• Journal of the Korean Data and Information Science Society
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• 제26권3호
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• pp.715-727
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• 2015

본 연구는 우리나라 요양병원의 간호인력 확보수준과 간호결과의 관련성을 파악하고 간호에 민감한 환자 결과를 알아봄으로써 요양병원의 적정 간호인력 확보에 대한 근거를 제공하기 위해 시행되었다. 자료는 건강보험심사평가원의 2012년 '요양병원 병원평가정보'를 바탕으로 분석하였다. 연구결과, 간호사 1인당 환자 수가 평균보다 많은 그룹에서 유치도뇨관 비율 (고위험군/저위험군)이 통계적으로 유의하게 높았다. 간호인력 1인당 환자 수가 평균보다 많은 그룹에서 일상생활수행능력이 감퇴한 환자비율 (치매환자군/비치매환자군), 요실금, 욕창이 새로 발생한 환자 (고위험군)비율이 통계적으로 유의하게 더 높았다. 그리고 요양병원의 등급이 향상될수록 입원환자의 간호결과가 더 좋아지는 것으로 나타났다. 이는 간호인력 확보수준이 높을수록 그리고 요양등급이 높을수록 환자의 간호결과에 긍정적인 영향이 나타난다는 결과이다. 따라서 요양병원에서 간호인력 수를 적정화시킬 수 있는 보다 강력한 정책적 접근이 필요하다는 것을 제안하는 바이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권3호
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• pp.196-202
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• 2018

Purpose: Treatment of chronic constipation and fecal impaction is usually outpatient and requires high or frequent doses of laxatives. However, there are children who fail outpatient treatments, sometimes repeatedly, and are ultimately hospitalized. We sought to compare the characteristics of the children who failed outpatient treatment and needed inpatient treatment vs those who achieved success with outpatient treatment, in an effort to identify attributes that might be associated with a higher likelihood towards hospitalization. Methods: In this retrospective cohort study, we reviewed the medical records of all patients aged 0 to 21 years, with chronic functional constipation and fecal impaction seen in the pediatric gastroenterology clinic over a period of 2 years. Results: Total of 188 patients met inclusion criteria. While 69.2% were successfully treated outpatient (referred to as the outpatient group), 30.9% failed outpatient treatment and were hospitalized (referred to as the inpatient group). The characteristics of the inpatient group including age at onset of $3.6{\pm}3.6years$ (p=0.02); black ethnicity (odds ratio [OR] 4.31, 95% confidence interval [95% CI] 2.04-9.09); p<0.001); prematurity (OR 2.39, 95% CI 1.09-5.26; p=0.02]; developmental delay (OR 2.20, 95% CI 1.12-4.33; p=0.02); overflow incontinence (OR 2.26, 95% CI 1.12-4.53, p=0.02); picky eating habits (OR 2.02, 95% CI 1.00-4.08; p=0.04); number of ROME III criteria met: median 4, interquartile range 3-5 (p=0.04) and $13{\pm}13.7$ constipation related prior encounters (p=0.001), were significantly different from the outpatient group. Conclusion: Identification of these characteristics may be helpful in anticipating challenges and potential barriers to effective outpatient treatment.

• 지식경영연구
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• 제16권1호
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• pp.209-224
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• 2015

Previous studies provided that limiting the number of services provided in hospital had influences in decreasing cost in delivering medical services. Hospitals could have positive effects on their profit by concentrating small number of services which they have comparative advantages. This study purposed to analyze the relationship between the concentration status of hospitals and medical charge for inpatients. National Inpatient sample data provided by the Health Insurance Review and Assessment Service (HIRA) for three years, 2009 to 2011 was used to compute the three concentration indices (Information Theory Index (ITI), Internal Herfindahl Index (IHI), and number of distinct Diagnosis-Related Groups (DRGs) treated) and total medical charge per inpatient case in each year. It was also used to select the control variables such as bed size, number of doctors per 100 beds, and locations. The ordinary least square regression models were developed and tested for hospital and general hospitals separately. The results showed that the total medical charge per inpatient case was significantly differed depending on the concentration indices, and there were positive relationships in ITI and IHI. The number of distinct DRGs had different directions in regression coefficients depending on the locations and hospital types. Hospitals had larger absolute standardized regression coefficients compare to those of general hospitals. However, their effects could be varied by the hospital types, number of doctors, and locations. It seems that hospitals have more influences on medical charges by concentrating their services than general hospitals. Study results provide knowledges to hospital administrators that concentration strategy can positive influences on the performance of small size hospitals.

• 한국의류학회지
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• 제30권8호
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• pp.1253-1262
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• 2006

This research explored the clothing behavior of dementia inpatient according to the dementia severity, dementia type and demographic characteristics. Data were collected by surveying 149 dementia inpatients and their caregivers. The collected data were analysed through frequency analysis, $X^2$-test, one way ANOVA, Duncan's multiple range test and t-test. The results were as follows: First, the dementia severity was classified into the severe, moderate and mild dementia by K-MMSE and the dementia types were composed of Alzheimer's disease, vascular dementia and the others. The severe dementia group and Alzheimer's disease group included the more aged and more female inpatients. And the severe dementia group was lower self-support of the basic activities of daily living than the mild dementia group. Second, the change motions of the dementia inpatient's clothing differed from the clothing item and dementia severity. That is, the motions for pants were more difficult than those for upper garment. And the motions for severe dementia group were more difficult than those for the mild dementia group. Third, there were significant differences among the three groups by dementia severity and between the male and female dementia inpatient in the clothing behavior. Most of abnormal clothing behaviors were found in the severe dementia group. The positive clothing behaviors appeared in the mild dementia group. And interests of clothing and appearance appeared in the female inpatients.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권4호
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• pp.67-75
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• 2017

Purpose: This study is for the facility eligibility and improvement evaluation analysis for the patient care environment of 7 facilities which has national inpatient isolation units. Methods: For the evaluation, first of all, the patient care environment of national inpatient isolation units are scrutinized by the checklist which is used on from 2014 with the 4 fields of criteria : architectural planning and layout, general requirement and condition for operating the negative pressured isolated patient room, HVAC system, and waste water discharging system. Finally, the evaluation results are compared with that of 2014. Results: The result shows that the average value of facility eligibility is 89.3 percent and which is 8.9 percent higher than the value before the MERS occurred. Implications: It is clear that facility remodeling of 7 institutions is being performed continuously, and the result of facility eligibility evaluation is reflected on design of a new 21 national inpatient isolation units those are going to be constructed from 2016. Therefore, it is expected that this study is used as a practical reference to establish the criteria of patient care environment management and safety management for both infectious disease outbreak and general service condition.

• 보건행정학회지
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• 제3권1호
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• pp.25-52
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• 1993

Variation in the utilization of medical services is a very important issue in cost containment and quality assurance of health care. Practice variation directly affects health care expenditure especially in fee-for-service system, which is the payment system of health insurance in Korea. In addition to cost issue it is generally accepted that variations in medical practice and the cost of inpatient care suggest the possibility of inappropriate quality of care. This study is to closely examine the patterne and degrees of variation in cost structure of inpatient care among types of hospital and individual hospitals in some tracer diseases, and also to inquire into the service items which contribute much to the variation of total medical care cost. Foru common diseases, i.e. Cesarean Section, appendectomy, cataract extraction and pediatric pneumonia, were selected as tracer diseases. In most tracer diseases there were statistically significant differences in total medical care cost among hospitals in same type of hospital as well as among types of hospital(p<0.01). When total medical care cost were subdivided into the types of service, cost of medication and diagnostic examination varied the most prominenly. When the cost of medication were subdivided again, cost of parenteral antibiotics showed the most prominent variation. Of total medical care cost, medication was most contributory to the variation of total medical care cost(58.1~82.3%), and cost of antibiotics was most contributory to the variation of medication cost(63.9~92.2%). The results of study implicated that reducing the variation of medication may plays a significant role in containing the cost of inpatient care. In order to sort out the factors affecting practice variations including drug prescription pattes further researches are required.

• 한방안이비인후피부과학회지
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• 제16권1호
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• pp.130-140
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• 2003

Objectives : Lately the oriental medical treatment of Bell's palsy is various. In various treatments. this study reports the effect of our clinical treatment using aqua-acupuncture with hominis placenta and electroacupuncture treatment for Bell's palsy, The other purpose of this study is to compare the outcome of inpatient group with that of outpatient group. Materials and Methods : From March 1, 2003 to June 30, 2003, we observe 25 patients who visited to the department of oriental medical surgery, ophthalmology & otolaryngology, in oriental medicine hospital Sang-ji university with Bell's palsy. limited to patients who receive treatment more than 5th times and 4 weeks poured aqua-acupunture with homonis placenta both inpatient group and outpatient group, Inpatient group used electroacupunture treatment after 1 week after onset and outpatient group used electroacupunture treatment after 4 weeks after onset. Results and Conclusions : 40$\%$ were male and 60$\%$ female. Of 25 cases. 30's and 50's were 24$\%$ respectively, 40's, 60's and over 70 were 16$\%$ respectively, 20's were 4$\%$. 50$\%$ of male and 60$\%$ of female had the affected side at left side and right occured at 50$\%$ of male and 40$\%$ of female. The most common cause of Bell's palsy was nonspecific 36$\%$, followed by labor 28$\%$, stress 20$\%$, In 48$\%$ of all cases, 2~3 days were spent before a patient visited the hospital after onset, followed by 4~7 days (24$\%$), 44$\%$ were treated 11~20 times followed by those who received 21~30 times (28$\%$). The results of treatment with aqua-acupunture wth hominis placenta and electroacupunture treatment showed that 21 of 25(84$\%$) patients achived fair or more recovery. the overall therapeutic rate of inpatient group was 90.9$\%$, which was higher than that of outpatient group(78.6$\%$).

• 임상간호연구
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• 제28권2호
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• pp.122-136
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• 2022

Purpose: This study attempted to recommend a revision of inpatient nursing fees based on analyzing current and appropriate staffing levels. Methods: Staffing grades and their inpatient nursing fees as of the first quarter of 2022 were analyzed. Nurse managers and staff nurses answered surveys about the current and appropriate staffing levels, working days, and monthly salary. A total of 101 nurse managers and 588 staff nurses working in general wards at tertiary hospitals and general hospitals participated in the study. Results: The results showed that grade 1 staffing was found in 73.3% of tertiary hospitals and 63.7% of general hospitals. The current staffing ratios of tertiary hospitals and general hospitals were 1:9.3 and 1:10.4, respectively. The appropriate staffing ratios according to nurse managers and staff nurses at tertiary hospitals were 1:7.6 and 1:7.0, respectively, and 1:8.7 and 1:8.8 in general hospitals, respectively. The average estimated annual working days of staff nurses were 235.2 days in tertiary hospitals and 240.0 days in general hospitals. The median monthly salary for staff nurses was 4.957 million won in tertiary hospitals and 4.140 million won in general hospitals. The new staffing grade system was suggested from 1:6 (Grade 1) to 1:12 (Grade 5). The new inpatient nursing fee schedules were recommended to be paid based on nursing hours per patient day of each grade. Conclusion: The new staffing grade and inpatient nursing fee schedules are expected to increase staffing levels, improve the quality of nursing care, and provide a better work environment for nurses.

• 재활간호학회지
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• 제2권2호
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• pp.215-224
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• 1999

This study was designed to compare care needs of patients with cancer and family members in inpatient and outpatient settings. The questionnaire was a Likert type 5 point scale with 57 items on four need categories; informational, physical care emotional care and socioeconomic care. There were significant differences between inpatient and outpatient settings. Also, there were significant differences in degree of care need according to gender, religion, marital status, economic status, public insurance status, and the past regimen. In conclusion, emotional needs perceived by patients with cancer and family members were higher than the others. Based upon the result, it is recommended that the research to compare needs between cancer patients who have a same illness and family member are necessary.

• 보건행정학회지
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• 제13권3호
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• pp.129-147
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• 2003

This study is to grasp a trend of profitability classified by characteristics of hospitals and to analyze related factors. Subjects are 145 hospitals which have gotten the standardization audit by Korean Hospital Association during 1998-200l. Profitability was measured in the aspect of operation profit rate with operating margin to gross revenue as proxy variables. Independent variables were classified by general factors (ownership, number of beds, period of establishment, competition), financial factors (liabilities to total assets, current ratio, fixed ratio, total asset turnover, inventories turnover), and factors related to patient treatment (average length of stay, bed occupancy rate, new outpatient ratio, admission ratio of outpatients, number of patients per specialist, personnel costs per adjusted inpatient, administrative costs per adjusted inpatient). Hierarchical multiple regression analysis model was used in this study. As a result of hierarchical multiple regression analyzation of operating margin to gross revenue, adjustive $R^2$ of general factors was relatively more powerful. The factors had significant effect on operating margin to gross revenue were ownership(+), number of beds(+), competition(+), current ratio(+), fixed ratio(+), total asset turnover(+), personnel costs per adjusted inpatient(-).