No abstract available.
Hospitals, Teaching* ; Prospective Studies*

Since nationwide compulsory health insurance started in 1977, shortage of hospital beds has become apparent and this is related in part to the length of hospital stay. To determine the factors which affect the length of stay a total of 1,003 in-patients medical records for appendectomy, cholecystectomy, and Cesarean section discharged in 1965, 1970, 1975 and 1980 from a university hospital were studied. The major findings are as follows; The average length of stay showed a statistically significant difference by year among the cholecystectomy and Cesarean section patients. For the appendectomies no statistically significant difference was found. Complications after surgical operation explained the length of stay mostly in all three procedures; the next factors were age, character of surgery, day of the week of surgery, and multiple diagnoses in this order for appendectomy; day of the week of surgery, age, type of accommodation, route of admission in this order for cholecystectomy; and day of the week of surgery, multiple diagnoses, residential area and type of accommodation in Cesarean section respectively.
Adolescent ; Adult ; Age Factors ; Child ; Hospitals, Teaching/utilization* ; Hospitals, University/utilization* ; Human ; Korea ; Length of Stay* ; Regression Analysis

BACKGROUND: To evaluate the appropriateness of intravenous (IV) ciprofloxacin usage in university hospitals in Korea. MATERIALS AND METHODS: We prospectively evaluated the appropriateness of drug usage in 290 consecutive adult patients who received IV ciprofloxacin in eight teaching hospitals during the period from September 25, 2003 to November 15, 2003. Drug use evaluation (DUE) in this study was based on the modified standard by the American Society of Hospital Pharmacy with regard to the justification of drug use, critical and process indications, complications, and outcome measures. RESULTS: Average age of the patients was 54 years. The use of IV ciprofloxacin was appropriate only in 33 cases (26.9%). Common reasons for inappropriate use of IV ciprofloxacin include perioperative uses or prophylactic injection before urologic procedures, and empirical therapy for febrile episodes. Most of the "critical indications" and "process indications" showed high rate of appropriateness (82.4-100%). However, the rate of taking culture and sensitivity test before (73.8%) and during ciprofloxacin use (68.6%) were low. Complications with ciprofloxacin use were rare. In 93.3% of cases, ciprofloxacin treatment was clinically effective. CONCLUSION: Use of intravenous ciprofloxacin is frequently inappropriate in tertiary care hospitals in Korea. Implementation of education program and antibiotic control system is critical in improving the appropriateness of antimicrobial use.
Adult ; Ciprofloxacin* ; Education ; Hospitals, Teaching ; Hospitals, University* ; Humans ; Korea* ; Outcome Assessment (Health Care) ; Pharmacy ; Prospective Studies ; Tertiary Healthcare

BACKGROUND: To evaluate the appropriateness of intravenous (IV) ciprofloxacin usage in university hospitals in Korea. MATERIALS AND METHODS: We prospectively evaluated the appropriateness of drug usage in 290 consecutive adult patients who received IV ciprofloxacin in eight teaching hospitals during the period from September 25, 2003 to November 15, 2003. Drug use evaluation (DUE) in this study was based on the modified standard by the American Society of Hospital Pharmacy with regard to the justification of drug use, critical and process indications, complications, and outcome measures. RESULTS: Average age of the patients was 54 years. The use of IV ciprofloxacin was appropriate only in 33 cases (26.9%). Common reasons for inappropriate use of IV ciprofloxacin include perioperative uses or prophylactic injection before urologic procedures, and empirical therapy for febrile episodes. Most of the "critical indications" and "process indications" showed high rate of appropriateness (82.4-100%). However, the rate of taking culture and sensitivity test before (73.8%) and during ciprofloxacin use (68.6%) were low. Complications with ciprofloxacin use were rare. In 93.3% of cases, ciprofloxacin treatment was clinically effective. CONCLUSION: Use of intravenous ciprofloxacin is frequently inappropriate in tertiary care hospitals in Korea. Implementation of education program and antibiotic control system is critical in improving the appropriateness of antimicrobial use.
Adult ; Ciprofloxacin* ; Education ; Hospitals, Teaching ; Hospitals, University* ; Humans ; Korea* ; Outcome Assessment (Health Care) ; Pharmacy ; Prospective Studies ; Tertiary Healthcare

In an attempt to understand the changing pattern of hospital care utilization and costs, a study was made of the medical and administrative records of 7,798 patients, who were discharged from a private, university teaching hospital in the years 1955, 1960, 1965, 1970 and 1974. An analysis of the ages of the patients who utilized the hospital, revealed little change over the study in the age distribution of female patients, but did show increases in the percentages of male patients who were under 5 and over 60 years of age. The overall average length of stay in hospital decreased continuously, from 17.1 days in 1955 to 10.4 days in 1974, and the average length of stay of those who were discharged within 90 days of admission decreased from 14.4 days in 1955 to 8.9 days in 1974. Patients who received surgical treatment remained in hospital for three to four days longer than did those who received non-surgical treatment. Obstetrical cases remained in hospital for 6.9 days in 1955, and 4.8 days in 1974. A large majority of the patients (87 - 96%) were discharged within one month of admission, and virtually all (97.5 - 99.4%) within three months. In respect to the place of residence of the patients, the data revealed that 80% were from Seoul Two-thirds of the patients from Seoul resided in districts immediately surrounding the hospital, showing that despite increasingly effective transportation facilities, hospital utilization continued to be localized to people living in areas near the institution. The study revealed little change in disease patterns over the years: the percentage of obstetrical admissions remained highest with infectious and parasitic diseases, gastrointestinal diseases, injuries, neoplasms and respiratory diseases ranking in descending order. The status of patients at time of discharge showed improvement: the recovery rate increased, and the proportion of patients who died decreased. Total hospital expenses increase 4.4 times and expenses per patient day increased 6.2 times, both results having been determined through the use of constant market prices. It is considered that the latter increase resulted primarily from intensification of medical care and shortening of the hospitalization period. Among the various components of hospital care costs, room (hotel-type) and treatment expenses remained at approximately 40%of the total, while expenses for drugs and injections were approximately 20% in each of the five years of the study. Study of the relative increase of hospital costs by component of care revealed that the highest. increases over the twenty-year period was in the cost of laboratory services, followed by drugs and injections. It would seem that these high increases resulted from rapid technological developments in diagnostic and therapeutic procedures.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Costs and Cost Analysis* ; Female ; Hospitals, Teaching/utilization* ; Hospitals, University/economics ; Hospitals, University/trends ; Hospitals, University/utilization* ; Human ; Korea ; Length of Stay ; Male ; Middle Age

This Study was conducted to study the importance of infectious diseases in Korea by computing the records of ambulatory and hospitalized patients at two university hospitals. Infectious diseases were 74.7% and non-infectious diseases were 25.3% at Severance Hospital, while infectious diseases were 82.7% and non-infectious diseases were 17.3% at the Wonju Christian Hospital. Among the infectious diseases, viral infection were 72.4% bacterial infections were 24.7% at Severance Hospital, while viral infections were 81.8% and bacterial infections 17.4% at Wonju Christain Hospital in 1980. Of the five major viral infections, upper respiratory infections, gastroenteritis, pneumonia, bronchiolitis, and hepatitis were in that order at both Severance and Wonju Christian Hospital and the incidence of each disease was similar. Of the ten major bacterial infections, tuberculosis was ranked the first, pneumonia, bronchitis, pertussis, shigellosis, sepsis, meningitis, urinary tract infections, impetigo and salmonellosis were in that order at Severance Hospital, while tuberculosis, pneumonia, shigellosis, meningitis, bronchitis, sepsis, pertussis, urinary tract infections, salmonellosis and cellulitis were in that order at Wonju Christian Hospital. The number of diseases was closely related to the number of infectious diseases which also had a close relationship to the number of epidemic diseases in 1980. In the relationship of infectious diseases to age, younger children have more infectious diseases than older children.
Adolescent ; Age Factors ; Child ; Child, Preschool ; Communicable Diseases/epidemiology* ; Comparative Study ; Hospitals, Teaching* ; Hospitals, University* ; Human ; Infant ; Infant, Newborn ; Korea ; Seasons

PURPOSE: to measure the nurses need for the Hospital Information System(HIS) and identify the change of nurses' attitude toward computerization in pre and post HIS implementation. METHOD: Prospective survey using repeated measures design. The subjects were 166 nurses working at surgical units in a tertiary and teaching hospital. Questionnaire was developed by researchers based on the Stronge and Brodt s study (1985). Cronbach' s coefficient was 0.80. RESULT: Nurses' attitudes toward computerization were positive in pre and post Hospital Information Systems. Favorable attitude of staff nurses significantly increased after computerization. Those who were higher position, highly educated, and working longer at their hospital had more favorable attitude toward computerization. Nurses wanted a computerization of works related to laboratory tests and order check most. After computerization, nurses evaluated works related to laboratory tests and order most convenient. CONCLUSION: Appropriate reflection of nurses' need on computerization improved their favorableness towards computerization.
Hospital Information Systems* ; Hospitals, Teaching ; Surveys and Questionnaires

The work suggested in this paper addresses a method for collecting beam data for small circular fields. Beam data were obtained from Philips 6 and 8 MV LINAC at Dept. Radiation Therapy at Gainesville Incorporated and Shands Teaching Hospital. Specific quantities measured include tissue maximum ratio (TMR), off-axis ration (OAR) and relative output factor (ROF). In small field irradiation, special collimators were used to produce circular fields of 1 cm to 3 cm diameter in 2 mm steps, measured at SAD (soura axis distance) of 100 cm. Diode detector was chosen for primary beam measurement and compared with measurements made with photographic film and TLD dosimeters. The measured TMRs and OARs were formulated from limited measurements to generate basic beam data for reference set-up. The empirical formula were later, extended and generalized for any possible set-up using the trends of fitting parameters. The measured TMRs and OARs were well represented by the fitting formula developed.
Axis, Cervical Vertebra ; Hospitals, Teaching ; Particle Accelerators*

No abstract available.
Hospitals, Teaching* ; Internal Medicine* ; Internship and Residency*

Awareness ; Curriculum ; Hospitals, Teaching ; India ; Tertiary Healthcare