• Journal of Korean Critical Care Nursing
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• v.12 no.1
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• pp.94-108
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• 2019

Purpose : Heart failure (HF) is considered an important medical burden with rehospitalization and mortality. Anemia is a major risk factor associated with the severity of HF. To improve the understanding of the impact of anemia in the population with HF, we explored the prevalence of anemia, its guidelines, relationship between anemia and mortality or rehospitalization, and limitation of reviewed papers of various populations with HF. Method: We used Whittemore and Knafl's integrative review methodology (2005), and thirty research papers were analyzed. PubMed, CINAHL, Cochrane, PsychInfo, Embase, Web of Science were searched for papers published between January 1960-June 2018. Results: Anemia in individuals with HF was primarily defined using the World Health Organization guideline. The prevalence of anemia in patients with HF varied from 9% to 56.7%. Moreover, such a condition significantly increases the prevalence of mortality or rehospitalization in patients with HF. The analyzed majority were non-prospective cohort study including secondary data analysis. Conclusion: Anemia in individuals with HF is a significant risk factor of mortality and rehospitalization. Prospective cohort studies should be designed to identify the optimal value for screening anemia and the impact of anemia on rehospitalization and mortality among HF patients.

• Journal of Digital Convergence
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• v.13 no.5
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• pp.259-267
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• 2015

This study is aimed at understanding the factors affecting rehospitalization of a tuberculosis patient. In a public hospital with a tuberculosis ward in Seoul, the data of 360 patients who discharged the hospital from July 1, 2012 to December 31, 2012. Data was selected from 'nursing information survey' or 'discharge analysis DB' of the department of medical records. The possibility of rehospitalization was higher in the group with those who has no job, those with medical care assistant than with health insurance, drinks about 10 times a month, personally came to the hospital, main guardian is the patient's spouse, have discharged from hospital against the doctor's advise, and principle diagnosis is not a pulmonary tuberculosis but the other respiratory disease. Therefore, it is expected that the possibility of rehospitalization would be effectively reduced if an intensive intervention is taken on the first hospitalized patients who have the features described above.

• Clinical and Experimental Pediatrics
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• v.45 no.12
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• pp.1503-1511
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• 2002

Purpose : Although the short- and long-term outcomes of low birth weight(LBW) neonatal intensive care unit(NICU) survivors have been extensively studied, much less information is available for normal birth weight(NBW) infants(greater than 2,500 gm) who require NICU care. Methods : We retrospectively examined the neonatal hospitalizations and one year health status of 302 NBW and 131 LBW admissions to our NICU. Information on the neonatal hospitalization was obtained from a review of medical records. Postdischarge health status was collected by using telephone surveys and medical records. Results : After initial discharge, 21.2% of the NBW infants and 23% of the LBW infants required rehospitalization during the first year of life and there was no significant difference between the two groups. The reasons for rehospitalization of the NBW infants included respiratory disorders (32.1%), G-I problems(26.2%), genitourinary problems(11.9%), surgery(10.7%), cardiac problems(7.1%), and congenital/developmental problems(1.2%). For the LBW infants, the order of frequency was the same, with the percentages slightly different. Neonatal risk factors related to the rehospitalization of the NBW infants included mechanical ventilation, duration of mechanical ventilation, and congenital anomaly. But no positive significant correlation of neonatal risk factors with rehospitalization of LBW infants was found. Conclusion : Low and normal birthweight NICU survivors were rehospitalized at similar rates. The most common cause of rehospitalization was respiratory problems. Neonatal risk factors related to rehospitalization of NBW infants were mechanical ventilation, duration of mechanical ventilation, and congenital anomaly. However, no positive significant correlation of neonatal risk factors with rehospitalization of LBW infants was found. The data suggests that NBW infant survivors, as well as LBW infant NICU survivors, require close follow up.

• Korean Journal of Schizophrenia Research
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• v.22 no.2
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• pp.66-73
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• 2019

Objectives: This study aimed to elucidate the effectiveness of long-term psychosocial intervention in reducing the disabling period of patients with major psychiatric disorders by their rehospitalization rate. Methods: Of the 210 patients with major psychiatric disorders received psychosocial interventions in a Mental Health and Welfare Center, 192 patients (147 with schizophrenia spectrum disorders, 45 with mood disorders) who received interventions more than 6 months were selected. Review of case management records was conducted to obtain information. Results: The number and length of hospitalization and the hospital days per year significantly decreased after psychosocial intervention. Additional analysis of 102 patients followed up for more than 5 years suggested that the effectiveness of the intervention persisted for a sufficient period. However, no significant difference was observed in the number of rehospitalization in 45 patients with mood disorders, though the length of hospitalization significantly decreased. In addition, the hospital days per year of 21 patients with mood disorder followed up for more than 5 years also showed no significant decrease. Conclusion: Long-term psychosocial intervention had a significant effect on reducing the number and length of hospitalization for patients with major psychiatric disorder and the effectiveness maintained for more than 5 years.

• Journal of Preventive Medicine and Public Health
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• v.45 no.4
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• pp.259-266
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• 2012

Objectives: This study aims to determine the risk factors predicting rehospitalization by comparing three models and selecting the most successful model. Methods: In order to predict the risk of rehospitalization within 28 days after discharge, 11 951 inpatients were recruited into this study between January and December 2009. Predictive models were constructed with three methods, logistic regression analysis, a decision tree, and a neural network, and the models were compared and evaluated in light of their misclassification rate, root asymptotic standard error, lift chart, and receiver operating characteristic curve. Results: The decision tree was selected as the final model. The risk of rehospitalization was higher when the length of stay (LOS) was less than 2 days, route of admission was through the out-patient department (OPD), medical department was in internal medicine, 10th revision of the International Classification of Diseases code was neoplasm, LOS was relatively shorter, and the frequency of OPD visit was greater. Conclusions: When a patient is to be discharged within 2 days, the appropriateness of discharge should be considered, with special concern of undiscovered complications and co-morbidities. In particular, if the patient is admitted through the OPD, any suspected disease should be appropriately examined and prompt outcomes of tests should be secured. Moreover, for patients of internal medicine practitioners, co-morbidity and complications caused by chronic illness should be given greater attention.

• Quality Improvement in Health Care
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• v.20 no.1
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• pp.76-88
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• 2014

Objectives: Parents of a premature baby feel a pressure on their baby's growth and they are highly in need for proper education. However, the lack of proper education can cause the difficulty of follow-up care and rehospitalization. Currently, methods of education among each nurse are based on verbal explanation and can be often different. Therfore, it is true that the psychological burden is great during education. Hence, by enforcing discharge education activities, we intend to provide information; induce participation of parents; promote the level of performance; standardize education program; and increase the job satisfaction of nurses. Methods: NICU conducted a questionnaire survey of the demand and satisfaction for discharge education among mothers that left hospital. And before and after the improvement activity, the satisfaction level of mothers and nurses were studied, and rehospitalization rate were analyzed. Results 1)The survey results of the satisfaction level of mothers towards education program as followes: The level of understanding of content, general babysitting, special situation, education method, and educator attitude showed statistically significant increase. 2)The survey results of the satisfaction level of nurses towards education program as followes: While, the need for education program decreased, the adequacy of education content and method, consistency of education, understanding of learner, and learner's performance increased. All the factors except for the need for education program and the adequacy of education content showed statistically significant difference. 3)Rehospitalization rate of premature babies decreased. According to analysis of the cause of rehospitalization, breast-feeding related apnea turned out to be the highest. Conclusion: Through QI, satisfaction of mothers and nurses improved more than 10%. And rehospitalization rate of premature babies decreased by the same amount as well. Therefore, with the help of the standardized discharge education program, mothers who is not easy to take care of after leaving hospital can be seen to significantly affect their healthy growth and development.

• Neonatal Medicine
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• v.17 no.1
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• pp.13-20
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• 2010

Purpose : Because infants who have been hospitalized in the neonatal intensive care unit (NICU) are usually ill or premature, they are hospitalized repeatedly after their discharge. We intended to survey the frequencies and the medical costs of those rehospitalizations. Methods : The NICUs of 7 major hospitals were included. The subjects were 3,451 infants that were admitted to the NICU from July 2005 to June 2006, and discharged to home. The frequency, causes, mean cost and distribution and proportion of National Health Insurance coverage and non covered costs were analyzed. Results : The rate of rehospitalization after discharge from the NICU over 1 year was 14.8%. If multiple cases are considered as individual cases, it is 21.7%. The major causes of admission were pneumonia (15.8%), bronchiolitis (14.5%), gastroenteritis (10.4%), urinary tract infection (6.3%) and sepsis (6.3%). The mean cost for each admission was 1,652 thousand won. The mean cost of National Health Insurance coverage was 1,170 thousand won and non covered coat were 472 thousand won 70.9% and 28.6% respectively. Conclusion : The ratio of rehospitalization of infants after their discharge from the NICU over 1 year was approximately 20% and it means that follow-up management of these infants is very important and meticulous concerns after discharge should be given. However the rehospitalization and the non-coverage proportion of National Health Insurance cost is considerably high. It strongly implies that National Health Insurance should cover much more proportion, and personal cost exemption should be proceeded in case of rehospitalization of infants after discharge from the NICU.

• International Journal of Heart Failure
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• v.6 no.3
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• pp.119-126
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• 2024

Background and Objectives: Beta-blockers (BBs) improve prognosis in heart failure (HF), which is mediated by lowering heart rate (HR). However, HR has no prognostic implication in atrial fibrillation (AF) and also BBs have not been shown to improve prognosis in heart failure with preserved ejection fraction (HFpEF) with AF. This study assessed the prognostic implication of BB in HFpEF with AF according to discharge HR. Methods: From the Korean Acute Heart Failure Registry, 687 patients with HFpEF and AF were selected. Study subjects were divided into 4 groups based on 75 beats per minute (bpm) of HR at discharge and whether or not they were treated with BB at discharge. Results: Of the 687 patients with HFpEF and AF, 128 (36.1%) were in low HR group and 121 (36.4%) were in high HR group among those treated with BB at discharge. In high HR group, HR at discharge was significantly faster in BB non-users (85.5±9.1 bpm vs. 89.2±12.5 bpm, p=0.005). In the Cox model, BB did not improve 60-day rehospitalization (hazard ratio, 0.93;95% confidence interval [95% CI], 0.35-2.47) or mortality (hazard ratio, 0.77; 95% CI, 0.22-2.74) in low HR group. However, in high HR group, BB treatment at discharge was associated with 82% reduced 60-day HF rehospitalization (hazard ratio, 0.18; 95% CI, 0.04-0.81), but not with mortality (hazard ratio, 0.77; 95% CI, 0.20-2.98). Conclusions: In HFpEF with AF, in patients with HR over 75 bpm at discharge, BB treatment at discharge was associated with a reduced 60-day rehospitalization rate.

• Journal of Chest Surgery
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• v.57 no.2
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• pp.184-194
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• 2024

Background: Left ventricular assist devices (LVADs) are widely employed as a therapeutic option for end-stage heart failure. We evaluated the outcomes associated with centrifugal-flow LVAD implantation, comparing 2 device models: the Heartmate 3 (HM3) and the Heartware Ventricular Assist Device (HVAD). Methods: Data were collected from patients who underwent LVAD implantation between June 1, 2015 and December 31, 2022. We analyzed overall survival, first rehospitalization, and early, late, and LVAD-related complications. Results: In total, 74 patients underwent LVAD implantation, with 42 receiving the HM3 and 32 the HVAD. A mild Interagency Registry for Mechanically Assisted Circulatory Support score was more common among HM3 than HVAD recipients (p=0.006), and patients receiving the HM3 exhibited lower rates of preoperative ventilator use (p=0.010) and extracorporeal membrane oxygenation (p=0.039). The overall early mortality rate was 5.4% (4 of 74 patients), with no significant difference between groups. Regarding early right ventricular (RV) failure, HM3 implantation was associated with a lower rate (13 of 42 [31.0%]) than HVAD implantation (18 of 32 [56.2%], p=0.051). The median rehospitalization-free period was longer for HM3 recipients (16.9 months) than HVAD recipients (5.3 months, p=0.013). Furthermore, HM3 recipients displayed a lower incidence of late hemorrhagic stroke (p=0.016). In the multivariable analysis, preoperative use of continuous renal replacement therapy (odds ratio, 22.31; p=0.002) was the only significant predictor of postoperative RV failure. Conclusion: The LVAD models (HM3 and HVAD) demonstrated comparable overall survival rates. However, the HM3 was associated with a lower risk of late hemorrhagic stroke.

• Korean Circulation Journal
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• v.52 no.8
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• pp.576-592
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• 2022

Acute heart failure is associated with high mortality and frequent rehospitalization, resulting in enormous healthcare costs and declining physical function, activities of daily living, and quality of life. Cardiac rehabilitation has been recommended as one of the non-pharmacologic treatments for patients with heart failure. However, much of the evidence for cardiac rehabilitation interventions reported to date has been limited to chronic heart failure. In recent years, the effectiveness of rehabilitation intervention in patients with acute heart failure has been reported, led by the Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial. This review overviews the recent evidence of rehabilitation in patients with acute heart failure.