• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.97-101
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• 2012

Objective: With the background of aging population in China and advances in clinical medicine, the amount of operations on old patients increases correspondingly, which imposes increasing challenges to critical care medicine and geriatrics. The study was designed to describe information on the length of ICU stay from a single institution experience of old critically ill gastric cancer patients after surgery and the framework of incorporating data-mining techniques into the prediction. Methods: A retrospective design was adopted to collect the consecutive data about patients aged 60 or over with a gastric cancer diagnosis after surgery in an adult intensive care unit in a medical university hospital in Shenyang, China, from January 2010 to March 2011. Characteristics of patients and the length their ICU stay were gathered for analysis by univariate and multivariate Cox regression to examine the relationship with potential candidate factors. A regression tree was constructed to predict the length of ICU stay and explore the important indicators. Results: Multivariate Cox analysis found that shock and nutrition support need were statistically significant risk factors for prolonged length of ICU stay. Altogether, eight variables entered the regression model, including age, APACHE II score, SOFA score, shock, respiratory system dysfunction, circulation system dysfunction, diabetes and nutrition support need. The regression tree indicated comorbidity of two or more kinds of shock as the most important factor for prolonged length of ICU stay in the studied sample. Conclusions: Comorbidity of two or more kinds of shock is the most important factor of length of ICU stay in the studied sample. Since there are differences of ICU patient characteristics between wards and hospitals, consideration of the data-mining technique should be given by the intensivists as a length of ICU stay prediction tool.

• Journal of Preventive Medicine and Public Health
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• 제16권1호
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• pp.157-162
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• 1983

In order to determine the factors affecting the length of stay by pay status, a total of 961 in-patients medical records with appendectomy. cholecystectomy and Cesarean section discharged from the January 1979 to December 1981 from the University hospital were reviewed. Average length of stay showed no statistically significant difference by year between the insured and the non-insured patients, however multiple diagnoses and surgical complication were significantly different from single diagnosis and non-complicated cases. Surgical complication explained the length of stay mostly, and physician in discharge, multiple diagnoses, and accommodation in order for insured patients. Surgical complication, admission route, physician in charge and age in order explained the length of stay for non-insured patients.

• 보건의료산업학회지
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• 제8권4호
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• pp.47-55
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• 2014

The purpose of this study was to analyze the differences in the outcome for CABG according to whether hospitals provided heart related surgeries. The 2011 National Inpatient Sample (NIS) and inpatient quality indicator principles from the Healthcare Research and Quality (AHRQ) were used for analysis. Hospitals were divided into three groups according to the surgeries they provided. The length of stay and in-hospital deaths were adjusted for the differences in risks. ANOVA was performed to examine the differences for the risk-adjusted in-hospital mortality rate and risk-adjusted length of stay among the three groups. The analysis results showed that hospitals providing CABG, PTCA, and PHS had lower risk-adjusted in-hospital mortality rates or similar risk-adjusted lengths of stay compared to those of hospitals providing only CABG. However, the three groups did not have statistically significant differences in outcome indicators. Another study will be needed with a larger sample.

• 보건행정학회지
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• 제31권2호
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• pp.173-179
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• 2021

Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients. Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals. Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001). Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.

• 한국멀티미디어학회논문지
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• 제22권7호
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• pp.804-814
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• 2019

The patient's waiting time and length of stay have been reported as a factor decreasing their satisfaction in the hospital, especially in developing countries. This paper focuses on modeling hospital's outpatient department workflow in a developing country and optimizing the patient waiting time as well as total length of stay. By using discrete-event simulation, many alternative scenarios have raised, such as adding more working time, altering human resources, and adjusting the staff's responsibility, those scenarios will be examined to explore better settings for the hospital. The results show that possible to achieve a 9.6% reduction in patient total length of stay and it could be accomplished without adding more resources to the hospital.

• 문화기술의 융합
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• 제9권3호
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• pp.137-143
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• 2023

이 연구는 어린이(0-12세)손상 환자의 특성에 따른 재원일수의 관계를 규명하여, 어린이손상 환자 재원일수에 미치는 요인을 분석하고자 시행하였다. 조사대상은 퇴원손상심층조사 자료에서 2016년 1월1일부터 2020년 12월31일 까지 퇴원한 환자 중 0-12세 이하이며, 주진단이 손상 및 사고의 외인(S00-T98)인 환자 7,804명이었다. 분석은 빈도 분석 및 독립표본 t-검정, ANOVA 검정을 실시하였다. 재원일수에 영향을 미치는 요인을 알아보고자 회귀분석을 시행하였다. 연구대상자의 평균재원일수는 5.5일 이었다. 학령기(7-12세)기 아동이 학령전기(0-6세)보다 재원일수가 길었으며, 진료비 지불방법이 의료급여 및 기타보험 환자가 재원일수가 길었다. 의료기관 소재지가 수도권보다 비수도권(전라도, 경상도)일 때, 병상규모가 100-299병상인 경우 재원일수가 길었다. 내원경로는 외래인 경우 재원일수가 짧았고, 손상기전이 운수사고, 화상인 경우 재원일수가 길었다. 부진단이 있고, 주수술을 시행한 경우 재원일수가 길었으며, 퇴원후 방향이 사망인 경우 재원일수가 길게 나타났다. 이 연구는 전국 단위 자료인 퇴원손상심층조사 자료를 이용하여 우리나라 어린이 손상환자의 재원일수의 특성 및 결정요인을 파악하였다는 점에서 의의를 갖는다. 또한, 안전교육 및 예방 활동만으로도 발생을 줄일 수 있는 어린이 손상의 관련 요인 대한 적극적인 치료와 다양한 예방정책 마련을 위한 기초 자료를 제공했다는 점에서 의의가 있다.

• 한국콘텐츠학회논문지
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• 제11권9호
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• pp.372-383
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• 2011

본 연구의 목적은 관상동맥중재술 입원 환자의 재원일수의 변이를 규명하기 위해 중증도 보정 모형을 개발하였다. 2004~2006년 퇴원손상환자 조사자료 중 관상동맥중재술 입원 환자 1,011건을 연구대상으로 하였으며, 재원일수의 변이분석은 t검정, 분산분석을 실시하였고, 중증도 보정 재원일수 모형은 데이터마이닝 기법을 이용하였다. 개발된 다중회귀분석 모형을 이용하여 예측 재원일수를 산출하고 이를 실제 재원일수와 비교한 결과 병상규모별, 보험유형과 지역별로 재원일수의 변이가 존재하는 것으로 나타났다. 환자 특성과 중증도를 통제하고 나타난 재원일수의 변이는 공급자 요인으로 설명될 수 있는데, 진료행태나 의료자원에 대한 후속 연구가 필요한 것으로 보인다. 본 연구는 행정 데이터를 이용하여 중증도 모형을 개발하고 변이를 확인하였다는 점에서 활용의 효용성을 높이는 데 기여할 것으로 사료된다.

• 디지털융복합연구
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• 제18권1호
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• pp.257-263
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• 2020

본 연구는 건강보험심사평가원 자료를 이용하여 조현병 환자의 인구사회학적 특성, 의료기관 특성, 입퇴원 특성이 재원일수에 미치는 영향을 분석하여 국가 보건 정책 질 향상을 위한 기초 자료로 활용하고자 시행하였다. 건강보험심사평가원 2016년 환자 데이터셋(HIRA-NIS)에서 조현병이 주진단인 4,692명의 진료비 명세서를 연구대상으로 하였다. 조현병 환자의 재원일수 영향 요인을 확인하기 위하여 인구사회학적 특성, 의료기관 특성, 입퇴원 특성을 설명변수로, 재원일수를 종속변수로 회귀분석을 실시하였다. 연구결과 재원일수에 주요하게 영향을 미치는 요인은 여자, 연령, 의료 급여, 병원급, 요양병원, 강원도, 정신질환 부진단, 기타 부진단 등으로 밝혀졌다. 공공 데이터를 이용하여 조현병 환자의 재원일수에 영향을 미치는 요인을 찾고자 함에 의의가 있으며, 중증도는 고려하고 있지 않아 향후 중증도에 따른 재원일수의 차이에 대한 연구가 진행되어야 할 것으로 보여 진다.

• 임상간호연구
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• 제17권3호
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• pp.340-348
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• 2011

Purpose: The purpose of this study was to develop and provide a standardized nursing intervention program for stroke patients with dysphagia and evaluate the effectiveness of the program. Methods: Data on the number of tube feedings, incidence of aspiration pneumonia and length of stay were collected from 42 patients in the control group and 51 patients in the experimental group over the 6 months of this study. The data were analyzed using $x^2$-test and t-test. Results: The number of tube feedings in the experimental group was significantly lower than control group (p=.002). The incidence of aspiration pneumonia in the experimental group was not significantly lower than the control group (p=.097). Length of stay in the experimental group was significantly shorter than the control group (p<.001). Conclusion: The results of this study indicate that a standardized nursing intervention program for stroke patients with dysphagia could be useful to decrease tube feedings and length of stay.

• Safety and Health at Work
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• 제14권2호
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• pp.229-236
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• 2023

Background: In workers with moderate to severe work-related traumatic brain injury (wrTBI), this study aimed to investigate the effect of the timing of rehabilitation therapy initiation on the length of hospital stay and the factors that can influence this timing. Methods: We used data obtained from the Republic of Korea's nationwide Workers' Compensation Insurance. In the Republic of Korea, between the years 2010 and 2019, a total of 26,324 workers filed a claim for compensation for moderate to severe wrTBI. Multiple regression modeling was performed to compare the length of hospital stay according to the timing of rehabilitation therapy initiation following wrTBI. According to the timing of the initiation of rehabilitation therapy following TBI, the proportions of healthcare institutions that provided medical care during each admission step were compared. Results: The length of hospital stay for workers who started rehabilitation therapy within 90 days was significantly shorter than that for workers who started rehabilitationment were first admitted to tertiary hospitals. Approximately 39% of patients who received delayed rehabilitation treatment were first admitted to general hospitals, and 28.5% were first admitted to primary hospitals. Conclusions: Our findings demonstrate the importance of early rehabilitation initiation and that the type of healthcare institution that the patient is first admitted to after wrTBI may influence the timing of rehabilitation initiation. The results of this study also emphasize the need to establish a Worker's Compensation Insuranceespecialized rehabilitation healthcare delivery system.