• Journal of Korean Neurosurgical Society
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• v.67 no.1
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• pp.84-93
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• 2024

Objective : We aimed to examine trends in critically ill neurology-neurosurgery (NNS) patients who were admitted to the intensive care unit (ICU) in South Korea and identify risk factors for in-hospital mortality after ICU admission in NNS patients. Methods : This nationwide population-based retrospective cohort study enrolled adult NNS adult patients admitted to the ICU from 2010 to 2019 extracted from the National Health Insurance Service in South Korea. The critically ill NNS patients were defined as those whose main admission departments were neurology or neurosurgery at ICU admission. The number of ICU admission, age, and total cost for hospitalization from 2010 to 2019 in critically ill NNS patients were examined as trend information. Moreover, multivariable logistic regression modeling was used to identify risk factors for in-hospital mortality among critically ill NNS patients. Results : We included 845474 ICU admission cases for 679376 critically ill NNS patients in South Korea between January 1, 2010 to December 31, 2019. The total number of ICU admissions among NNS patients was 79522 in 2010, which increased to 91502 in 2019. The mean age rose from 62.8 years (standard deviation [SD], 15.6) in 2010 to 66.6 years (SD, 15.2) in 2019, and the average total cost for hospitalization per each patient consistently increased from 6206.1 USD (SD, 5218.5) in 2010 to 10745.4 USD (SD, 10917.4) in 2019. In-hospital mortality occurred in 75455 patients (8.9%). Risk factors strongly associated with increased in-hospital mortality were the usage of mechanical ventilator (adjusted odds ratio [aOR], 19.83; 95% confidence interval [CI], 19.42-20.26; p<0.001), extracorporeal membrane oxygenation (aOR, 3.49; 95% CI, 2.42-5.02; p<0.001), and continuous renal replacement therapy (aOR, 6.47; 95% CI, 6.02-6.96; p<0.001). In addition, direct admission to ICU from the emergency room (aOR, 1.38; 95% CI, 1.36-1.41; p<0.001) and brain cancer as the main diagnosis (aOR, 1.30; 95% CI, 1.22-1.39; p<0.001) are also potential risk factors for increased in-hospital mortality. Conclusion : In South Korea, the number of ICU admissions increased among critically ill NNS patients from 2010 to 2019. The average age and total costs for hospitalization also increased. Some potential risk factors are found to increase in-hospital mortality among critically ill NNS patients.

• Korean Journal of Adult Nursing
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• v.20 no.1
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• pp.44-54
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• 2008

Purpose: The purpose of the study were to examine the nutritional status of severe brain injury adult patients in critical period, and to compare the nutritional states before and after tube feeding. Methods: Data from 19 patients admitted to the SICU in a university hospital due to severe brain injury were analyzed. Nutritional states were measured by anthropometric and blood biochemical indicators. Results: MAC and MAMC were significantly decreased only at 7 days after admission compared with those on the day of admission. TSF was significantly decreased from 7 days to 14 days after admission. Fat rate was significantly decreased from 3 days to 14 days after admission. Hb was significantly decreased only at 3 days after admission. Albumin was significantly decreased from 3 days to 14 days after admission. However, lymphocyte was significantly increased at 14 days after admission. TSF and Albumin became significantly worse even after initiating tube feeding. Conclusions: Nutritional status of severe brain injury patients in SICU became worse after admission whichever indicators were adopted to evaluate nutritional status, anthropometric or blood biochemical indicators, and became worse even after initiating tube feeding.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.1 no.2
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• pp.101-109
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• 2006

Objective: The purpose of this study is finding tendencies admission patients to orient medical hospital due to Traffic Accident. Method: We studied 34 cases who were admitted in Dong-eui University Oriental Hospital from 1st, December, 2003 to the 30st, May, 2005. And we came to some conclusion about clinical tendencies as follows. Results and Conclusions: 1. Women had occupied more than men, And 10 persons in 30th were the most distribution of age. 2. Most patients used western medical hospital as primary hospital and after several days they started to search for orient medical treatments. 3. In the diagnosis through radiological test, cervical spine sprain was most(19 cases, 55.6%). The others were lumbar spine sprain(14 cases, 41.2%), fracture of other bone{4 cases, 11.8%), fracture of spine(3 cases, 8.8%), Intercranial hemorrhage(3 cases, 8.8%). 4. In chief complaint, low back pain was most(19 cases, 55.9%), The others were neck stiffness(17 cases, 50.0%), headache(13 cases, 38.2%), lower limb pain(9 cases, 26.5%). 5. Simple Disease had higher than complex disese at effective rate. 6. Both $43{\sim}60$ days admission and $15{\sim}21$ days admission were the best effective. $8{\sim}14$ days admission was next effective. 7. Early visit made more effective.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.3
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• pp.197-208
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• 2021

Objectives: The purpose of this retrospective study was to evaluate the variables associated with length of stay (LOS), hospital costs, intensive care unit (ICU) use, and treatment outcomes in patients hospitalized for maxillofacial infections at a tertiary medical center in South Korea. Materials and Methods: A retrospective chart review was conducted for patients admitted for treatment of maxillofacial infections at Dankook University Hospital from January 1, 2011 through September 30, 2020. A total of 390 patient charts were reviewed and included in the final statistical analyses. Results: Average LOS and hospital bill per patient of this study was 11.47 days, and ₩4,710,017.25 ($4,216.67), respectively. Of the 390 subjects, 97.3% were discharged routinely following complete recovery, 1.0% expired following treatment, and 0.8% were transferred to another hospital. In multivariate linear regression analyses to determine variables associated with LOS, admission year, infection side, Flynn score, deep neck infection, cardiovascular disease, admission C-reactive protein (CRP) and glucose levels, number and length of surgical interventions, tracheostomy, time elapsed from admission to first surgery, and length of ICU stay accounted for 85.8% of the variation. With regard to the total hospital bill, significantly associated variables were age, type of insurance, Flynn score, number of comorbidities, admission CRP, white blood cell, and glucose levels, admission temperature, peak temperature, surgical intervention, the length, type, and location of surgery, tracheostomy, time elapsed from admission to first surgery, and length of ICU use, which accounted for 90.4% of the variation. Age and ICU use were the only variables significantly associated with unfavorable discharge outcomes in multivariate logistic regression analysis. Conclusion: For successful and cost-effective management of maxillofacial infections, clinicians to be vigilant about the decision to admit patients with maxillofacial infections, perform appropriate surgery at an adequate time, and admit them to the ICU.

• Journal of Preventive Medicine and Public Health
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• v.27 no.3 s.47
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• pp.609-626
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• 1994

This study was conducted to investigate whether variations in hospital services utilization across small geographic areas in Korea existed, and if so, what factors are responsible for the variation. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows: 1 Extremal Quotients (EQ) of hospital expenditure per capita and hospital days per capita were 2.69 and 2.73, and Coefficient of Variation (CV) were 0.14, both, respectively. The EQ and the CV of admission rate were also 2.71, 0.15. The EQ and the CV of expenditure per admission were 1.73, 0.10 and those of hospital days per admission were 1.29, 0.06. All these statistics were statistically significant and this result provides strong evidence for the existence of small area variations. 2. Comparing patterns of variation among areas, the area which showed higher utilization amounts is Chansungp'o. Koje area, whereas the areas which showed lower utilization amounts are Yongju, Changhung, Miryang, Mokp'o, Koch'ang area. 3. Multivariate analytic methods were used to examine factors related to the variation across areas. In terms of the health resource availability variables, beds per capita or physicians per capita were positively associated with all utilization indices. As for the health service market structure variables, the proportion of health care institutions operating for less than f years was positively related to the expenditure per capita, hospital days per capita and expenditure per admission. In addition the proportion of the private health care institutions also had a negative relationship with total utilization amount and admission rate and the proportion of physicians under age 40 was negatively associated with expenditure per capita and expenditure per admission. With regard to the socio-demographic characteristics, proportion of medicaid population was positively related to hospital days per capita, and percentage of paved road was positively related to hospital days per admission. As a conclusion, wide variations existed across small areas in Korea and supply factors were found to be important in explaining the variation.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.61-67
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• 2018

Purpose: To evaluate the association between neutrophil-to-lymphocyte ratio (NLR) and occurrence of aspiration pneumonia in drug intoxication (DI) patients in the emergency department (ED) and to evaluate the relationship between NLR and length of hospital admission/intensive care unit (ICU) admission Methods: A total of 466 patients diagnosed with DI in the ED from January 2016 to December 2017 were included in the analysis. The clinical and laboratory results, including NLR, were evaluated as variables. NLR was calculated as the absolute neutrophil count/absolute lymphocyte count. To evaluate the prognosis of DI, data on the development of aspiration pneumonia were obtained. Also, we evaluated the relationship between NLR and length of hospital admission and between NLR and length of ICU admission. Statistically, multivariate logistic regression analyses, receiver-operating characteristic (ROC) curve analysis, and Pearson's correlation (${\rho}$) were performed. Results: Among the 466 DI patients, 86 (18.5%) developed aspiration pneumonia. Multivariate logistic regression analysis revealed NLR as an independent factor in predicting aspiration pneumonia (odds ratio, 1.7; p=0.001). NLR showed excellent predictive performance for aspiration pneumonia (areas under the ROC curves, 0.815; cut-off value, 3.47; p<0.001) with a sensitivity of 86.0% and a specificity of 72.6%. No correlations between NLR and length of hospital admission (${\rho}=0.195$) and between NLR and length of ICU admission (${\rho}=0.092$) were observed. Conclusion: The NLR is a simple and effective marker for predicting the occurrence of aspiration pneumonia in DI patients. Emergency physicians should be alert for aspiration pneumonia in DI patients with high NLR value (>3.47).

• Health Policy and Management
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• v.26 no.1
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• pp.4-11
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• 2016

Background: Hospital admissions for ambulatory care sensitive conditions (ACSCs), which are widely used as an indicator of poor access to primary care, can be used as an efficiency indicator of healthcare use in countries providing good access to health care. Korea, which has a national health insurance (NHI) system and a good supply of health care resources, is one such country. To quantify admission rates of ACSC and identify characteristics influencing variation in Korean health care institutions. Methods: By using NHI claims data, we computed the mean ACSC admission rate for all institutions with ACSC admissions. Results: The average ACSC admission rate for 4,461 institutions was 1.45%. Hospitals and clinics with inpatient beds showed larger variations in the ACSC admission rate (0%-87.9% and 0%-99.6%, respectively) and a higher coefficient of variation (7.96 and 2.29) than general/tertiary care hospitals (0%-19.1%, 0.85). The regression analysis results indicate that the ACSC admission rate was significantly higher for hospitals than for clinics (${\beta}=0.986$, p<0.05), and for private corporate institutions than public institutions (${\beta}=0.271$, p<0.05). Conclusion: Substantial variations in ACSC admission rates could suggest the potential problem of inefficient use of healthcare resources. Since hospitals and private corporate institutions tend to increase ACSC admission rates, future health policy should focus on these types of institutions.

• Korea Journal of Hospital Management
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• v.18 no.4
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• pp.18-38
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• 2013

This study aims to analyze the effect of quality of health care on perceived value, patient satisfaction and revisit intention. Especially, it was focused on outdoor environment, indoor environment, admission procedure, hospital image, service quality of physicians nurses medical technicians medical staff that patients perceived. Inpatients and outpatients were selected from three hospital in D city Questionnaire survey was employed to collect data from the subjects. For inpatients, indoor environment, admission procedure, hospital image and service quality of physicians have an effect on perceived value. Admission procedure, hospital image and service quality of physicians nurses medical technicians has an effect on the patient satisfaction. Hospital image and service quality of physicians nurses medical technicians have an effect on revisit intention. Perceived value have an effect on the patient satisfaction. Perceived value have an effect on revisit intention. Patient satisfaction have an effect on revisit intention. For outpatients, Admission procedure, hospital image and service quality of physicians medical technicians have an effect on perceived value. Indoor environment, hospital image and service quality of physicians medical technicians medical staff has an effect on the patient satisfaction. Indoor environment, hospital image and service quality of physicians medical technicians have an effect on revisit intention. Perceived value have an effect on the patient satisfaction. Perceived value have an effect on revisit intention. Patient satisfaction have an effect on revisit intention. They should evaluate customer satisfaction on their services and analyze various factors that affect on it to improve middle hospitals.

• Journal of Korean Clinical Nursing Research
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• v.21 no.3
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• pp.293-308
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• 2015

Purpose: This study aimed to develop nursing practice standards of hemodialysis care according to admission types. Methods: The standards were developed in four phases. Phase 1: The preliminary standards of hemodialysis care were developed based on literature review and evaluation of professional experts. Phase 2: Content validity was evaluated by 34 professional experts and the standards were modified and revised. Phase 3: Clinical validity was evaluated by 212 hemodialysis nurses. Expert group validated and verified the final outcome. Phase 4: Final standards of hemodialysis care according to admission types were developed. Results: The standard of hemodialysis care for out-patients included 5 standards, 9 contents, 43 nursing activities. The standard for in-patients included 6 standards, 10 contents, 50 nursing activities. The standards for critical patients included 4 standards, 10 contents, 43 nursing activities. There were differences in nursing activities according to admission type. Time required to meet the standards were different according to admission types. Conclusion: The findings of this research demonstrated that the time required for hemodialysis care and appropriate number of nurse would be different according to admission types. Different nursing workload according to admission type of hemodialysis patients need to be considered in allocating nursing manpower.

• Sleep Medicine and Psychophysiology
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• v.4 no.1
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• pp.77-88
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• 1997

The purpose of this study was to investigate the prevalence, primary causes, and management of insomnia newly admitted patients in a university hospital. Subjects consisted of 168 adult patients (95 men and 73 women, 88 medical and 94 surgical patients) newly admitted to Gyeongsang National University Hospital from September 7 through September 27, 1996. Sleep patterns of all subjects in the usual nights before admission(UN), the previous night to admission(PN), the night on admission(ON), and the 5th night after admission(5N) were investigated using the Korean version of the St. Mary's Hospital Sleep Questionaire. In addition, all insomnia patients and their doctors and nurses in charge were interviewed by psychiatric residents. Additionally, their medical records were reviewed. Prevalence of insomnia were 22.6% in the UN, 42.9% in PN, 51.8% in ON, and 43.5% in 5N. The prevalence of insomnia was significantly increased immediately before and after admission. There were no significant differences in the prevalence of insomnia by age and sex. The most ammon primary causes of insomnia were somatic symptoms and psychological factors in PN, somatic symptoms and noise in ON and 5n. Only 17 (10.1%) of insomnia patients took medicstions for insomnia control(analgesics in 15, hypnotics in 2). These results shorred that the prevalence of insomnia was significantly increased on hospitalization due to somatic symptoms, environmental factors, and psychological factors, but nearly none were adequately managed.