Kim M I, Kim E S, Ryu H S, Chu S K, Lee K S, Lee C K
Kanhohak Tamgu. 1993;2(1):151-78; discussion 179-80.
This report was done mid way through the study "A Demonstration-Cum-Research on the Reimbursement system and cost-effectiveness of Home Health Care Program in Korea". It focused on developing an estimation of early discharge day to home health care based on analysis medical records and on an analysis of medical expenses based on a detailed statement of treatment for inpatients who were hospitalized at S General Hospital in 1991. Two research methods were adopted for estimation of the early discharge day. One was micro-analysis from the medical records and the other was macro-analysis to clarify the estimated early discharge day to home health care for patients with four diseases judged from need assessment to be candidates for this type of program, namely patients with, Cesarean Section, Hypertension, Diabetes Mellitus, Chronic Obstructive Pulmonary Disease (COPD). Estimation of early discharge day to home health care were developed through many aspects of analysis of the signs and symptoms by disease in a micro-analysis in addition to a decrease in the amount of treatment, drugs, tests and changes in the test consistency, drug methods, and client's condition in the macro-analysis. Accordingly, an early discharge day for inpatients was finally estimated through the analysis of the client's conditions and treatment, drugs, tests, and nursing care activities that the patient received during hospitalization. From the research findings, the following summarized conclusions have drawn. First, for patients with Cesarean Sections, after assessing each items using the two analysis methods, the mean period of hospitalization was 8.8 days, but the mean period of hospitalization was estimated at 4.1 days if early discharge to home health care could be done. Second, for patients with Hypertension, the same method as for the patients with the Cesarean Sections was used and the result was reduction from a mean period of the hospitalization of 9.9 days to a mean period of the hospitalization of 5.2 days. Third, for patients with Diabetes Mellitus there was a decrease from a mean period of the hospitalization of 11.7 days to a mean period of hospitalization of 8.4 days if early discharge to home health care could be done. Fourth, for patients with Chronic Obstructive Pulmonary Disease, the mean period of the hospitalization was 14.3 days, but the mean period of the hospitalization could be 8.1 days if early discharge to home health care could be done.(ABSTRACT TRUNCATED AT 400 WORDS)
本报告是在“韩国居家医疗保健项目报销系统与成本效益的示范暨研究”这一研究进行到一半时完成的。它着重基于病历分析来估算居家医疗保健的早期出院日期，并基于对1991年在S综合医院住院的患者详细治疗清单的分析来估算医疗费用。采用了两种研究方法来估算早期出院日期。一种是对病历进行微观分析，另一种是宏观分析，以明确根据需求评估判断为该类项目候选对象的四种疾病患者（即剖宫产、高血压、糖尿病、慢性阻塞性肺疾病（COPD）患者）居家医疗保健的估算早期出院日期。在微观分析中，除了分析治疗量、药物、检查的减少以及检查一致性、用药方法和患者状况的变化外，还通过对疾病症状和体征的多方面分析来制定居家医疗保健的早期出院日期估算。因此，最终通过分析患者住院期间接受的患者状况及治疗、药物、检查和护理活动来估算住院患者的早期出院日期。从研究结果得出了以下总结性结论。第一，对于剖宫产患者，使用两种分析方法对各项进行评估后，平均住院时间为8.8天，但如果能早期出院接受居家医疗保健，平均住院时间估计为4.1天。第二，对于高血压患者，采用与剖宫产患者相同的方法，结果是平均住院时间从9.9天减少到5.2天。第三，对于糖尿病患者，如果能早期出院接受居家医疗保健，平均住院时间从11.7天减少到8.4天。第四，对于慢性阻塞性肺疾病患者，平均住院时间为14.3天，但如果能早期出院接受居家医疗保健，平均住院时间可为8.1天。（摘要截取自400字）
