Abundant data on patients have been accumulated in hospital since the introduction of the computerized system. Now data mining is required for the survival and growth of hospital. Cases of 19,558 patients were analyzed to investigate factors influencing readmission and repeated admissions, and to estimate probability of readmission with considering covariate effects. Techniques of Kaplan-Meier method, Cox proportional hazards model, and WLW method were applied to the analysis. The conclusions are as follows. The severity of disease, congenital defect and chronicity of disease are influencing readmission or repeated admissions of a patient. Patient s characteristics, such as gender, distance from residence and type of discharge are also related to them. The probability of readmission can be estimated for a patient with variety of conditions for certain period of time. It is suggestive that survival analysis is a good methodology for data mining works on computerized data in hospital. If death certificate data are connected with patients' data, we will be able to get a good data source to medical studies.
Congenital Abnormalities ; Information Storage and Retrieval ; Data Mining ; Death Certificates ; Humans ; Medical Records* ; Proportional Hazards Models ; Survival Analysis*

To identify the factors related to the readmission and ambulatory visit we analyzed the data in discharge abstract DB(DADB) and outpatient database(OPDB) for 19,983 patients discharged in 1990 from an university hospital(S Hospital) in Seoul. The target patients were limited to those who didn' t have previous episode of discharge in that hospital. Readmission data for 10 years(1990-1999) and ambulatory visit data for 5 years(1995-1999) were analyzed by using x2 test and multiple logistic regression analysis. The main results of this study is as follows. 1) As the number of readmission was increased, readmission rate(RR) was also increased while the average length of stay(ALOS) was decreased. 2) RR was higher in male, transferred from other health care facilities, with consultation, biopsy, ICU care episode during hospitalization. 3) In logistic regression, RR of patients living close to S Hospital hospital was higher than the others wh?n other variables were adjusted. 4) RR of the patients with the diagnosis(Dx) of cancer or cancer related condition was the highest(47.6%), and the consistency rate (CR) of principal Dx group with that of previous admission was also the highest in cancer patients. As the number of readmission was increased the CR of Dx group was also increased. 5) 23.4%(4866) of the target patients had episode of visiting outpatient dispensary(OPD) for between 1995-1999 and the average number of visit was 13.6 times. Patients with the Dx of heart disease showed the highest proportion in ambulatory visit.
Biopsy ; Delivery of Health Care ; Episode of Care ; Heart Diseases ; Hospitalization ; Humans ; Logistic Models ; Male ; Outpatients ; Patient Care* ; Seoul

This paper deals with cerebral paragonimiasis and cerebral hemispherectomy conducted as a treatment of cerebral paragonimiasis by Bo Sung Sim in Korea in 1950s-1960s. He demonstrated that cerebral hemispherectomy could be used for unilateral diffuse cerebral paragonimiasis. Sim learned cerebral hemispherectomy from Dr. L. A. French. at the University of Minnesota from 1955 to 1957 in America. The authors argues that Bo Sung Sim's introduction of cerebral hemispherectomy to Korea was not a simple application of an advanced medical technology, but a complicated and active process in that Sim used the technique to intervene intractable complications from cerebral paragonimiasis such as generalized convulsions, spastic hemiplegia and mental deterioration. Bo Sung Sim, one of the neurosurgeons of the first generation in Korea, was trained in neurology, neuropathology, neuroradiology and animal experiments as well as in neurosurgery at the University of Minnesota. After returning to Korea, Sim faced parasitic diseases, one of the most serious public health problems at that time, which were far different from what he learned in America. As a neurosurgeon, Sim tackled with parasitic diseases of the central nervous system with various diagnostics and therapeutics. In 1950s, more than one million populations suffered from pulmonary paragonimiasis acquired by eating raw crabs or by feeding juice of crushed crayfish for the treatment of measles in Korea. About 26.6 percent of people with paragonimiasis had cerebral paragonimiasis. Before bithionol therapy was introduced in 1962, neurosurgery was the only available treatment to control increased intracranial pressures, intractable epilepsy, paralysis and mental deterioration. Between 1958 to 1962, Bo Sung Sim operated on 24 patients of cerebral paragonimiasis. In two of them, he performed cerebral hemispherectomy to control intractable convulsions when he found diffuse cerebral paragonimiasis and cerebral atrophy at the operating table. The two patients were recovered dramatically after the operation. The first patient became a part of medical campus for 20 years after hemispherectomy, doing chores at the hospital and helping Bo Sung Sim for his teaching neuroanatomy. The presence of the hemispherectomized patient in the classroom impressed the students deeply. Furthermore, the hemispherectomized patient stimulated Sim and his school to perform research upon the neuroanatomy and neurophysiology of the brain with hemispherectomized animals.
Animals ; Brain/parasitology ; Hemispherectomy/*history ; History, 20th Century ; Humans ; Paragonimiasis/*history/surgery ; Parasitic Diseases/history/therapy ; Trematoda

PURPOSE: This study aimed to validate an automated calculating system developed for determining the adenoma detection rate (ADR). METHODS: To calculate the automated ADR, the data linking processes were as follows: (1) matching the selected colonoscopy results with the pathological results, (2) matching the polyp number from colonoscopy with that from pathology and confirming the histopathological results of each colonic polyp, and (3) confirming the histopathological results, especially the adenoma status of each colonic polyp. To verify the accuracy of the automated ADR calculating system, we manually calculated the ADR for 3 months through medical record review. Accuracy was calculated by measuring the error rate for each value. The cause of error was analyzed by additional order and chart review. RESULTS: After excluding 318 cases, 2,543 patients (1,351 men and 1,192 women; median age, 57.9 years) who underwent colonoscopy were included in this study. When the automated calculating system was used, polyps were found in 1,336 cases (52.6%) and adenomas were found in 1,003 cases (39.4%). When the manual calculating system was used, polyps were found in 1,327 cases (52.2%) and adenomas were found in 1,003 cases (39.4%). The accuracies of the polyp detection rate and ADR according to the automated calculating system were 99.3% and 100%, respectively. CONCLUSION: We developed a system to automatically calculate the ADR by extracting hospital electronic medical record results and verified that it provided satisfactory results. It may help to improve colonoscopy quality.
Adenoma ; Colon ; Colonic Polyps ; Colonoscopy ; Colorectal Neoplasms ; Electronic Health Records ; Female ; Humans ; Male ; Medical Records ; Pathology ; Polyps ; Quality Improvement