• 제목/요약/키워드: Length of Stay

검색결과 788건 처리시간 0.024초

Patient Flow Optimization for Outpatient Department Using Discrete-Event Simulation

  • Dieu, Xuan-Manh;Hoang, Huu-Trung;Kim, Jung Eon;Kim, Hoon;Park, Junseok;Hwang, Won-Joo
    • 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.

손상 및 외상 사망 환자의 재원일수 특성에 관한 융합 연구 -퇴원손상심층조사자료를 중심으로 (A Convergence Study on the Characteristics of Length of Hospital Stays of Injured and Traumatic Death Patients - Based on the Korea National Hospital Discharge Injury Survey Data)

  • 송유림;이무식;김두리;김광환
    • 한국융합학회논문지
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    • 제8권5호
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    • pp.87-96
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    • 2017
  • 이 연구는 퇴원손상심층조사 자료를 이용해 손상 및 외상 사망환자의 재원일수 특성을 분석하여 손상 및 외상으로 인한 사망 예방을 위한 기초 자료 제공을 목적으로 시행되었다. 조사대상은 퇴원손상심층조사 자료에서 2014년 1월 1일부터 12월 31일까지 퇴원한 환자 중, 치료결과가 '사망'이며, 주진단이 손상 및 사고의 외인(S00-T98)인 환자 233명이었다. 연구결과, 여자의 재원일수가 남자보다 길었다. 주진단은 기타 내부 인공삽입장치, 삽입물 및 이식편의 합병증(T85)에서 재원일수가 가장 길었다. 이상의 연구결과로 볼 때 손상으로 인한 사망 재원일수 영향 요인을 파악하여 이들을 집중적으로 관리하기 위한 정책개발이 필요한 것으로 판단된다.

A Comparison of the Effectiveness of Before and After the Regional Trauma Center's Establishment

  • Song, Bo Hyung;Hyun, Sung Youl;Kim, Jin Joo;Cho, Jin Seong;Ma, Dae Sung;Kim, Ha Kyung;Lee, Geun
    • Journal of Trauma and Injury
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    • 제29권3호
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    • pp.68-75
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    • 2016
  • Purpose: The purpose of this study was to analyze the effectiveness of regional trauma center's management. Methods: Data collected between January 2013 and December 2015 from a regional trauma center registry was retrospectively reviewed. The patients who had injury severity score (ISS) greater than 15 and over the age of 18 were included. We compared annual general characteristics, the injury mechanism, the pathway of transportation, the injury severity score, the length of stay in emergency department (ED) and hospital, the in-hospital mortality. Results: The annual numbers of enrolled patients were 337, 334 and 278, respectively. No significant differences were found in the annual patient's median ages, injury mechanism, ISS and in-hospital mortality. The annual proportions of coming from other hospital and the median length of stay in hospital were increased after establishment of regional trauma center. The annual median lengths of stay in ED were decreased remarkably. Conclusion: Through the establishment of regional trauma center, the length of stay in ED can be reduced but not in-hospital mortality. More multidisciplinary cooperation and well-organized study is needed to reduce mortality of major trauma patients and maximize effect of regional trauma center.

농촌체험의 체험요인이 지각된 가치와 만족에 미치는 영향 - 체류기간의 조절효과 - (A Study on the Relationships among Experience, Perceived Value, and Satisfaction of Rural Tourism - The Moderating Effect of Length of Stay -)

  • 김경희;이선민
    • 농촌지도와개발
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    • 제23권1호
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    • pp.1-14
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    • 2016
  • The purpose of this study was to examine the relationships among experience, perceived value, and satisfaction of rural tourists based on the experience economy(Pine, & Gilmore, 1998; 1999). In addition, this study included the moderating effect of length of stay on the proposed relationships. This study was attempt to develop measurement scales based on the theory of experience economy(Pine, & Gilmore, 1998). Data were collected from 481 visitors by field survey from the 10 rural tourism communities. SPSS 20.0 and Amos 18.0 statistical package were used for frequency, reliability, confirmatory factor, and structural equation modelling analysis. The results of a confirmatory factor analysis yielded four dimensions of experience(esthetics, education, escape, and entertainment). The results of structural equation modeling indicated that entertainment, esthetics, and education had positive effects on perceived value, which in turn had a positive effect on satisfaction. In addition, length of stay moderated the relationships among experience, perceived value, and satisfaction. The entertainment and esthetics among experience factor had an effects on perceived value in the group of day visit group, and the entertainment, education, and esthetics among experience factor had an effects on perceived value in the group of stay night group. And the perceived value had a positive effect on satisfaction in the all group. Therefore, in order to increase rural tourists' satisfaction effectively, practitioners needs to develop rural tourism products by considering area of experience economy including tourists' length of stay.

유휴산업시설 재생공간의 장소성이 방문만족도와 체류시간에 미치는 영향 - 문래예술창작촌의 방문자들을 대상으로 - (The Influence of the Sense of Place on Regeneration Space using Idle Industrial Facilities on Visitors' Satisfaction and Length of Stay - Focused on Visitors of Mullae Art Village -)

  • 윤한;윤희정
    • 한국조경학회지
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    • 제46권4호
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    • pp.1-10
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    • 2018
  • 본 연구는 유휴산업시설 재생공간 방문자들의 장소성이 방문만족도와 체류시간에 미치는 영향을 밝히는 것을 연구목적으로 한다. 이를 위하여 본 연구는 서울시 영등포구에 위치한 문래예술창작촌을 연구대상지로 선정하였으며, 방문자를 대상으로 설문조사를 진행하였다. 탐색적 요인분석 및 신뢰도분석, 다중회귀분석결과, 문래예술창작촌의 장소성 요인인 매력성, 의미성은 방문만족도와 체류시간에 정(+)의 영향을 미치는 것으로 나타났으며, 매력성이 가장 큰 영향을 미치는 것으로 나타났다. 그러나 역사성은 방문만족도와 체류시간에 유의미한 영향을 미치지 못 하는 것으로 나타났다. 또한, 방문만족도는 체류시간에 정(+)의 영향을 미치는 것으로 분석되었다. 이상의 연구결과는 유휴산업시설 재생공간의 장소성을 진단하고, 추후 도시공간 계획가 및 관리자가 유휴산업시설 재생공간을 활성화시킬 수 있는 장소마케팅 전략을 수립하는 데에 유용한 지침이 될 수 있을 것이다.

조산원과 병원 분만 산모의 재원일 수, 의료비용, 산후불편감과 의료서비스 만족도 비교 (Length of Stay, Health Care Cost, Postpartum Discomfort, and Satisfaction with Medical Service in Puerperas Giving Birth in Midwifery Clinic and Hospitals)

  • 박미란;이주영
    • 여성건강간호학회지
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    • 제24권1호
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    • pp.24-32
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    • 2018
  • Purpose: To determine traits related to pregnancy and delivery, length of stay, health care cost, postpartum discomfort, and satisfaction with medical service of puerperas giving birth in midwifery clinic and hospitals. Methods: This study used a comparative survey design. Data were collected from a total of 140 postpartum mothers composed of 70 mothers who gave births in two hospitals and another 70 mothers who delivered in one midwifery clinic. Results: Delivery in midwifery clinic had higher Apgar score at 1 minute and 5 minutes after birth than hospital. Those who delivered in midwifery clinic had shorter stay in the clinic, fewer health care cost, less postpartum discomfort in physical, environmental, social, and cultural areas, higher satisfaction with medical services than those who delivered in hospitals. Conclusion: Results of this study can be used as a basis for studies on giving birth in midwifery clinic and hospitals. They might increase the autonomy of women in giving birth with positive effect on the delivery experience of the mother and her spouse.

인공수정체 보험급여 전.후 진료양상의 변화 (Changes in Medical Practice Pattern before and after Covering Intraocular Lens in the Health Insurance)

  • 최노아;유승흠;민혜영;정은욱
    • 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.

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응급실 환자의 응급의료센터 체류시간 단축프로그램 개발 및 효과 (Evaluation of Shortening the Stay Time of Patients in an Emergency Medical Center (EMC))

  • 김은주;임지영
    • 가정간호학회지
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    • 제17권1호
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    • pp.21-27
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    • 2010
  • Purpose: The study evaluated a program to shorten EMC stay time. Methods: The subjects were EMC patients, and comprised a control group of 8,477 and an experimental group of 8,378. Data were collected from June 2006 to August 2007, and analyzed concerning stay time for doctor visit, decision making, and discharge. The data were analyzed by $X^2$-test and ANCOVA using SPSS14.0. Result: The stay time of doctor visit, decision making and discharge of the experimental group was significantly less compared to the control group. Using second and third grade triage criteria, the stay time of experimental group was statistically reduced from the control. Conclusion: The implemented shortening program was effective in reducing EMC stay time and increasing EMC effectiveness.

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위암환자에서 의무기록과 행정자료를 활용한 Charlson Comorbidity Index의 1년 이내 사망 및 재원일수 예측력 연구 (Prognostic Impact of Charlson Comorbidity Index Obtained from Medical Records and Claims Data on 1-year Mortality and Length of Stay in Gastric Cancer Patients)

  • 경민호;윤석준;안형식;황세민;서현주;김경훈;박형근
    • Journal of Preventive Medicine and Public Health
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    • 제42권2호
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    • pp.117-122
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    • 2009
  • Objectives : We tried to evaluate the agreement of the Charlson comorbidity index values(CCI) obtained from different sources(medical records and National Health Insurance claims data) for gastric cancer patients. We also attempted to assess the prognostic value of these data for predicting 1-year mortality and length of the hospital stay(length of stay). Methods : Medical records of 284 gastric cancer patients were reviewed, and their National Health Insurance claims data and death certificates were also investigated. To evaluate agreement, the kappa coefficient was tested. Multiple logistic regression analysis and multiple linear regression analysis were performed to evaluate and compare the prognostic power for predicting 1 year mortality and length of stay. Results : The CCI values for each comorbid condition obtained from 2 different data sources appeared to poorly agree(kappa: 0.00-0.59). It was appeared that the CCI values based on both sources were not valid prognostic indicators of 1-year mortality. Only medical record-based CCI was a valid prognostic indicator of length of stay, even after adjustment of covariables($\beta$ = 0.112, 95% CI = [0.017-1.267]). Conclusions : There was a discrepancy between the data sources with regard to the value of CCI both for the prognostic power and its direction. Therefore, assuming that medical records are the gold standard for the source for CCI measurement, claims data is not an appropriate source for determining the CCI, at least for gastric cancer.

척추전문병원과 비전문병원의 의료이용 비교분석 (Comparative Analysis of Medical Use of Spine Specialty Hospitals and Nonspecialty Hospitals)

  • 이영노;정윤지;이광수
    • 보건행정학회지
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    • 제34권1호
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    • pp.26-37
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    • 2024
  • 연구배경: 본 연구의 목적은 척추전문병원과 비전문병원의 건당 진료비 및 재원일수 차이를 비교 분석하고, 이에 영향을 미치는 요인을 파악하는 것이다. 방법: 본 연구는 2021년 1월부터 2022년 12월까지의 입원 환자 진료비를 포함한 건강보험심사평가원의 청구 데이터를 사용했다. 의료기관 현황 데이터는 연구대상 병원의 특성을 파악하는 데 사용되었다. 다수준분석을 통해 건당 진료비와 관련된 요인을 파악하고, 포아송 회귀분석을 통해 척추전문병원과 비전문병원 간 재원일수를 분석했다. 분석대상은 척추전문병원 32,015건, 비전문병원 17,555건이었다. 결과: 다빈도 척추 수술 5건 중 4건의 경우, 전문병원이 비전문병원보다 재원일수가 더 긴 것으로 나타났다. 다수준분석 및 포아송 회귀분석 결과, 수술유형에 관계없이 연령이 높고, Charlson comorbidity index 점수가 높을수록 건당 진료비와 재원일수 모두 유의하게 증가하는 것으로 나타났다(p<0.05). 그러나 병원이 대도시에 위치한 경우에는 유의미하게 감소하였다(p<0.05). 결론: 본 연구에서는 기존 연구결과와 달리 전문병원의 건당 진료비와 재원일수가 더 긴 것으로 나타났다. 향후 이러한 차이의 원인을 찾기 위해 추가적인 연구가 필요하다.