• Title/Summary/Keyword: Hospitalized medical patient

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Clinical Study for Tremor in 36 Cases (진전(震顫) 환자 36예에 대한 임상적 고찰)

  • Shin, Woo-Jae;Ko, Heung;Kim, Gi-Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.6
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    • pp.1044-1049
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    • 2011
  • The purpose of this study was to study clinical characteristics of patients complained of tremor and to evaluate availability of oriental medical treatment. This observation was made on 36 cases that were hospitalized in the Semyung University Oriental Medicine Hospital and evaluated tremor using clinical rating tremor scale(CRTS). The ratio of patients were essential tremor(50%), parkinson's disease(13.9%), psychogenic tremor(13.9%), physiologic tremor(11.1%), cerebellar tremor(11.1%). CRTS score of essential tremor patients decreased significantly. Physiologic tremor patients's CRTS score were under 15 points. Every patient's scores decreased. Two patients's score decreased to 0 point. Every patient were treated with Bojungikki-tang-gamibang. CRTS scores of psychogenic tremor patients were various.(4~24 points) Two patients's scores decreased to 0 point. The CRTS scores of three cases among four patients with cerebellar tremor were not changed. Changes of CRTS score between oriental medication group and western-oriental combined medication group were statistically significant. Changes of CRTS score between over 15 points group and under 15 points group were statistically significant. Kejigayongolmoryo-tang was one of the most widely used herbal medication, which was diagnosed as ascendant hyperactivity of liver yang.

A Case of Dural Ectasia with Low Back Pain and Sciatica Treated with Integrative Korean Medical Treatment

  • Kwon, Oh-Hoon;Kim, Sang-Gyun;Park, Ju-Hun;Yoo, Dong-Hwi;Choi, Ki-Hoon;Choi, Ki-Won;Ha, Do-Hyung;Cho, Hyun-Woo
    • Journal of Acupuncture Research
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    • v.36 no.3
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    • pp.182-185
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    • 2019
  • Dural ectasia is defined as ballooning or expansion of the dural sac surrounding the spinal cord. This report describes a rare case of low back pain and sciatica, suspected as being dural ectasia. The patient was hospitalized for 45 days, and underwent integrative Korean medical treatment, including pharmacopuncture, acupuncture, herbal medicine, Chuna therapy, cupping therapy, and physiotherapy. The effect of the treatment was evaluated using the numerical rating scale, Oswestry disability index, European quality of life 5 dimensions, and subjective symptoms. After inpatient treatment, the pain the patient experienced was significantly reduced and the evaluation indices improved. This case report suggested that integrative Korean medical treatment could be an effective therapeutic choice for low back pain and sciatica, with dural ectasia. Further clinical studies are needed to support this observation.

Determination of Nursing Costs for Hospitalized Patients Based on the Patient Classification System (종합병원에 입원한 환자의 간호원가 산정에 관한 연구)

  • 박정호;송미숙
    • Journal of Korean Academy of Nursing
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    • v.20 no.1
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    • pp.16-37
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    • 1990
  • A cost analysis for hospitalized patients was carried out based upon Patient Classification System(PCS) in order to determine an appropriate nursing fee. The data were collected from 21 nursing units of three teaching hospitals from April 1 to June 30, 1989. first, all of the 22,056 inpatients were classified into mildly ill(Class Ⅰ), moderately ill(Class Ⅱ), acutely ill(Class Ⅲ), and critically ill(Class Ⅳ) by the PCS which had been carefully developed to be suitable for the Korean nursing units. Second. PCS cost accounting was applied to the above data. The distribution of inpatients, nursing costs, and nursing productivity were as follows : 1) Patient distribution ranged from 45% to class Ⅰ, 36% to class Ⅱ, 15% to class Ⅲ, and 4% to class Ⅳ, the proportion of class Ⅳ in ‘H’ Hospital was greater than that of the other two hospitals. 2) The proportion of Class Ⅲ and Ⅳ in the medical nursing units was greater than that of surgical nursing units. 3) The number of inpatients was greatest on Tuesdays, and least on Sundays. 4) The average nursing cost per hour was W 3,164 for ‘S’ hospital, W 3,511 for ‘H’ hospital and W 4,824 for ‘K’ hospital. The average nursing cost per patient per day was W 14,126 for ‘S’ Hospital, W 15,842 for ‘H’ hospital and W 21,525 for ‘K’ hospital. 5) The average nursing cost calculated by the PCS was W 13,232 for class Ⅰ, W 18,478 for class Ⅱ, W 23,000 for class Ⅲ, and W 25,469 for class Ⅳ. 6) The average nursing cost for the medical and surgical nursing units was W 13,180 and W 13,303 respetively for class Ⅰ, W 18,248 and W 18,707 for class Ⅱ, W 22,303 and W 23,696 for class Ⅲ, and W 24,331 and W 26,606 for class Ⅳ. 7) The nursing costs were composed of 85% for wages and fringe benefits, 3% for material supplies and 12% for overhead. The proportion of wages and fringe benefits among the three Hospitals ranged from 75%, 92% and 98% for the ‘S’, ‘H’, ‘K’ hospitals respectively These findings explain why the average nursing cost of ‘K’ hospital was higher than the others. 8) According to a multi- regression analysis, wages and fringe benefits, material supplies, and overhead had an equal influence on determining the nursing cost while the nursing hours had less influence. 9) The productivity of the medical nursing units were higher than the surgical nursing units, productivity of the D(TS) - nursing units was the lowest while the K(Med) - nursing unit was the highest in 'S' hospital. In ‘H’ hospital, productivity was related to the number of inpatients rather than to the characteristics of the nursing units. The ‘K’ hospital showed the same trend as ‘S’ hospital, that the productivity of the medical nursing unit was higher than the surgical nursing unit. The productivity of ‘S’ hospital was evaluated the highest followed by ‘H’ hospital and ‘K’ hospital. Future research on nursing costs should be extended to the other special nursing areas such as pediatric and psychiatric nursing units, and to ICU or operating rooms. Further, the PCS tool should be carefully evaluated for its appropriateness to all levels of institutions(primary, secondary, tertiary). This study took account only of the quantity of nursing services when developing the PCS tool for evaluating the productivity of nursing units. Future research should also consider the quality of nursing services including the appropriateness of nursing activities.

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Analysis of Medical Use and Costs Related to the Management of Liver Cirrhosis Using National Patients Sample Data (환자표본자료를 이용한 간경변증 환자의 의료이용 특성 및 의료비용 분석)

  • Kim, Hye-Lin;Park, Jae-A;Sin, JiYoung;Park, Seung-Hoo;Lee, Eui-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.4
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    • pp.341-347
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    • 2016
  • Background: Liver cirrhosis causes substantial socio-economic burden and is one of the major severe liver diseases in Korea. Nonetheless, there is only a few studies that analyzes disease burden of liver cirrhosis in Korea. Such study must be carried out due to its increasing need from the invention of new drugs for chronic hepatitis and demand for cost-effectiveness analyses. Methods: Patient sample data with ensured representativeness was analyzed retrospectively to compare the medical costs and uses for patients with compensated cirrhosis and decompensated cirrhosis. Patient claims data that include K74 and K703 from the year of 2014 were selected. Within the selected data, decompensated cirrhosis patient was identified if complications such as ascites (R18), encephalopathy (B190), hepatic failure (K72), peritonitis (K65), or esophageal varices (I85) were included, and they were compared to compensated cirrhosis patients. Results: 6,565 patients were included in the analysis. The average cost per patient was 6,471,020 (SD 8,848,899) KRW and 2,173,203 (4,220,942) KRW for decompensated cirrhosis and compensated cirrhosis, respectively. For inpatients, the average hospitalized days was 38.0 (56.4) days and 27.2 (57.2) days for decompensated cirrhosis and compensated cirrhosis, respectively. For outpatients, the average number of visits was 8.7 (9.1) days and 5.3 (7.5) days for compensated cirrhosis and decompensated cirrhosis, respectively. Conclusion: Compared to compensated cirrhosis patients, decompensated cirrhosis patients had higher costs, especially for hospitalization, injection, examination, and drugs administrated within medical institutions.

Factors related to willingness of choosing the same hospital (입원환자의 재선택 의향과 결정요인)

  • Seol, Dong-Won;Yu, Seung-Hum;Park, Eun-Cheol;Kim, Eun-Suak
    • Korea Journal of Hospital Management
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    • v.2 no.1
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    • pp.65-79
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    • 1997
  • This study aims to measure in-patients' willingness to choose the same hospital, and to define the related factors. The willingness was measured by the fact whether in-patients would return to the same hospital for their future hospitalization and can be said as the essence of ascertaining patients' satisfaction. Data was collected from 236 patients hospitalized in two hospitals selected according to its superiority, one being superior in medical technique, the other being superior in facility and equipment. To enhance the comparability between the two hospitals, the department and the diagnosis were matched, and structured questionnaires were self-fill-up. The main findings are as follows. Hospitals were analyzed by their superiority : medical services, facility and equipment. In case of hospitals with superior medical services, the willingness was proportional to positive doctor-patient relationship, to satisfaction with the medical level, and to the acknowledgement of utility in cure. In case of hospitals with superior facility and equipment, the willingness was proportional to the satisfactory state of overall facility. Two types of hospitals were combined and analyzed. The willingness for choosing hospitals with superior medical services was stronger than that for choosing the other hospitals. The satisfaction with overall facility, satisfaction with medical level, acknowledgement of utility in cure, positive doctor-patient relationship, and better consultation produced higher willingness to choose the same hospital. The willingness for the option shows to what degree the hospital suffices patients' expectation. Patients' understanding views were obviously influential. The satisfaction level for medical aspect was more influential than the level for non-medical aspect.

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A Case Report on Cervicogenic Dizziness and Headache Treated with Korean Medicine in a Hospitalized Patient (한방병원에 입원한 경추성 현훈 및 두통 환자에 대한 한방 치료 1례)

  • Gil-geun Baek;Sang-yoon Kim;Yen-min Wang;Sang-hun Yun;Yu-jin Lee;Hyung-chul Lee;Man-ho Kang;Sung-hwan Park
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.885-893
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    • 2023
  • Objective: The purpose of this study is to report the efficacy of using Korean medicine treatment with cervicogenic dizziness and headache. Methods: We used Korean medicine treatments (herbal medicines, acupuncture, pharmaco-acupuncture, and Chuna) to treat a hospitalized patient with cervicogenic dizziness and headache. The treatments were assessed using the Korean Dizziness Handicap Inventory (K-DHI) to evaluate the degree of dizziness. The Numerical Rating Scale (NRS) was used to evaluate headaches and post-traumatic neck pain. General health status was evaluated using the European Quality of Life Five Dimensions (EQ-5d) scale. Results: The patient's NRS and EQ-5d scores improved after treatment. The change in the K-DHI scores showed that the patient's cervicogenic dizziness symptoms were relieved. Conclusions: The results of this study suggest that Korean medicine therapies may be effective for treating cervicogenic dizziness and headaches.

Stress of the Pediatric Patient′s Parent in the Emergency Department (응급의료센터에 내원한 환아부모의 스트레스)

  • Park In-Sook;Lee Nam-Hyeong
    • Child Health Nursing Research
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    • v.8 no.3
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    • pp.260-271
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    • 2002
  • This study was performed to identify the level of stress recognized by the parents as a support system for their infant patients who were hospitalized in an emergency department, thus to provide the resulting data as the basic material of care intervention for the families of infant patients. This study subjected the parents with infant patients who were hospitalized in emergency department of C University Hospital in Daejeon, and the data was collected from questionnaires for them, dating from Mar. 20, to Jun. 24, 2001 This study used the tool(30 questions) which was originally developed by Ji, Dong-ok (1992) for measuring the stress of families of infant patients in emergency room, and then was modified and complemented by this researcher suitably for infant patients. Collected data was statistically analyzed with frequency, percentage, mean, standard deviation, t-test, ANOVA, by using SPSS WIN10.0 program, and the results were as follows: 1. The stress of parents with infant patients hospitalized in emergency department averaged 3.31 on the basis of 5-point measure, which means that they felt stress beyond means. 2. The factor with high average out of stress factors the parents of infant patients recognized included the followings: 'about the pain of infant patients due to examination(3.91±1.00)'; 'about rare opportunity to be in contact with physician(3.78±1.09)'; 'delay in emergent treatment required for infant patients(3.75±1.31)'; 'delay in the general treatment of infant patients(3.72±1.32)'. Factors of the stress level includes the followings: 'care and medical treatment'(3.46±.72); 'body and diseases'(3.41±.97)'; 'lack of information and supportable resources (3.25±.77)'; and so on. 3. For the stress level according to general characteristics, there were statistically significant differences in the result of the condition of infant patients, medical treatment(P<.01), religion, the procedure of treatment(P<.05). With little preceding studies for infant patients hospitalized in emergency department, this study looked through the level of stress recognized by the parents of infant patients. Based on the comprehension on the parents with infant patients and the knowledge on stress factors recognized by the parents, it is expected that we can seek the methods of care intervention such as explanation of care and treatment procedures, unit policies, continuous interest and emotional supports as well as the provision of information to understand the responses of parents and reduce accompanied stresses.

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Development of Case Review Form for Detecting Adverse Events (위해사건 확인을 위한 증례검토지 개발)

  • Ock, Min-su;Lee, Sang-il;Kim, Yoon;Lee, Jae-ho;Lee, Jin-yong;Jo, Min-woo;Kim, Seon-ha;Son, Woo-seung;Kim, Hyun-joo
    • Quality Improvement in Health Care
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    • v.21 no.1
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    • pp.66-76
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    • 2015
  • Objectives: The purpose of this study is to develop a case review form for detecting adverse events through a medical records review in hospitalized patients in South Korea. Methods: To develop the case review form, several literatures were reviewed, first. Through the clinical expert meeting, screening criteria were selected and case review form was developed. Result: The Korean version of case review form consisted of the review form-1 for adverse event screening and form-2 for adverse event identification. The applied methodology for the case review form is determined according to the previous studies. For example, the method used in the first stage review is nurse review. Furthermore, the National Coordinating Council for Medication Errors Reporting and Prevention index is used to categorize disability, and a scale of 1 to 6 was used in the causation scores and preventability scores, respectively. Through the clinical expert meeting, a total of 41 screening criteria were selected. Conclusion: The Korean specific case review form was developed for detecting adverse events in hospitalized patients. The results from this study can be used in a large-scale study regarding the nationwide incidence of adverse events.

The Effects of Patient and Hospital characteristics on Hospital Care Outcome of the Patients with Tuberculosis (결핵 입원환자의 치료결과에 영향을 미치는 환자 특성과 의료기관 특성)

  • Youn, Kyung I.
    • Korea Journal of Hospital Management
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    • v.19 no.2
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    • pp.44-54
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    • 2014
  • In spite of effective curative therapy, morbidity and mortality remain high for hospitalized patients with tuberculosis(TB) in Korea. The purpose of this study was to identify patient and hospital characteristics associated with hospital care outcome. Using annual patient survey data produced by Korea Institute for Health and Social Affair, we identified 8,562 hospital discharge with primary diagnosis of TB. Logistic regression analyses were performed on a model that included age, gender, residence area, insurance status, hospital admission source, length of stay, hospital ownership and class of hospital as the explanatory variables and outcome of treatments as the dependent variable. The results show that negative outcome was associated with the patients older than 65 years, medical aid beneficiary, admission through emergency department, and the patients admitted to public owned hospitals. On the other hand, the patients who were admitted to teaching hospitals were associated with positive outcome. To improve hospital treatment outcome of TB patients, more vigorous strategies should be implemented targeting the older and poor population in regard to social support as well as the clinical management and prevention.

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A Study on the Activities of IV Team In the Children's Hospital (소아병원의 정맥주사팀 활동에 대한 조사연구)

  • Hwang, Jeong Hae;Hwang, Jee In;Kim, Mi Ran;Shin, Hee Young;Ahn, Hyo Seop
    • Quality Improvement in Health Care
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    • v.6 no.1_2
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    • pp.92-106
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    • 1999
  • Background : In many university hospitals, intravenous(IV) therapies and samplings had been one of the most important works of doctors who are in training. However, recently as patient oriented care is becoming more weighted for qualified health service IV therapies should be the works of specialized personnels. This study was conducted to investigate the medical staff's perception on IV team, to survey patient or parent's expectation on IV team, and to assess the frequency of IV therapy related complications and the characteristics of phlebitis among the hospitalized children. Methods : We collected data prospectively before the start of IV team from February 22 to February 29. 1999 and from September 27 to October 3, 1999, 6 months after beginning of IV team at Seoul National University Children's Hospital. IV team started their activities from March 1, 1999. General pediatric wards were not included for the IV and sampling team and oncology ward and surgical units were all included for the IV and sampling team's work. IV specialist was the well trained nurse who had been working in the field of pediatrics especially for the oncology patients. The subjects of this study were medical staffs who were working in children's hospital as doctors in training and patients who were treated with IV therapies in children's hospital during the same period. Results : Doctors responded that IV team need to be organized for IV care and expected IV team could reduce their work load. Parents of patients also responded IV team was very improtant to perform high quality IV care. They had willingness to pay extra charge for IV team care. In the wards where IV team did not work, they used various kinds and sizes of catheters, but in the wards where IV team worked, they needed just one or two types of catheters. As the exact role of IV team is not still established, job description is needed between the IV team and medical doctors. In the aspects of medical costs. it could save the materials for the IV also. Conclusion : This study showed that IV team could increase patient's satisfaction with decrease of medical doctors work load and concomitantly could save the costs of IV materials. And for the expansion of the IV team, job description is needed and for the total care of the children IV specialist and sampling team should expand their roles.

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