• 제목/요약/키워드: inpatient

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지리적가중회귀분석을 이용한 관외입원진료비 비율의 지역 간 차이 분석 (Analysis on the Regional Variation of the Rate of Inpatient Medical Costs in Local-Out: Geographically Weighted Regression Approach)

  • 조은경;이광수
    • 보건의료산업학회지
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    • 제8권2호
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    • pp.11-22
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    • 2014
  • This study purposed to analyze the regional variation of the local-out rates of inpatient services. Multiple data sources collected from National Health Insurance Corporation and statistics Korea were merged to produce the analysis data set. The unit of analysis in this study was city, Gun, Gu, and all of them were included in analysis. The dependent variable measured the local-out rate of inpatient cost in study regions. Local environments were measured by variables in three dimensions: provider factors, socio-demographic factors, and health status. Along with the traditional ordinary least square (OLS) based regression model, geographically weighted regression (GWR) model were applied to test their effects. SPSS v21 and ArcMap v10.2 were applied for the statistical analysis. Results from OLS regression showed that most variables had significant relationships with the local-out rate of inpatient services. However, some variables had shown diverse directions in regression coefficients depending on regions in GWR. This implied that the study variables might not have consistent effects and they may varied depending the locations.

상급종합병원 입원환자의 낙상 후 상해 실태 및 상해에 영향을 미치는 요인 (Factors Associated with Injuries after Inpatient Falls in a Tertiary Hospital)

  • 조문숙;이향열
    • 임상간호연구
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    • 제23권2호
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    • pp.202-210
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    • 2017
  • Purpose: In this study an investigation was done of injuries from inpatient falls and diagnostic tests and treatment after falls to identify what factors affect the occurrence of injury from inpatient falls in a tertiary hospital. Methods: Data for this cross-sectional study were retrieved for 428 fall events from data reported between January 1 and December 31, 2015 and were retrieved from the patient-safety reporting system in the hospital's electronic health records. A multivariate logistic regression model was developed with STATA 13.0. Results: Of the patients, 197 (46.0%) had physical injuries due to falls, 119 (27.8%) were given further diagnostic tests, and 358 (83.6%) received treatment including close observation after inpatient falls. Logistic-regression results identified that age, department, and risk factors had significant impact on injuries from falls. Conclusion: Findings indicate that to reduce the severity of injury after inpatient falls, each hospital should regularly evaluate identified factors, design fall-prevention practices specialized for elders and vulnerable patients, and initiate environmental and equipment innovations.

국가지정 입원치료 격리병상 시설적격성 평가분석에 관한 연구 (A Study on the Facility Eligibility Inspection of National Inpatient Isolation Units)

  • 홍진관
    • 설비공학논문집
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    • 제27권10호
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    • pp.506-514
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    • 2015
  • During the progression of this study, we visited 17 medical institutions. These medical institutions underwent inspection for facility eligibility of national inpatient isolation units to care for patients. Seventeen consultation meetings were held to gather expert opinions, and conferences were held with the medical institutions and local levels of government. Based on these facts, we established a field application model of the criteria of safety-management and conducted a study on this method in order to create more scientific and systematic safety-management criteria including criteria regarding facilities maintenance and methods of equipment inspection. According to an analysis on the 17 medical institutions examined, facility eligibility of 17 national inpatient isolation units was found to be 78.3% on average. Through analysis of the present domestic and foreign conditions of medical institutions, we proposed improvements for when remodeling becomes necessary and established criteria for safety-management in national inpatient isolation units for the care of patients in accordance with the domestic healthcare system.

자동차보험 진료비심사 일원화 이후 의료기관 진료행태 변화 (Changes in Providers' Behavior after the Reviewer Unification of Auto Insurance Medical Benefit Claims)

  • 김재선;서원식
    • 보건행정학회지
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    • 제27권1호
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    • pp.30-38
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    • 2017
  • Background: This study aims to analyze the behavioral changes of healthcare providers and influencing factors after the reviewer unification of auto insurance medical benefit claims by an independent review agency. Methods: The comparison data were collected from the second half of 2013 and the same period of 2014. The key indicators are the number of admission days, the number of outpatient visits, inpatient ratio, inpatient medical expenses, and outpatient medical expenses. Results: Four indicators (number of admission days, number of outpatient visits, inpatient ratio, and outpatient medical expenses) showed statistically significant drops, while one indicator (inpatient medical expenses) showed no significant change. Conclusion: The reviewer unification of auto insurance medical benefit claims by an independent review agency showed significant reduction in cost and patient days.

입원 환자경험이 병원 추천의도에 미치는 영향 - 건강상태의 조절 효과를 중심으로 - (The Influence of Inpatient's Experience on Hospital Recommendation Intention - Focusing on the Moderating Effects of Health Condition -)

  • 이경숙;김정애;이왕준
    • 한국병원경영학회지
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    • 제22권3호
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    • pp.133-143
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    • 2017
  • Purpose : This study is to analyze the inpatients's experience of medical services provided by hospital including medications, treatments, and environment. Based on the results of surveys conducted as part of the inpatient experience evaluation in A hospital in Goyang, Gyeonggi province. Methodology : A sample of 300 adults aged 19 years or older who had more than one day of hospitalization was selected. The questionnaire was conducted from April 3rd to June 21st, 2017 by telephone. Findings : It is found that recommendation intention influenced by medical services, hospital environment, medication treatment process. but it turns out that there is no moderate effects of health condition between patient's experience and recommendation. Practical Implication : In order to improve the inpatient experience, there should be a way to improve experience in providing patient-centered services in the hospital s environment, medication and treatment.

종합병원 병동부의 간호사 대기실 및 관련공간의 효율적인 구성에 관한 연구 (A Study on the efficient Composition of a Nurse Station and Attached Spaces in General Hospitals)

  • 정선애;김형우
    • 한국실내디자인학회논문집
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    • 제18호
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    • pp.44-50
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    • 1999
  • The purpose of this study is to suggest reasonable composition and layout of a nurse station and attached spaces-which are central sector of patient caring in the inpatient department- in the view of funtional efficiency. The method of this study is examining other studies and case study of inpatient department in general hospitals. through this research we find out the plan type of inpatient department and layout of nurse station and attached spaces in the view of 'the efficiency of circulation' and 'the easiness of observation' . It is also found out that the nursing delivery system effects to the composition and layout of nurse station attached spaces. Therefore, the efficient design of inpatient department by this study can accomplish 'patient-focused' medical environment and aid to develop their health.

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Predictors of Readmission after Inpatient Plastic Surgery

  • Jain, Umang;Salgado, Christopher;Mioton, Lauren;Rambachan, Aksharananda;Kim, John Y.S.
    • Archives of Plastic Surgery
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    • 제41권2호
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    • pp.116-121
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    • 2014
  • Background Understanding risk factors that increase readmission rates may help enhance patient education and set system-wide expectations. We aimed to provide benchmark data on causes and predictors of readmission following inpatient plastic surgery. Methods The 2011 National Surgical Quality Improvement Program dataset was reviewed for patients with both "Plastics" as their recorded surgical specialty and inpatient status. Readmission was tracked through the "Unplanned Readmission" variable. Patient characteristics and outcomes were compared using chi-squared analysis and Student's t-tests for categorical and continuous variables, respectively. Multivariate regression analysis was used for identifying predictors of readmission. Results A total of 3,671 inpatient plastic surgery patients were included. The unplanned readmission rate was 7.11%. Multivariate regression analysis revealed a history of chronic obstructive pulmonary disease (COPD) (odds ratio [OR], 2.01; confidence interval [CI], 1.12- 3.60; P=0.020), previous percutaneous coronary intervention (PCI) (OR, 2.69; CI, 1.21-5.97; P=0.015), hypertension requiring medication (OR, 1.65; CI, 1.22-2.24; P<0.001), bleeding disorders (OR, 1.70; CI, 1.01-2.87; P=0.046), American Society of Anesthesiologists (ASA) class 3 or 4 (OR, 1.57; CI, 1.15-2.15; P=0.004), and obesity (body mass index ${\geq}30$) (OR, 1.43; CI, 1.09-1.88, P=0.011) to be significant predictors of readmission. Conclusions Inpatient plastic surgery has an associated 7.11% unplanned readmission rate. History of COPD, previous PCI, hypertension, ASA class 3 or 4, bleeding disorders, and obesity all proved to be significant risk factors for readmission. These findings will help to benchmark inpatient readmission rates and manage patient and hospital system expectations.

데이터마이닝을 이용한 융복합 입원 의료서비스 환자경험 관리모형 개발 (Development of a convergence inpatient medical service patient experience management model using data mining)

  • 유진영
    • 디지털융복합연구
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    • 제18권6호
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    • pp.401-409
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    • 2020
  • 본 연구는 환자중심성 의료문화 조성을 위한 의료기관 경영전략에 도움이 될 수 있는 융복합 입원 의료서비스 환자경험 관리모형을 개발하고자 하였다. '2018 의료서비스경험조사' 원시자료를 이용하여 만 15세 이상 입원 의료서비스 경험이 있는 593명을 분석하였다. 의사결정나무 모형을 활용하여 입원 의료서비스 경험에 대한 전반적 만족도와 환자 경험 추천 의사 예측모형을 개발하였으며 유형은 4개, 7개로 각각 분류되었다. 모형의 정확도는 68.9%, 78.3%였다. 입원 의료서비스 환자경험 전반적 만족도 결정요인은 간호사 영역과 병실 소음관리 영역이었으며 추천 의사 결정요인은 간호사 영역이었다. 입원 의료서비스 환자경험 관리모형을 제시하고 간호사 영역과 병실 소음관리 영역이 입원환자 경험에 중요한 요인임을 확인한 점이 의의가 있다. 입원 의료서비스 환자경험 관리모형의 일반화를 위한 추가 연구가 필요하다 생각된다.

건강보험 암 중증질환 급여확대가 의료이용 형평성에 미친 영향 (The Effect of Expanding Health Insurance Benefits for Cancer Patients on the Equity in Health Care Utilization)

  • 김수진;고영;오주환;권순만
    • 보건행정학회지
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    • 제18권3호
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    • pp.90-109
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    • 2008
  • Government has extended the benefit coverage and reduced out-of-pocket (OOP) payment for cancer patients in 2005. This paper intends to examine the impact of the above policy on the equity in health care utilization. This paper analyzed the national health insurance data and compared the health care utilization of cancer patients before and after the policy change for people with 10 different income levels. For the equity in health care utilization, we examined the change in concentration index (CI) for visit days, inpatient days, and health expenditure. In the case of outpatient care, CI of visit days and health expenditure were positive(favoring the rich) in both regional and employee health insurance members and both 'before' and 'after' the policy change. CI values rarely changed after the policy change, and the policy change seems to have little impact on the equity of outpatient care utilization except expenditure of regional subscriber. In the case of inpatient care, CI of inpatient days was negative and CI of health expenditure was positive in both regional and work subscriber and both 'before' and 'after' the policy change. After the policy change, CI of inpatient expenditure in both groups of members decreased. CI of inpatient days changed in the direction favoring the poor in regional insurance members, but it rarely changed in employee insurance members. These results suggest that the policy of reducing OOP payment has a positive impact and reduced the inequity particularly in the utilization of inpatient care of cancer patients.