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Factors associated with inappropriate hospitalization days in regional public hospitals in Korea: An analysis using a two-part model

문현정|최숙자
한국보건경제정책학회 (The Korean Association of Health Economics and Policy)|2020.06|보건경제와 정책연구 (The Korean Journal of Health Economics and Policy)|제26권 제2호|pp. 83-101

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참고문헌

키워드

지방의료원AEPtwo-part 모형two-part modelRegional public hospitalshospitalization daysappropriateness evaluation protocol재원 부적절성
주제분류사회과학일반

초록

Objectives: The objective was to ascertain the extent of inappropriate hospitalization days (IHDs) and to identify associated factors in public hospital inpatients. Methods: This cross-sectional study employed concurrent and retrospective medical record reviews to examine patients (n = 800) consecutively discharged from four regional public hospitals’ general care units. Three registered nurses retrospectively reviewed medical records after being trained and assessed in the use of the Korean version of the Appropriateness Evaluation Protocol (K-AEP). A two-part model (TPM) was employed with logistic and multiple regression analyses to identify the predictors of IHDs. Results: Overall, 27.5% (1,466) of the hospital days reviewed were judged to be inappropriate. Factors associated with IHDs included age, LOS, admission route, and clinical department in the first part of the model. A log-linear multiple regression analysis revealed that both LOS and undergoing surgery were significantly associated with a higher IHD rate. Delays in performing diagnostic and therapeutic procedures and stays required to undergo such procedures were the most common causes of IHDs. Conclusions: This study showed that a substantial proportion of hospital stays was inappropriate. The characteristics associated with IHDs should be considered as criteria to promote the appropriate use of regional public hospital beds.

Abstract

Objectives: The objective was to ascertain the extent of inappropriate hospitalization days (IHDs) and to identify associated factors in public hospital inpatients. Methods: This cross-sectional study employed concurrent and retrospective medical record reviews to examine patients (n = 800) consecutively discharged from four regional public hospitals’ general care units. Three registered nurses retrospectively reviewed medical records after being trained and assessed in the use of the Korean version of the Appropriateness Evaluation Protocol (K-AEP). A two-part model (TPM) was employed with logistic and multiple regression analyses to identify the predictors of IHDs. Results: Overall, 27.5% (1,466) of the hospital days reviewed were judged to be inappropriate. Factors associated with IHDs included age, LOS, admission route, and clinical department in the first part of the model. A log-linear multiple regression analysis revealed that both LOS and undergoing surgery were significantly associated with a higher IHD rate. Delays in performing diagnostic and therapeutic procedures and stays required to undergo such procedures were the most common causes of IHDs. Conclusions: This study showed that a substantial proportion of hospital stays was inappropriate. The characteristics associated with IHDs should be considered as criteria to promote the appropriate use of regional public hospital beds.

참고문헌 (35)

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관련 논문AI추천

Reliability and Validity of the Appropriateness Evaluation Protocol for Public Hospitals in Korea신의철, 이창우, Clara Lee, Stella Jung-Hyun Kim대한예방의학회 · 예방의학회지2019 · 제52권 제5호환자의 특성에 따른 공공병원과 민간병원 차이 분석김상미, 오지영, 황성완경영연구원 · 의료경영학연구2015 · 제9권 제2호허혈성 심장질환 환자의 재원일수 결정요인우혜경, 이재빈한국보건정보통계학회 · 보건정보통계학회지2020 · 제45권 제1호환자 및 가족에 의한 입원이용 결정의 양상안병기한국보건경제정책학회 · 보건경제와 정책연구2017 · 제23권 제3호지방거주환자의 서울지역 의료기관 이용에 영향을 미치는 요인서원식, 홍성옥한국보건교육건강증진학회 · 보건교육건강증진학회지2009 · 제26권 제4호상급종합병원 입원의 특성 및 이용 요인 분석: 한국 의료패널 자료(2008∼2011)를 이용하여박영희보건의료산업학회 · 보건의료산업학회지2014 · 제8권 제3호

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