(t=6.50, P<.001). From the above results, it can be concluded, that the empathic ability of the pediatric nurses is not sufficient for caring children and mothers of ficiently. So, the pediatric nurses' empathic ability is needed to improve through facilitative relationship training as refreshment in-service education program.

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Comparison of four nutritional screening tools for Korean hospitalized children

  • Lee, Yeoun Joo;Yang, Hye Ran
    • Nutrition Research and Practice
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    • v.13 no.5
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    • pp.410-414
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    • 2019
  • BACKGROUND/OBJECTIVES: Several nutritional screening tools were recently developed to screen the risk of malnutrition in hospitalized children, but have not been validated in Asia. We compared four nutritional screening tools for pediatric patients in evaluating nutritional risks in newly hospitalized children. SUBJECTS/METHODS: Medical records of newly admitted pediatric patients between June 2016 and May 2017 at two tertiary hospitals were reviewed. Initial information by nurses and hospital records by doctors on baseline demographic, clinical, and anthropometric data at admission were collected in all subjects. Nutritional risks were evaluated using four nutritional screening tools including the pediatric nutritional risk score (PNRS), the screening tool for the assessment of malnutrition in pediatrics (STAMP), the paediatric Yorkhill malnutrition score (PYMS), and the screening tools for risk of nutritional status and growth (STRONGkids). RESULTS: A total of 559 patients (310 boys and 249 girls, mean age $6.3{\pm}5.5years$) were recruited. Patients in medical and surgical departments were 469 (83.9%) and 90 (16.1%), respectively. The prevalence of patients at risk of malnutrition were 31.1% for low risk, 52.2% for medium risk, and 16.6% for high risk by PNRS; 11.4%, 39.7%, and 48.8% by STAMP; 26.5%, 25.4%, and 48.1% by PYMS; and 35.6%, 58.9%, and 5.5% by STRONGkids. PNRS versus STRONGkids and STAMP versus PYMS showed moderate agreement (kappa = 0.566 and kappa = 0.495, respectively). PYMS and STAMP revealed a relatively high sensitivity of 87.8% and 77.6% for wasting. CONCLUSION: Different nutritional screening tools revealed considerably different results in evaluating nutritional risks in newly hospitalized children. Since pediatric patients are at risk of malnutrition at admission and during hospitalization, screening tools should be applied properly according to the situation of each hospital.