Graft Rejection ; Humans ; Kidney Transplantation ; mortality ; statistics & numerical data ; Patient Care

PURPOSE: The objective of this study was to analyze the effects of medical staffing level as bed-to-medical staff ratio on patient outcomes as length of stay (LOS) among hospitals in Korea. METHODS: Two hundred and fifty one hospitals participated in the study between January and March 2008. Data for the study was requested by an electronic data interchange from the Health Insurance Review Agency in 2008. In data analysis, SPSS WIN 15.0 program was utilized for descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression. RESULTS: The mean score for length of stay was 13.6 days. The mean of operating bed-to-nurse ratio was 7.93:1. The predicting factors for LOS were bed-to-nurse's aide ratio, bed-to doctor's ratio, severely ill patient rate, and hospital type. These factors explained 28.9% of the variance in patient outcomes. CONCLUSION: This study results indicate that the relationship between medical staffing level and patient outcomes is important in the improvement of the quality of patient care. Thus, improvements in the quality of the nurse practice environment could improve patient outcomes for hospitalized patients.
Electronics ; Electrons ; Humans ; Insurance, Health ; Length of Stay ; Patient Care ; Statistics as Topic

PURPOSE: The main purpose of this study was to compare the level of satisfaction of patients with nursing care received, and of nurses with nursing care provided to their patients. Another purpose of this study was to identify the relationship between job satisfaction by the nurses and satisfaction with nursing care they provide. METHOD: A self-report questionnaire developed by Yoo & Hong (1999) was used to measure patient and nurse satisfaction. The participants were 147 patients and 133 nurses and data were collected from October 23 to October 30, 2002. Data analysis was done using SPSS WIN 11.0. RESULT: The average score for patient satisfaction was 2.47 (maximum score 5.0) and for nurses, 2.20. This difference was statistically significant. The patients gave high scores on care related personal hygiene, but they gave low scores for critical nursing areas such as following appropriate procedure for administering medications. No significant relationship was found between satisfaction with their nursing care by the nurses and satisfaction with the job. CONCLUSION: Even though the patient scores were significantly higher than nurses', the overall average score was very low and critical nursing actions received the lowest scores. It is necessary to identify areas in need of improvement and develop continuing education programs for nurses.
Education, Continuing ; Humans ; Hygiene ; Job Satisfaction ; Nursing ; Nursing Care ; Patient Satisfaction* ; Surveys and Questionnaires ; Statistics as Topic

Objective To investigate the health care-seeking behaviors of Mosuo and Pumi people.Methods The subjects were enrolled by using the multi-stage stratified random sampling method and surveyed by the self-designed questionnaire.Results To tally 1669 subjects including 1121 Mosuo people and 548 Pumi people completed the survey.When Mosuo and Pumi people suffer from ailments,they preferred to buy drugs in drugstores(47.3% for Mosuo and 46.9% for Pumi),followed by visiting a local township hospital(27.0% for Mosuo and 24.3% for Pumi).When they suffered from severe diseases,they preferred to visit the county/city/state hospital(93.4% for Mosuo and 91.1% for Pumi).The mental disease were mainly treated in the county/city/state hospitals(49.3% for Mosuo and 52.7% for Pumi);notably,39.3% of the Mosuo respondents and 31.5% of the Pumi respondents skipped this question.Conclusion Health education,including awareness-raising activities on mental health,should be enhanced in Mosuo and Pumi people to further improve their health care-seeking behaviors.
China ; Humans ; Patient Acceptance of Health Care ; statistics & numerical data ; Surveys and Questionnaires

PURPOSE: This study was to investigate the performance of safety care activities among nurses in small-medium sized general hospitals and to identify factors associated with the safety care activities. METHODS: In this cross-sectional descriptive study, 455 nurses were recruited from small-medium sized general hospitals. Data were collected with the ‘Questionnaire on Patient Safety Care Activities’ by web based survey. Descriptive statistics, independent t-test and One-way ANOVA with Duncan test for multiple comparison were used for data analysis. RESULTS: The mean score of patient safety care activity was 4.52 out of a total of 5 points. The total score of patient safety care activities according to the characteristics of the subjects was significantly higher than those of patients who had more than 15 years of clinical nursing career (F=7.06, p < .001) and there was a significant difference according to experience of healthcare accreditation (t=−2.10, p=.036). CONCLUSION: In order to raise the level of patient safety care activity among nurses in small-medium sized general hospitals, it is important to retain experienced nurses. Practical training and regular educations on patient safety care activities are required for nurses in small-medium sized general hospitals.
Accreditation ; Delivery of Health Care ; Hospitals, General* ; Humans ; Nursing ; Patient Safety* ; Statistics as Topic

Patients readmitted to the intensive care unit (ICU) have a significantly higher mortality rate. The role of intensivists in judging when to discharge patients from the ICU is very important. We undertook this study to evaluate the effect of the intensivists' discharge decision-making on readmission to ICU. The intensivists actively participated in the discharge decision-making, with the discharge guideline taken into consideration, in respect of group 1 patients, but not in respect of group 2. The readmission rate in group 1 was lower than that in group 2. The readmission in patients in each group was associated with higher mortality rates and longer lengths of stay at the ICU. Respiratory failure was the major cause of readmission. In the non-survivors out of the readmitted patients, the Acute Physiology and Chronic Health Evaluation (APACHE) III scores on the initial discharge and readmission, the multiple organ dysfunction syndrome (MODS) scores on the initial admission, discharge and readmission were higher than the corresponding indices in the survivors. We conclude that the readmission rate was lower when intensivists participated in the discharge decision-making, and that APACHE III and MODS scores on the first discharge and readmission were significant prognostic factors in respect of the readmitted patients.
APACHE ; Acute Disease/*mortality/therapy ; Adult ; Aged ; Decision Making ; Female ; Human ; Intensive Care Units/*statistics & numerical data ; Male ; Middle Aged ; *Patient Discharge ; Patient Readmission/*statistics & numerical data

Adult ; Antarctic Regions ; Emergency Medical Services ; statistics & numerical data ; Expeditions ; Female ; Humans ; Male ; Middle Aged ; Patient Care Team ; statistics & numerical data ; Patient-Centered Care ; statistics & numerical data ; Retrospective Studies

PURPOSE: The purpose of this study was to analyze the status of inpatient care for acute first-ever stroke at three general hospitals in Korea to provide basic data and useful information on the development of comprehensive and systematic rehabilitation care for stroke patients. MATERIALS AND METHODS: This study conducted a retrospective complete enumeration survey of all acute first-ever stroke patients admitted to three distinct general hospitals for 2 years by reviewing medical records. Both ischemic and hemorrhagic strokes were included. Survey items included demographic data, risk factors, stroke type, state of rehabilitation treatment, discharge destination, and functional status at discharge. RESULTS: A total of 2159 patients were reviewed. The mean age was 61.5+/-14.4 years and the ratio of males to females was 1.23:1. Proportion of ischemic stroke comprised 54.9% and hemorrhagic stroke 45.1%. Early hospital mortality rate was 8.1%. Among these patients, 27.9% received rehabilitation consultation and 22.9% underwent inpatient rehabilitation treatment. The mean period from admission to rehabilitation consultation was 14.5 days. Only 12.9% of patients were transferred to a rehabilitation department and the mean period from onset to transfer was 23.4 days. Improvements in functional status were observed in the patients who had received inpatient rehabilitation treatment after acute stroke management. CONCLUSION: Our analysis revealed that a relatively small portion of patients who suffered from an acute first-ever stroke received rehabilitation consultation and inpatient rehabilitation treatment. Thus, applying standardized clinical practice guidelines for post-acute rehabilitation care is needed to provide more effective and efficient rehabilitation services to patients with stroke.
Acute Disease ; Aged ; Aged, 80 and over ; Demography ; Female ; Hospitalization/statistics & numerical data ; Humans ; *Inpatients/statistics & numerical data ; Male ; Middle Aged ; *Patient Care/statistics & numerical data ; Patient Discharge/statistics & numerical data ; Recovery of Function ; Risk Factors ; Stroke/classification/epidemiology/*rehabilitation/therapy

PURPOSE: To examine the relationships between emergency department length of stay (EDLOS) with hospital length of stay (HLOS) and clinical outcome in hemodynamically stable trauma patients. METHODS: Prospective data collected for 2 years from consecutive trauma patients admitted to the trauma resuscitation bay. Only stable blunt trauma patients with appropriate trauma triage criteria requiring trauma team activation were included in the study. EDLOS was determined short if patient spent less than 2 h in the emergency department (ER) and long for more than 2 h. RESULTS: A total of 248 patients were enrolled in the study. The mean total EDLOS was 125 min (range 78-180). Injury severity score (ISS) were significantly higher in the long EDLOS group (17 ± 13 versus 11 ± 9, p < 0.001). However, when leveled according to ISS, there were no differences in mean in diagnostic workup, admission rate to intensive care unit (ICU) or HLOS between the short and long EDLOS groups. CONCLUSION EDLOS is not a significant parameter for HLOS in stable trauma patients.
Emergency Service, Hospital ; statistics & numerical data ; Hospitals ; statistics & numerical data ; Intensive Care Units ; statistics & numerical data ; Israel ; Length of Stay ; Patient Admission ; statistics & numerical data ; Patient Outcome Assessment ; Time Factors ; Trauma Severity Indices ; Wounds and Injuries

INTRODUCTIONThe aim of this study was to find out the effects of group psychoeducation (GPE) on the scheduled clinic appointments of patients admitted for psychosis and depression after discharge from hospital.

MATERIALS AND METHODSA randomised controlled trial (RCT) of 4 sessions of GPE delivered while the patients were admitted was conducted and compared to no session of GPE with the usual care. This RCT was conducted in a 60-bed state reference neuropsychiatric hospital in Southwest of Nigeria. The study population consisted of 48 admitted patients for psychotic disorders, including schizophrenia and depression. Twenty-five patients admitted were randomly selected to undergo 4 sessions of GPE before discharge from hospital, and 23 patients were randomly selected to receive regular medication and care without undergoing GPE. Both groups were then followed for 9 months on clinic days to measure compliance with scheduled appointments. Main outcome was measured by the number of clinic appointments kept within the period of study after discharge from hospital.

RESULTSPatients in the treatment group were consistently more compliant with scheduled clinic appointments than those in the experimental group (P = 0.0009, DF = 34; t-test at 95% CI). There was also no significant difference in compliance with visits among patients with different diagnoses (treatment group; P = 0.90, DF = 12, experimental group; P = 0.33, DF = 11).

CONCLUSIONGPE is effective in improving patients' compliance with scheduled clinic appointments after discharge for a period of 9 months. GPE can be used as part of treatment package for all psychiatric diagnoses and it has no age bias.

Adult ; Aftercare ; methods ; psychology ; utilization ; Appointments and Schedules ; Depressive Disorder ; therapy ; Female ; Hospitals, Psychiatric ; utilization ; Humans ; Male ; Nigeria ; Patient Acceptance of Health Care ; statistics & numerical data ; Patient Compliance ; statistics & numerical data ; Patient Education as Topic ; methods ; Program Evaluation ; Psychotherapy, Group ; Psychotic Disorders ; therapy