Research in Community and Public Health Nursing (지역사회간호학회지)

Korean Academy of Community Health Nursing (한국지역사회간호학회)
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Factors Related to Long-term Hospital Length of Stay and Opinions on Discharge-related Community-based Medical and Welfare Service on Elderly Patients with Chronic Diseases in Korean Veterans Hospitals

  • Received : 2021.11.08
  • Accepted : 2022.09.20
  • Published : 2022.12.31
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Abstract

Purpose: This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. Methods: The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion. These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). Conclusion: In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.

Keywords

Acknowledgement

This study was conducted with support from the Veterans Medical Research Institute in 2019.

References

  1. Korean Veterans Health Service. Introduction of veterans health service [Internet]. Wonju: Korean Veterans Health Service. 2021 [cited 2021 Jul 31] Available from: https://www.bohun.or.kr/050business/business01.php
  2. Koo GH, Dong JY, Lee KH, Seo YJ. The effect of integrated health and welfare services on the control of medical use and medical expenses in Korean veteran's hospitals. Korean Journal of Hospital Management. 2021;26(2):1-16.
  3. Statistics Korea. The ratio of elderly people [Internet]. Daejeon: Statistics Korea. 2021 [cited 2021 Jul 31] Available from: http://kosis.kr/statisticsList/statisticsListIndex.do?menuId=M_01_01&vwcd=MT_ZTITLE&parmTabId=M_01_01
  4. Ministry of Patriots and Veterans Affairs. The status subjects of veterance [Internet]. Sejong: Ministry of Patriots and Veterans Affairs; 2021 Jun [cited 2021 Jul 31] Available from: https://www.mpva.go.kr/mpva/selectBbsNttView.do?key=181&bbsNo=54&nttNo=225313&searchCtgry=&searchCnd=all&searchKrwd=&integrDeptCode=&pageIndex=1
  5. Kim JH, Im ES, Lee KA, Suh DM, Kim JS, Park YJ, et al. Survey on validity for foundation of province veterans hospital and a Doctor's office in affiliation veterans hospital. Research Report. Seoul: Seoul National University and Korean Veterans Health Service; 2018 Nov. Report No: non.
  6. Moon JH, Kim YS. Comparison of socio-economic characteristics, presence of chronic disease, medical use and expenditure between olders with and without disabilities: Using data of Korea health panel (2015). The Journal of Korea AgingFriendly Industry Association. 2018;10(2):9-18. https://doi.org/10.34264/jkafa.2018.10.2.9
  7. Choi JS, Park KC, Han SJ, Tae SI, Park SA, Jang SJ, et al. 2017 Medical aid statistics. Research Report. Seoul: Health Insurance Review & Assessment Service; 2018 Nov. Report No:11-1352000-002197-10
  8. Moon KJ, Lee KS. Does the level of hospital caseloads influences on the length of stay for the delivery inpatients. Journal of the Korea Contents Association. 2013;13(8);314-323. https://doi.org/10.5392/JKCA.2013.13.08.314
  9. Kim SH. Estimation of long-term care among in-patients at a veterans hospital. Korean Journal of Family Medicine. 2006;27(3):215-221.
  10. National Institute of Korean Language. Standard Korean language encyclopedia [Internet]. Seoul: National Institute of Korean Language; 2019 [cited 2021 Jul 31] Available from: http://www.stdict.korean.go.kr/main/main.do
  11. Mader SL, Medcraft MC, Joseph C, Jenkins KL, Benton N, Chapman K, et al. Program at home: A veterans affairs healthcare program to deliver hospital care in the home. Journal of the American Geriatrics Society. 2008;56(12):2317-2322. https://doi.org/10.1111/j.1532-5415.2008.02006.x
  12. Murphy MM. Telehealth factors for predicting hospital length of stay. Journal of Gerontological Nursing. 2018;44(10):16-20. https://doi.org/10.3928/00989134-20180305-01
  13. Lovelace D, Hancock D, Hughes SS, Wyche PR, Jenkins C, Logan C. A Patient-centered transitional care case management program: taking case management to the streets and beyond. Professional Case Management. 2016;21(6):277-290. https://doi.org/10.1097/ncm.0000000000000158
  14. Lee YJ, Park CW. A study on the role of integrated local community care in the elderly care system in Korea in the age of aging. Journal of Community Welfare. 2022;80:205-231. https://doi.org/10.15300/jcw.2022.80.1.205
  15. Linn MW, Linn BS. The rapid disability rating scale-2. Journal of the American Geriatric Society. 1982;30(6):378-382. https://doi.org/10.1111/j.1532-5415.1982.tb02835.x
  16. Zigmond AS, Snaith PR. The hospital anxiety and depression scale. Acta Psychiatric Scandinavia. 1983;67(6):361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
  17. Oh SM, Min KJ, Park DB. A comparison of normal, depressed and anxious groups: a study on the standardization of the hospital anxiety and depression scale for Koreans. Journal of the Korean Neuropsychiatric Association. 1999;38(2):289-296.
  18. Kim YH, Lee HS. A study on the performance evaluation of effectiveness and satisfaction of veteran medical service delivery system: focused on the perspective of provider and beneficiary. Korean Journal of Social Welfare Studies. 2016;47(3): 187-221. http://.doi.org/10.16999/kasws.2016.47.3.187
  19. Ko Y. Family functioning perceived by caregiver who support the elderly. Journal of Korean Academy of Community Health Nursing. 2009;20(3):361-370.
  20. Shin SY. Factors related to long term admission among the national merit reward beneficiaries [master's thesis]. [Busan]: Inje University; 2014. 72 p.
  21. Hwang EJ. Effects of job satisfaction and patients satisfaction on medical profit at public hospitals. Korean Journal of Hospital Management. 2014;19(2):12-21.
  22. Lee HS. A study on the necessity of medical social work service of the inpatients of veterans hospital and their families. [master's thesis]. [Seoul]: Dongduk Womens University; 2002. 107 p.
  23. Son CW, Kim JA. Reality of healthcare utilization and health behaviors of medical aid beneficiaries in Seoul. Research Report. Seoul: The Seoul Institute; 2017 Dec. Report No: 2017-BR-06
  24. Majumdar UB, Hunt C, Doupe P, Baum AJ, Heller DJ, Levine EL, et al. Multiple chronic conditions at a major urban health system: A retrospective cross-sectional analysis of frequencies, costs and comorbidity patterns. BMJ Open. 2019;9(10):e029340. https://doi.org/10.1136/bmjopen-2019-029340
  25. Korea Institute for Health and Social Affairs. 2014 survey of living conditions and welfare needs of Korean older persons. Sejong City: Korea institute for health and social affairs, 2014. Report No.:11-1352000-001426-12.
  26. Choi IY, Hwang MS. Impediment in activity of daily living and social support for rural elderly farmers undergoing nerve block due to low back pain. Journal of Korean Academy of Community Health Nursing. 2019;30(2):206-216. https://doi.org/10.12799/jkachn.2019.30.2.206
  27. Burns A, Davenport A. Functional status of elderly adults receiving dialysis. The New England Journal of Medicine. 2010; 362(5):468-469. https://doi.org/10.1056/nejmc0911236
  28. Nam EJ, Park JK. The effects of chronic diseases, sleep and serotonin concentration on depression among elderly people living in the community. Journal of Korean Academy Community Health Nursing. 2020;31(4):472-480. https://doi.org/10.12799/jkachn.2020.31.4.472
  29. Yoo HW. Inpatient care focused strategy and convergence performance in hospitals. Journal of the Korea Convergence Society. 2016;7(4):59-66. https://doi.org/10.15207/JKCS.2016.7.4.059
  30. Cho BR. Korea's primary care-centered chronic disease management plan. Healthcare Policy Forum. 2018;16(3):13-19.