• 한국의료질향상학회지
• /
• 제30권1호
• /
• pp.15-32
• /
• 2024

Purpose: The number of severely ill patients requiring post-acute care has been increasing. Careful discharge planning minimizes unplanned emergency room visits and readmissions. This study aimed to survey the knowledge, experience, confidence, and obstacles faced by medical residents and fellows regarding the discharge process of severely ill patients. Methods: A survey consisting of 27 questions was sent electronically to residents and fellows who had experience in discharging severely ill patients from a tertiary hospital in Korea. The survey was conducted over a two-week period from September 29, 2022. Results: A total of 98 residents and fellows responded to the survey. Of these, 94% experienced difficulties related to the discharge process. The main obstacle was changes in the patient's condition during discharge planning (92.3%). Although 95% of the respondents acknowledged the need for providing discharge information, only 53.1% of the residents and fellows practiced this. Only 42.9% of the respondents and 20.4% of residents and fellows explained local community healthcare and welfare resources to patients because of a lack of relevant knowledge (69.7%) and feeling no responsibility to explain (40.4%). Conclusion: This study revealed that residents and fellows experienced difficulties in devising discharge plans and providing post-acute care related information, despite recognizing the importance of these. These gaps result from the lack of a discharge planning curriculum regarding critically ill patients and appropriate training in the discharge process. This suggests that an integrated discharge planning curriculum should be developed and adopted in residents' training programs for the differentiated treatment of critically ill patients.

• 대한치과기공학회지
• /
• 제33권4호
• /
• pp.539-550
• /
• 2011

Purpose: The aim of this study was to investigate distribution of the admitted patients with disease of oral cavity, salivary glands and jaws, current clinical treatment condition and clinical dental practice. Methods: The subject were 4,564 patients with disease of oral cavity, salivary glands and jaws of the Korean National Hospital Discharge Injury Survey 2004-2008 data. This study was carried out using the administrative database including patients' characteristics and comorbidity. The statistical analysis for ratio, gender, age, region, primary diagnosis, comorbidity, operation, hospital location and bed size of inpatients in Korean National Hospital Discharge Injury Survey was conducted by frequency analysis. Results: Among the total discharge injury patients in 2004-2008, the trend showed decrease of ratio of patients with disease of oral cavity, salivary glands and jaws. The portion of male was higher than female, and 20~29 age group was the highest portion compared with other age groups. Seoul-Gyunggi region was the highest among the other residences. patients with Dentofacial anomalies[including malocclusion] as primary diagnosis, digestive system as comorbidity and operations on facial bones and joins showed the highest portion respectively. Seoul-Gyunggi region was the highest portion compared with other residences. 500~999 bed size showed the highest portion. Conclusion: In this study showed that distribution of patients with disease of oral cavity, salivary glands and jaws, current dental clinical treatment condition using the Korean National Hospital data.

• 한국보건간호학회지
• /
• 제15권2호
• /
• pp.376-386
• /
• 2001

I. Background The problem of discharging patients from hospital have been well documented in the literature over the last 20 years. They included poor communication between hospital and community, inadequate notice of discharge, over-reliance on informal support and lack of statutory support, inattention to patients needs before leaving hospital, and wasted or duplicated visits by community nurses. Most patients discharged from hospital are able to return home with little or no support, while others will require a 'package of care' to support them back to good health. Patient with complex care needs, including the frail elderly and those with mental health problems, may require continuing care in special housing, residential, or nursing homes. With this population,effective discharge arrangement is needed and the study on this problem is urgent in Korea because the Medical Reform Project is on suspension of success. II. Results of the Study: 1. Discharge service needs assessed on 360 elderly patients who were hospitalized during the survey period at four university hospitals. Patients want to know the information on disease management after discharge. Follow-up telephone service is the most frequently checked service. 2. Multidisciplinary Discharge Planning is recommended at the hospital level to reduce the readmission and decrease the length of stay. 3. Further research is needed to validate and test the assumption of the solution which is developed in this research.

• 디지털융복합연구
• /
• 제11권5호
• /
• pp.371-384
• /
• 2013

본 연구에서는 한국 및 미국의 퇴원환자 자료를 이용하여 한국 및 미국의 중증도 보정 사망 모형을 개발하고 개발된 중증도 보정 사망모형에 따라 중증도 보정 사망률 지표를 산출 및 비교한 다음 이를 통해 국내 의료기관 사망률 관리 방안을 제시하고자 하였다. 한국 및 미국 의료기관의 중증도 보정 사망 모형은 데이터마이닝기법인 다중 로지스틱회귀분석 기법, 의사결정나무분석 기법을 이용하여 개발하였다. 개발된 의료기관의 중증도 보정 사망모형에 따라 한국 및 미국 의료기관의 중증도 보정 사망률을 산출한 결과 한국은 매년 증가하고 있는 반면 미국은 매년 감소하고 있는 것으로 나타나 한국과 미국간에 차이가 있었다. 의료기관의 병상규모별 중증도 보정 사망률의 변이 또한 한국이 미국보다 높았다. 국내 의료기관의 사망률 관리를 위해서는 의료기관 자체내에서 사망환자 관리가 가능한 대형 의료기관들의 경우 의료기관 중증도 보정 사망률 평가 결과 공개를 통해 지속적으로 사망률 관리를 유도하고, 의료기관 자체내에서 사망률 관리가 힘든 중소병원들은 국가 차원에서 파악한 국내 의료기관 사망환자 관리의 문제점 및 이를 개선할 수 있는 개선방안을 토대로 사망률 관리 컨설팅을 시행하는 등 의료기관 사망환자 관리 사업을 진행하여야 한다.

• 보건행정학회지
• /
• 제24권4호
• /
• pp.322-329
• /
• 2014

Background: As most of people in Korea are covered by National Health Insurance (NHI), the disease information collected in NHI provides high availability for health policy. Nevertheless, the validity of disease codes in NHI data has been controversial till now. So we tried to evaluate the validity of them by comparing the NHI claims data with Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) data. Methods: We compared the NHI patients sample data (2009) with the KNHDIIS data (2009). We selected the inpatient data of KNHDIIS and NHI patients sample. The weighted number of patients from NHI patients sample was 5,551,210 and the number of patients from KNHDIIS was 5,559,874. We classified the disease codes into principal diagnoses and other diagnoses, and we compared as one, two, three unit level. Also we calculated the agreement rate of each of them. Results: In the comparison of principal diagnoses, NHI claims data had more C code than KNHDIIS data did, whereas KNHDIIS data had more Z code than NHI claims data did. In the comparison of other diagnoses, NHI claims data had 2, 3 more codes than KNHDIIS data did. The overall agreement rate at three unit level was 76.5% in principal diagnoses and 46.8% in other diagnoses. Conclusion: Considering the large difference between the two data, the validity of disease codes in NHI Claims data seems to be low. To increase the validity of them, the definite detail coding indicator, the reinforcement of coding education, and the reform of system are needed.

• 한국병원경영학회지
• /
• 제26권1호
• /
• pp.17-25
• /
• 2021

This study aimed to analysis factors related to in-hospital death of injured patients by patient safety accident. A total of 1,529 inpatients were selected from Korea Centers for Disease Control and Prevention database(2013-2017). Frequency, Fisher's exact test, t-test, ANOVA, logistic regression analyses by using STATA 12.0 were performed. Analysis results show that the mortality rate was lower for female than male but the mortality rate was higher for the older age, the higher the CCI, head (or neck), multiple, systemic damage sites, internal and others, metropolitan cities based on Seoul and 300-499 based on the bed size of 100-299. Based on these findings, the possibility of using the in-depth investigation of discharge damage from the Korea Centers for Disease Control and Prevention as a data source for the patient safety survey conducted to understand the actual status of patient safety accident types, frequency, and trends should be reviewed. Also, it is necessary to prevent injury and minimize death by identifying factors that affect death after injury by patient safety accident.

• 한국병원경영학회지
• /
• 제19권4호
• /
• pp.21-33
• /
• 2014

This study was conducted to propose an insight into the appropriateness of hospital length of stay(LOS) by developing a severity-adjusted LOS model for patients with pneumonia, organism unspecified. The pneumonia risk-adjustment model developed in this paper is based upon the 2006-2010 the Korean National Hospital Discharge in-depth Injury Survey. Decision tree analysis revealed that age, admission type, insurance type, and the presence of additional disorders(pleural effusion, respiratory failure, sepsis, congestive heart failure etc.) were major factors affecting the severity-adjusted model using the Clinical Classifications Software(CCS). Also there was a difference in LOS among the regional hospitals, especially the hospital LOS has not been efficiently managed in Gyeongsangbuk-do, Jeollanam-do, Jeollabuk-do, Daejeon, and Busan. To appropriately manage hospital LOS, reliable statistical information about severity-adjusted LOS should be generated on a national level to make sure that hospitals voluntarily reduce excessive LOS and manage main causes of delayed discharge.

• International journal of advanced smart convergence
• /
• 제11권1호
• /
• pp.127-133
• /
• 2022

This study aims to find out the associative relationship between dementia and comorbidities. To conduct this study, we used KNHDIS(Korea National Hospital Discharge In-depth Injury Survey) data from 2009 to 2018 provided by the KDCA(Korean Disease Control and Prevention Agency) annually. We used MySQL for data preprocessing and R for data analysis. As a result of applying the Apriori algorithm criteria of support(≥0.01), confidence(≥ 0.6), and lift(>1), seventeen rules related to dementia were discovered. The diseases associated with dementia were diabetes mellitus, hypertension, disorders of lipoprotein metabolism, glomerular disorders in diabetes mellitus, renal diseases, cardiovascular disease, cerebrovascular disease, and other urinary system disorders. This study can be utilized as primary data for the care of patients with dementia and provides implications for improving effective dementia prevention policies.

• 한국학교ㆍ지역보건교육학회지
• /
• 제23권1호
• /
• pp.29-40
• /
• 2022

Objectives: The purpose of this study is to identify the relationship between metabolic syndrome factor diseases and falls in the elderly aged 65 years or older and use them as basic data to reduce the risk of falls. Methods: The method of this study was to compare the injury-related characteristics of the fall and non-fall groups with a factor disease of metabolic syndrome in Korea over 65 years of age. Data from the 14th National Hospital Discharge In-depth Injury Survey in 2018 were used to conduct the study. A total of 7,991 data were analyzed using SPSS 23.0. Results: Among the total injuries, the fall group with metabolic syndrome factor disease accounted for 69.0% and the non-fall group 31.0%. Falls occurred in 86.3% of households. In the fall group with metabolic syndrome factor disease, the number of females was 1.9~2.1 times higher than that of males. Compared to 65~69 years of age, the incidence of falls was 1.4~1.5 times higher in 70~79 years, 1.7~2.2 times higher in 80~89 years, and 2.5~3.6 times higher in 90-year-olds and older. In NISS, the incidence of falls was 1.7 times higher in moderate compared to mild. In principle diagnosis, the incidence of falls was 2.2 times higher in S40-S99 compared to S00-S19. Conclusion: The elderly with metabolic syndrome factor disease should continue to promote health through light exercise that can strengthen muscle strength to prevent falls.

• 한국간호교육학회지
• /
• 제17권2호
• /
• pp.287-295
• /
• 2011

Purpose: This study was done to compare educational needs for discharge after thyroid cancer surgery between patients and nurses. Methods: The participants were 107 patients who had thyroid cancer surgery and 70 nurses who have had experience of taking care of patients with thyroid cancer surgery at P hospital in Busan. The researcher reviewed the literature and conducted a preliminary survey to develop a questionnaire. Results: Although there was no significant difference in total perceived nursing discharge educational needs after thyroid cancer surgery between patients and nurses, both had a high level of nursing educational needs for discharge. The degree of patients' needs was higher than nurses in areas of dietary management after discharge and the degree of nurses' needs was higher than patients in the other areas. Although the first ranking area of educational needs was medication management for both patients and nurses, dietary management after discharge was the second ranking for patients and operation site and complication management was those for nurses. Conclusions: As the patients had different educational needs from the nurses, nurses need to focus on the patient's educational needs and provide relevant information. Educational programs should be developed and applied to post-surgical thyroid cancer patients.