• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.9
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• pp.146-155
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• 2018

This study was conducted to evaluate the clinical outcomes of coronary artery bypass surgery for ischemic heart disease according to use of a cardiopulmonary bypass machine. The subjects were 10,981 patients who underwent coronary artery bypass grafting for ischemic heart disease from July 2008 to June 2012. Analysis data were retrospectively collected using health insurance claims data. The results of the study showed that mean time to surgery (280 min vs 357 min, p<0.0001) and intubation time (about 24 hours vs 40 hours, p<0.0001) were significantly shorter in the Off-Pump CABG (OPCAB) group than in the On-Pump CABG (ONCAB) group. The rate of reoperation because of postoperative bleeding and hematoma was lower in the OPCAB group (2.7% vs 8.3%, p<.0001). The odds ratio of risk adjusted 30 days mortality rate was 0.339 (0.266-0.434) and the postoperative length of stay was decreased in the OPCAB (p<0.0001). Overall, the 30 days mortality and reoperation rates were lower in the OPCAB, as was the resources use.

• Journal of Home Health Care Nursing
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• v.7 no.1
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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.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.3
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• pp.480-488
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• 2016

This study examined the levels of ADL and IADL among elderly people who were institutionalized in long-term care facilities and determined their association with socio-demographic characteristics, health status, and health related behaviors. Interviews were performed, during the period from June 1 to July 31, 2015, to 205 elderlies received from long-term care service. As a results, the total mean score was $16.67{\pm}2.11$ for ADL (range: 6~8) and $15.13{\pm}3.79$ for IADL (range: 7~21). The selected factors associated with ADL were with or without a spouse, frequency of going out, subjective health status, and mastication ability. The factors associated with ADL were selected, such as gender, with or without a spouse, frequency of going out, subjective health status, disability of body, and amnesia. In conclusion, the level of ADL and IADL in the elderly people selected from long-term care insurance were influenced by the socio-demographic characteristics, health status and health-related behaviors.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.355-367
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• 2018

The purpose of this study was to identify the predictors of the quality of life in community dwelling vulnerable older women with chronic joint pain. A cross-sectional study was conducted on 234 participants registered at a visiting health care service in the public health center of C-city. The structured questionnaire were used to collect data on the general characteristics, pain rating index, pain intensity, perceived health status, functional independence, sleep pattern, depression, and quality of life from February 16 to March 13, 2017. The data were analyzed using a t-test, ANOVA, Pearson's correlation coefficients, and hierarchical multiple regression analysis. The significant factors of the quality of life including general characteristics were depression (${\beta}=-.60$, p<.001), pain intensity scale (${\beta}=-.15$, p=.007), health insurance type (${\beta}=.15$, p=.001), perceived health status (${\beta}=.14$, p=.007), duration of pain (${\beta}=-.10$, p=.019), marital status (${\beta}=.10$, p=.024), and functional independence (${\beta}=.09$, p=.036). These factors accounted for 63.1% of the total variance in the quality of life. The findings suggest that a public healthcare program on managing depression is effective in improving the quality of life in community dwelling older women with chronic joint pain. Public health nurses should intervene in nursing care for economically vulnerable aged and pain management based on a precise assessment from the beginning of pain.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.5
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• pp.1100-1108
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• 2009

The Objectives: The purpose of this study is to identify the factors related to management of DM in Korea. Methods: The subjects selected by using data of National Health and Nutrition Survey(NHANS) in 2005 were 415 adults, aged 20 and older, and diagnosed with DM. This study used data mining algorithms. This study validated the predictive power of data mining algorithms by comparing the performance of logistic regression, decision tree, and Neural Network on the basic of validation, it was found that the model performance of decision tree was the best among the above three techniques. Result: First, awareness of DM was positively associated with age, residential area, and job. The most important factor of DM awareness is age. Awareness rate of DM with 52 age over is 76.1%. Among the ${\geq}52$ age group, an important factor is family history. Among patients who are 52 years or over with family history of DM, an important factor is job. The awareness rate of patients who are 52 age over, family, history of DM, and professionals is 95.0%. Second, treatment of DM was also positively associated with awareness, region, and job. The most important factor of DM treatment is DM awareness. Treatment rate of patients who are aware of DM is 84.8%. Among patients who have awareness of DM, an important factor is region. The awareness rate of patients who are aware of DM in rural area is 10.4%. Conclusion: Finally, the result of analysis suggest that DM management programs should consider group characteristic of DM patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.6
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• pp.2078-2087
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• 2010

This study conducted a chi-square test and a logistic regression analysis by not only using a investigation data of discharged patients with damages from 2004 to 2006, but also using a census and a research data on the actual condition from health care system. The result follows; First, the centralization of medical utilization of operation patients is becoming apparent, centrally the capital area. To improve this, a policy that can not only provide medical centers and sickbed, but also improve the quality of local medical treatments for the localization of medical treatments. Second, propelling localization policy of certain diseases for the localization of medical utilization is needed as the rate of non-residential of operation patients that have diseases of the eye and adnexa, or cancers is high. Third, a localization policy for patients with damages is needed as the rate of treatments in other regions of operation patients with industrial accidents is increasing day by day.

• Journal of The Korea Institute of Healthcare Architecture
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• v.20 no.4
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• pp.67-80
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• 2014

Purpose : Long-term Care Insurance sets up facility standard and installation standard of aged care facilities and decides the presence of minimum number of rooms and its size in care facilities by using systematic instruments. Therefore, most aged care facilities had renovation in expansion and reconstruction following the revised regulations and even facility space structure and space composition are continuously improving. The study is to determine the purpose and trend by comparing before and after space composition of facilities which followed the implementation of Long-term Care Insurance and also to suggest hierarchical space composition suitable for aged care facilities through derived problems and to provide basic materials to plan the most appropriate facility for the aged. Methods : J-graph based on Space Syntax Theory will be schematized through in-site facility survey and before and after facility floor plan. Space composition trend will be analyzed by comparing indexes through S3 program. Results : As a result of 5 cases analysis, the following results were found; the average of whole space depth is increasing due to the Extension, the number of volunteers is decreasing and rooms for geriatric care helpers are being created due to the geriatric care helper introduction duty. Also, there are solariums being created to improve the health of the aged and dispensaries are being placed on every floor with the increase of documentary work for geriatric care helpers. With the policy implementation, care facility space composition and structure are changing with facility standard and it was analyzed that facilities were mostly put under the control of limited number of people in care room and total ground area per person. It was also found that there is increase in care space integration through before and after comparison of whole integration value. This is considered as the important result not only in facility standard satisfaction, but also in care support of geriatric care helpers and the aged, its main users. Implication : In order for elderly care facilities to have quality improvement and to develop as suitable facilities for characteristics of the aged, independent environmental facility standard preparation of elderly care facilities is needed through mutual cooperation of construction fields with regulation and policy related researches.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.2
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• pp.561-574
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• 2018

In this study, regional variations and factors associated with prevalence of metabolic syndrome were grasped using GWR (geographically weighted regression) and methodologies for the efficient management of metabolic syndrome were then set up to resolve health inequalities. Based on the National Health Screening Statistical Yearbook published by the National Health Insurance Service (NHIS), community health survey (KCDC) and other governmental institutions, indicators of social structural and mediation factors related to the regional prevalence of metabolic syndrome were collected. First, the existence of indicators to measure variations in metabolic syndrome were confirmed with the collected data by calculating the EQ (extremal quotient) and CV (coefficient of variations). The GWR, which is able to take spatial variations into consideration, was then adopted to analyze the factors of regional variations in metabolic syndrome. The GWR analysis revealed that severity and management of the main causes need to be prioritized in accordance with the prevalence of metabolic syndrome. Consequently, the order of priority in management of regional prevalence of metabolic syndrome was established, and plans that can increase the effectiveness of management of metabolic syndrome were confirmed to be feasible.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.6
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• pp.4067-4076
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• 2015

This study aims to examine the trend in household catastrophic medical expenditure according to the healthcare coverage types and its associated factors based on the raw data of the Korean Health Panel over the years 2008 to 2011. Correspondence analysis was used to investigate the trend in the incidence rates of annual catastrophic medical expenditure and generalized estimating equation to examine the factors influencing the incidence of catastrophic medical expenditure. The annual mean incidence rates of household catastrophic medical expenditure were 25.1%, 15.4%, 10.1%, 5.4% and 3.2% in the threshold levels of 10%, 15%, 20%, 30%, and 40% respectively. The incidence rate of household catastrophic medical expenditure was higher when the total annual household income was lower, the education level of the householder was lower, the healthcare coverage type was National Health Insurance, the householder had disability, the age of the householder was older, the number of household members was smaller, the subjective health status of household members was lower, and the prevalence rate of the chronic disease of the household was higher(p<0.05). Therefore, a policy for vulnerable households with older or patient members of chronic diseases should be established.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.11
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• pp.3465-3472
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• 2009

The aims of this study is to medical record data warehouse which had been collected from hospital information systems. continuous patient 2,118 60.5%, informally patient 1,385 39.5%. In using survival factors sex, age, area, insurance, admission-course, medical treatment, out-patient lesson, out-patient form, conference diagnosis, operation, cancer, medical reservation. As a result of making a predictive modeling using the logistic regression, the fitness of the predictive modeling of informally patient was 66.0% and neural network, the predictive was 66.72% and CHAID, the predictive was 63.25%, which is a data mining. The expected modeling of the informally patients, the hospital through the continuous patient management and trust of hospital.