• 지역사회간호학회지
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• 제10권1호
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• pp.80-92
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• 1999

The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

• Journal of the Korean Data and Information Science Society
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• 제24권4호
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• pp.763-771
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• 2013

1990년 이후 국내 저 출산 붐으로 인한 대학 입시생들의 감소로 인하여 2016년 이후는 대학 정원이 수험생들의 수요보다 많은 상황으로 예측된다. 이로 인해 지방대학들의 학생 충원이 대학의 존폐여부를 좌우할 만큼 학생수급 정도가 심각한 상황으로 부각되고 있다. 따라서 전국 대부분 대학들은 우수한 인재들을 선점하기 위한 특성화 및 전문화된 방식으로 신입생들을 선발하는 다양한 전형방법을 개발하여 시행하고 있다. 본 연구는 지방의 A국립대학교를 중심으로 동일계 특별전형 입학생들에 대한 통계적 분석을 통해 이들을 효과적으로 관리할 수 있는 방법을 찾아보고자 한다. 동일계 특별전형 입학생들을 대상으로 통계적 방법을 통한 재학현황과 학내 적응여부를 분석하고 계열별 성별과의 관계를 파악하여 보다 나은 신입생 선발을 위한 방법에 대해 살펴본다. 저 출산으로 인한 학생 수의 감소로 정원 외로 전형하는 동일계 특별전형을 통해 인재를 확보하는 방안으로 활용할 수 있으며, 이를 토대로 졸업 시까지 학생들을 추수 관리할 수 있다. 또한 다른 전형으로 확대하여 분석을 하고 서로 비교한다면 앞으로의 입시정책에 적합한 전형유형을 개발할 수도 있을 것이다.

• 한국병원경영학회지
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• 제15권4호
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• pp.125-142
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• 2010

Objective : To determine demographic, clinical, health care utilization factors predicting unplanned readmission(within 28 days) to the hospital. Methods : A case-control study was conducted from January to December 2009. Multiple logistic regression was used to examine risk factors for readmission. 180 patients who had been readmitted within 28 days and 1,784 controls were recruited from an university hospital in Seoul. Results : Six risk factors associated with readmission risk were identified and include mail sex, medical service rather than surgical service, number of comorbid diseases, type of patient's room, lenth of stay, number of admissions in the prior 12 months. Conclusions : One of the association with readmission risk identified was the number of hospital admissions in the previous year. This factor may be the only risk factor necessary for assessing prior risk and has the additional advantage of being easily accessible from computerized medical records without requiring other medical record review. This risk factor may be useful in identifying a group at high readmission risk, which could be targeted in intervention studies. Multiple risk factors intervention approach should be considered in designing future prevention strategies.

• Journal of Preventive Medicine and Public Health
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• 제52권5호
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• pp.316-322
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• 2019

Objectives: This study was conducted to assess the applicability of the Appropriateness Evaluation Protocol (AEP) for public hospitals in Korea. Methods: In May 2016, 1500 admission claims were collected from Korean public district hospitals using stratified random sampling. Of these claims, 560 admissions to 37 hospitals were retrieved for analysis. Medical records administrators determined the appropriateness of admission using the criteria detailed in the AEP, and a physician separately assessed the appropriateness of admission based on her clinical judgment. To examine the applicability of the AEP, the concordance of the decisions made between a pair of AEP reviewers and between an AEP reviewer and a physician reviewer was compared. Results: The results showed an almost perfect inter-rater agreement between the AEP reviewers and a moderate agreement between the AEP reviewers and the physician. The sensitivity and specificity of the AEP were calculated as 0.86 and 0.56, respectively. Conclusions: Our findings suggest that the AEP could potentially be applied to Korean public hospitals as a reliable and valid instrument for assessing the appropriateness of admissions.

• 대한화학회지
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• 제54권6호
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• pp.818-828
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• 2010

대학수학능력시험(수능)이 1994학년도에 처음 시행된 이후 17년이 지나고 여러 번의 모의평가 출제로 인해 문항의 패턴화, 지식 중심의 출제라는 비판이 제기되고 있다. 이러한 문제에 대한 시사점을 얻기 위해 한국과 마찬가지로 국가 중심 교육과정이며 국가 수준에서 이루어지는 선다형 시험 유형을 가진 일본의 대학입시센터시험(센터시험) 문항을 분석하였다. 이 연구에서는 2009년 1월에 시행한 센터시험의 이과시험에서 화학 문항을 수능과 관련하여 내용 요소 및 행동 영역에 따라 분석하고, 문항 유형과 특이 사항을 분석하였다. 또한 한국 수험생의 관점에서 예상 정답률을 추정하여 수능의 화학 문항 출제에 주는 시사점을 도출하였다.

• Journal of Preventive Medicine and Public Health
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• 제36권1호
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• pp.47-53
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• 2003

Objectives : I used a case-crossover design to investigate the association between air pollution, and hospital admissions for asthmatic children under the age of 15 years in Seoul, Korea Methods : I estimated the changes in the levels of hospitalization risk from theinterquartile (IQR) increase in each pollutant concentrations, using conditional logistic regression analyses, with controls for weather information. Results : Using bidirectional control sampling, the results from a conditional logistic regression model, with controls for weather conditions, showed the estimated relative risk of hospitalization for asthma among children to be 1.04 (95% confidence interval (CI), 1.01-1.08) for particulate matter with an aerodynamic diameter less than or equal to 10m (IQR=40.4ug/m3); 1.05 (95% CI, 1.00- 1.09) for nitrogen dioxide (IQR=14.6ppb): 1.02 (95% CI,0.97-1.06) for sulfur dioxide (IQR=4.4ppb): 1.03 (95% CI, 0.99-1.08) for ozone (IQR=21.7ppb): and 1.03 (95% CI, 0.99-1.08) for carbon monoxide f10R=1.0ppm). Conclusions : This empirical analysis indicates the bidirectional control sampling methods, by design, would successfully control the confounding factors due to the long-term time trends of air pollution. These findings also support the hypothesis that air pollution at levels below the current ambient air quality standards of Korea is harmful to sensitive subjects, such as asthmatic children.

• Child Health Nursing Research
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• 제26권1호
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• pp.55-63
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• 2020

Purpose: The purpose of this study was to evaluate the current level of sleep quality among Korean middle-school students using the Pittsburg Sleep Quality Index (PSQI), and to analyze the factors influencing sleep quality. Methods: The study used a descriptive cross-sectional design and a self-report questionnaire. The participants were 744 middle-school students. The questionnaire included the PSQI and health-related questions, such as the types of diseases they had been diagnosed with and the frequency of hospital admissions. The data were analyzed using the independent t-test, analysis of variance, Pearson correlation coefficients, and linear multiple regression. Results: The global PSQI score was 4.21, which indicated good sleep quality. The major factors that were associated with the sleep quality of middle-school students were the number of diseases they had been diagnosed with (β=.54, p=.001) and atopic dermatitis (β=.32, p=.001). In addition, asthma and the frequency of hospital admissions were significant factors influencing each component of the PSQI. Conclusion: The findings from this study suggest that sleep quality was associated with several health-related factors. Thus, nurses, school nurses, and nursing researchers may need to assess the health-related factors associated with adolescents' sleep quality as part of efforts to improve their sleep quality.

• Tuberculosis and Respiratory Diseases
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• 제70권5호
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• pp.416-422
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• 2011

Background: Inhaled corticosteroids (ICSs) are the most essential medication for asthma control. Many reports suggest that the usage of ICSs improves not only the control of asthma symptoms but also prevents exacerbation. We investigated whether increases in ICS prescriptions are associated with decreases in asthma exacerbation in the clinical practice setting. Methods: We retrospectively analyzed the database of adult asthma patients who had visited a tertiary referral hospital, the Asan Medical Center between January 2000 and December 2009. The number of emergency department (ED) visits, admissions, intensive care unit (ICU) care, deaths, and ICS prescriptions were analyzed to evaluate the time trend of asthma exacerbation as a function of the ICS prescription rate during the ten years. Results: The numbers of ED visits, admissions, and episodes of ICU care decreased during the ten years (p<0.001, p=0.033, p=0.001, respectively) while the number of ICS prescriptions increased (p<0.001). We found a correlation between the number of ICS prescriptions and the number of ED visits, admissions, or ICU care. For these outcomes, the correlation coefficients were r=-0.952, p<0.001; r=-0.673, p=0.033; r=-0.948, p<0.001, respectively. Conclusion: The number of ICS prescriptions increased during the past ten years while the number of asthma exacerbations decreased. Our results also showed a negative correlation between the ICS prescription rate and asthma exacerbation in the clinical practice setting. In other words, an increase in ICS prescription may be a major cause of a decrease in asthma exacerbations.

• 한국컴퓨터정보학회논문지
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• 제27권2호
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• pp.203-212
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• 2022

본 연구의 목적은 대학신입생의 학교 및 학과선택 요인과 만족도를 파악하기 위함이다. G시에 위치한 K대학의 2021년 신입생 499명을 대상으로 대학신입생의 학교 및 학과선택 요인과 만족도를 파악하고 SPSS WIN 18.0 Program으로 분석하였다. 연구결과 대학선택요인으로 대학정보매체는 인터넷/SNS, 대학정보제공자는 학교선생님, 대학등록에 영향요인은 취업률, 등록결정은 본인으로 나타났다. 대학만족도는 3.43점이고 성별(t=5.527, p=.019)과 입학전형(F=5.527, p<.001)에서 유의한 차이를 나타내었다. 학과만족도는 3.86점이고 입학전형(F=3.004, p=.018)에서 유의한 차이를 나타내었다. 학교만족도와 학과만족도는 유의한 양의 상관관계를 나타내었다(r=5.527, p<.001). 대학은 객관적이고 체계적인 대학 정보제공을 통해 학생들을 만족시키고 대학경쟁력을 향상시킬 수 있다.

• Journal of Korean Neurosurgical Society
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• 제62권2호
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• pp.232-242
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• 2019

Objective : To investigate the effects of trauma center establishment on the clinical characteristics and outcomes of trauma patients with traumatic brain injury (TBI). Methods : We enrolled 322 patients with severe trauma and TBI from January 2015 to December 2016. Clinical factors, indexes, and outcomes were compared before and after trauma center establishment (September 2015). The outcome was the Glasgow outcome scale classification at 3 months post-trauma. Results : Of the 322 patients, 120 (37.3%) and 202 (62.7%) were admitted before and after trauma center establishment, respectively. The two groups were significantly different in age (p=0.038), the trauma location within the city (p=0.010), the proportion of intensive care unit (ICU) admissions (p=0.001), and the emergency room stay time (p<0.001). Mortality occurred in 37 patients (11.5%). Although the preventable death rate decreased from before to after center establishment (23.1% vs. 12.5%), the difference was not significant. None of the clinical factors, indexes, or outcomes were different from before to after center establishment for patients with severe TBI (Glasgow coma scale score ${\leq}8$). However, the proportion of inter-hospital transfers increased and the time to emergency room arrival was longer in both the entire cohort and patients with severe TBI after versus before trauma center establishment. Conclusion : We confirmed that for patients with severe trauma and TBI, establishing a trauma center increased the proportion of ICU admissions and decreased the emergency room stay time and preventable death rate. However, management strategies for handling the high proportion of inter-hospital transfers and long times to emergency room arrival will be necessary.