Background: Although the number of cancer patients increase, the resources for cancer management are not increased. If the outpatient chemotherapy administration room is operated, the shift of patients from inpatient 10 outpatient is occurred. So the capacities for chemotherapy increased and the shifted rooms were occupied with new non-chemotherapy patients. The income of the hospital increased. The purpose of this study was to assess usefulness and cost-effectiveness of the outpatient-chemotherapy adminstration model. Method: There are six beds, two chairs and two nurses and one personnel in the outpatient chemotherapy room. The satisfaction study by patients/family and doctors and the cost analysis over 12 months, by comparing costs of chemotherapy administration at outpatient chemotherapy room with inpatient at ward and inpatient-nonchemotherapy at ward were done. Results: The 97.1 percent of patients/family and the 94.4 percent of doctor who involved chemotherapy were satisfied with outpatient chemotherapy administration. The 91.7% of doctors said there were no differences in treatment outcome between outpatient and inpatient chemotherapy administration. The average number of patients in outpatient chemotherapy room increased from 10.7 to 15.4 but in inpatient from 19.4 to 18.3. The average number of inpatient chemotherapy were not changed related to increase of the average number of outpatient chemotherapy. The profit between outpatient chemotherapy and inpatient chemotherapy administration was 45,344,710 won and the profit between outpatient chemotherapy and non chemotherapy treatment was -185,294,614 won. Conclusion: The outpatient chemotherapy administration model is good for patients/family, doctors and hospital partially. But the hypothesis described above was not correct. The process of cancer patients treatment were from diagnosis and treatment to first administration of chemotherapy. So the shift from inpatient to outpatient was not occurred. In economic aspect, the profit between outpatient chemotherapy and non chemotherapy treatment was in the red. As the level of health care fees was so low, the hospitals hesitate operating the room of outpatient chemotherapy. It is necessary to raise the level of health case fees for outpatient chemotherapy administration.
This study was designed to compare care needs of patients with cancer and family members in inpatient and outpatient settings. The questionnaire was a Likert type 5 point scale with 57 items on four need categories; informational, physical care emotional care and socioeconomic care. There were significant differences between inpatient and outpatient settings. Also, there were significant differences in degree of care need according to gender, religion, marital status, economic status, public insurance status, and the past regimen. In conclusion, emotional needs perceived by patients with cancer and family members were higher than the others. Based upon the result, it is recommended that the research to compare needs between cancer patients who have a same illness and family member are necessary.
Kim, Ye-seul;Han, Euna;Lee, Jae-woo;Kang, Hee-Taik
Journal of Hospice and Palliative Care
/
v.25
no.2
/
pp.76-84
/
2022
Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.
This study examined the effects of gender, parental support and treatment type on the treatment outcome of adolescent substance abusers. Outcome variable was the successful graduation (or drop) from an Intensive Adolescent Outpatient Program. Adolescents with their parents' support were treated in one of three treatment models (2-weeks Inpatient plus 6 week Intensive Croup-Oriented Outpatient, 8-weeks Intensive Croup-Oriented Outpatient, and 8-weeks Individual-Family Therapy) within a private hospital-affiliated treatment center by managed care practice allowing their own choice (non-random natural assignments). Several hypotheses were tested for main effects by the Log-Linear Analyses for a multi-dimensional contingency table with 440 adolescents (284 boys and 156 girls treated during 1992-l997) from middle-class families with private health insurances. The following results were found. Odds of graduating versus dropping out of the treatment program among : (1) girls were 1.7 times higher than those among boys; (2) adolescents with two-parent were 2.2 times higher than those among adolescents with one-parent ; (3) adolescents with Inpatient plus Outpatient was 1.7 times higher than that of those with Outpatient; (4) adolescents with Individual-Family Therapy was 2.3 times higher than that of those with Outpatient Model. There was no statistically significant outcome difference between the Individual-Family Therapy and the Inpatient plus Outpatient. Implications from the results were discussed. Suggestions were made to improve the treatment components in the areas of gender sensitivity, securing more parental support, alternatives for separation from peer group and integrating new peer groups, and flexibility for the unique needs of individual family. Also, some research questions for future studies were suggested.
This study, by grasping the degree of anxiety of Korean mothers and multicultural family mothers because of their hospitalized children, was aimed to arrange the basic data for developing the program to help the mothers of Korea and multicultural family reduce the anxiety happening due to the hospitalization of their children and adapt to their environment. Methods: The subjects of the study were a total of 200 people composed of 100 multicultural family mothers, and 100 Korean mothers respectively whose children were hospitalized in the pediatric department of K university hospital located in Daejeon City. And the period of data collection was from Aug 1, 2010 to Aug 31, 2010.As a study tool, the measuring tool of Kim Jeong Taek(1978), which STAI of Sielberger(1972) was adapted to Koreans, was used.The collected data was analyzed using SPSS WIN 12.0. Results. A result of the state anxiety of the Korean mothers with that of the multicultural family mothers of the inpatient children, Korean mothers 2.11, multicultural family mothers 2.17, result of temperament anxiety showed Korean mothers 2.09, multicultural family mothers 1.94. As a result of comparing the anxiety of the Korean mothers with that of the multicultural family mothers of the inpatient children, there was no difference between groups in both temperament anxiety and state anxiety. In a situation of anxiety, when there was no explanation of the treatment or therapy, both Korean mothers and multicultural family mothers showed the severe anxiety. In the degree of anxiety according to the general characteristics of the mothers of the inpatient children, there was not a statistically significant result in anxiety according to general characteristics of the inpatient children of korean family mothers, there was a significant difference in state anxiety according to the state of average monthly income in Korean mothers(P<.05), however, there was a significant one in temperament anxiety in the course of perceiving a test method in multicultural family mothers(P<.05). In the degree of anxiety according to the general characteristics of the mothers of the inpatient children, there was a significant difference in state anxiety according to the state of average monthly income in Korean mothers(P<.05), however, there was a significant one in temperament anxiety in the course of perceiving a test method in multicultural family mothers(P<.05). Conclusion: Through the results of the study above, no matter what socio-demographic characteristics of the mothers of the inpatient children are, regardless of the general characteristics of the inpatient children, it was found out that most of mothers felt anxiety.
Purpose: This study examined the quality of life (QoL) and quality of care (QoC) in inpatient hospice settings in Korea before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Data were obtained from three institutions that participated in two prospective cohort studies. The primary outcomes measured were the QoL of patients with terminal cancer and their family caregivers (FCs), as well as the QoC as perceived by the FCs. Results: Multivariable regression analysis revealed that during the COVID-19 pandemic, both patients and FCs experienced better QoL than before the pandemic, and FCs reported a higher QoC. Conclusion: Health policymakers should consider our findings when planning for future pandemics.
Park, Theresia;Ra, Jeong-Ran;Seo, In-Ok;Cho, Young-Yee;Choi, Suk-Kyung;Park, Myung-Hee;Heo, Jeong-Hee;Kim, Eun-Kyung
Journal of Hospice and Palliative Care
/
v.2
no.2
/
pp.91-100
/
1999
Purpose : This study was performed to investigate the satisfaction in the hospice services provided for inpatient families and bereaved families whose members had been admitted to the hospice unit at Kangnam St. Mary's Hospital to improve the quality of care for the terminally ill patients and their families. Methods : This sample consisted of 33 families of hospice patients during the period of April to lune, 1998 and 30 bereaved families whose patients had died from March, 1993 to March, 1998. The data were collected through a self-report questionnaire and analyzed using t-test and ANOVA. Results : 1) The satisfaction level of inpatient families and bereaved families showed the mean value of 3.5 where the highest value is 5.0. 2) According to age, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family, medical management and nursing management(P=0.0001). The level of satisfaction of bereaved families showed significant differences in the field of support for the family, medical management, nursing management, and facilities of the hospice unit(P=0.0001). 3) By family relationship, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family, medical management and nursing management (P=0.0001). 4) According to religion, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family and nursing management (P=0.0001), but there was no significant difference for the bereaved families. Conclusions : The findings of this study showed that hospice services had positive influence on families with terminal disease such as cancer. To improve the level of satisfaction in the hospice services for families with hospice patients, we need to provide care by an interdisciplinary hospice team approach, and to assess needs of the families according to their socio-psychological characteristics. Further studies need to be conducted with large samples.
We carried out this study for recognizing the staue of child inpatient nursing and providing child inpatient with better qualified nursing. We study this research from March 29, 93 to April 23, 93 to April 23, '93. First admission day in hospital, we ask 50 mothers of hospitalized child inpatient about the value of nursing and self-consciousness of mothers, also ask 10 nurse in charge about the satisfaction of tending child inpatient Two times-third admission day in hospital and leaving day, we inquired mothers the value of nursing of mothers by inquiry papers, each measurement was made up of five indexes. The result of research was as follow: 1. The subjects of research had following peculiarities. Average age : 2.5 years 0~ 1 years : 32.0% Baby girl : 56.0% first baby : 58.0% Experienced inpatient : 52.0% The number of hospitalization times was 1~2 times : 61. 5% The average period of hospitalization : 7 days Infected inpatient with respiratory organ disease : 40.0% The mother's average age of child inpatient : 30.5 years Mother's who finished high school : 90.9% Family that income about 600,000-700,000 won : 32.0% Mothers who belived an religion : 50.0% 2. As hospitalization time goes by, mothers gradually failed to recognize the value of nursing. 3. Self-estimated tending satisfactions have no connection with the value of nursing that mothers recognized. 4. The value of nursing was effected by mothers own personnality-salf-consciousness care, experience of hospitalization, academic background & religoin. So, we find out that the value of nursing had no connection with satisfaction of tending. Nurses must make every effort to provide child inpatient with nursing of good quality, that mothers confirm and nurses satisfy themselves. Also, we have to emphasize the importance of home and school education, because these education have a great influence upon mother s self-consciousness.
The purpose of this study was to provide the effective pain management care for post operative patients through understanding patient's knowledge and attitude about pain-management. The data was collected by distributing structured questionnaires to 200 inpatients in 2 secondary hospitals located in Ulsan, beginning June 28, 2010 to August 11, 2010, and analyzed by t-test, ANOVA, Pearson correlation coefficient. The level of Knowledge about pain management postperations was $6.44{\pm}2.03$. The level of attitude about pain management postperations was $6.92{\pm}1.78$. The significant differences were founded within the inpatient's knowledge about pain management according to the inpatient's demographic data:Age(F=5.55, p=.01), Marital status(t=-2.17, p=.03). The significant differences were founded within the inpatient's attitude about pain management according to the inpatient's demographic data:Job(F=3.45, p=.03). Developing educational material and guidebooks is needed to form more positive about pain-control after operations. This study researched only inpatient's knowledge and attitude about pain-management, but researching nurses, doctors, inpatients and family member's knowledge and attitude should be included in following studies.
The purpose of this study is to help the care of patient and to his family through comparison of the level of anxiety which between the family of admitted patient and the family without in patient, and to his family through comparison of the level of anxiety which between the family of admitted patient and the family without inpatient and exclude the factors which raised the level of anxiety in them. The experimental group in this study were samples of 200 patient's family selected by random sampling in H. University hospital located in Seoul (Department of patient were internal medicine, surgery, pediatrics and neuropsychiatry). The control group were samples of 70 family without inpatient selected by random sampling in Seoul. The data were collected through STAI (State-Trait Anxiety Inventory) by Spielberger (1970) for measurement to level of state and trait anxiety from April 1st to April 15th in 1982. The contents of data analysis by EDPS included the difference of level of anxiety between experimental and control group, correlationship between general characteristics of experimental group and level of anxiety, and correlation of trait and state anxiety in experimental group. The Findings of this study were as follows: 1) Level of anxiety of experimental group is higher than control group. 2) In the correlation between general characteristics and level of anxiety of experimental group, there were no significant difference which revealed in correlation with age of family member, family life cycle, marital status, the relation between patient and family member, the degree of symptom, number of admission, admission or nonadmission of medical insurance, number of family member, and division of disease to level of anxiety However, according to the sex of family member, hospitalization period, a monthly income of family, the degree of confidence toward medical team, religion of family, academic background of family, a tendency of significant differences to level of anxiety were seen. To put them in the concrete, they were as follow; a) Level of. anxiety on female family member is higher than male in experimental group. b) Admission period of patient is positively related to the level of anxiety of patient's family. c) The degree of confidence of patient's family toward medical team is in inverse proportion to the level of anxiety. d) A monthly income of patient's family is in inverse proportion to the level of anxiety. e) Levlt of anxiety of believer in patient's family is lower than unbeliever. f) The academical background of patient's family is in inverse proportion to the level of anxiety g) Level of state anxiety of patient's family at the time of admission is positively related to the level of trait anxiety.
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