이화여자대학교 의과대학 부속병원에 있어서의 최근 5개년간 (1971-1975)의 입원환자에 관한 조사연구

Abstract

한 地域社會住民의 病原利用에 관하여 調査硏究하는 것은 合理的인 病院運營의 施策을 導出할 뿐 아니라 더 나아가서는 國民保健에 이바지 하는데에 重要할 것이다. 특히 病院 入院患者의 人口學的特性, 入院期間, 治療結果, 退院率의 測定은 病院行政의 計劃, 豫算 및 評價에 必要한 基本的인 資料가 되며, 醫療技術 및 病院運營 向上에 대한 間接的 評價 資料가 된다. 이에 著者는 梨花女子大學校 醫科大學 附屬病院에 入院한 患者중에서 1971年1月1日부터 1975年12月31日까지 5個年 동안의 退院患者 20,969名을 調査對象으로 정하고, 退院 患者의 退院記錄簿를 통해서 患者의 性, 年令, 入院期間, 退院當時의 結果등의 變數에 대해서 資料를 蒐集하고 分析하여 다음과 같은 結論을 얻었다. 1. 年度別 退院患者의 男女 分布狀況은 1971~1975年에 있어서 男子患者가 22.2%~35.4%의 範圍로 分布되었고, 女子患者는 64.6%~77.8%를 차지하여 女子患者가 훨씬 많았음을 관찰할 수 있었다. 年度別로 본 男女 構成比率은 1971年에 女子患者가 77.8%이고 1975年에는 67.6%로 계속 감소되었으며 상대적으로 男子患者가 증가되었다. 年齡別 分布는 男女를 合하여 25~29歲에서 全體年度에 있어서 22.7%~30.4%를 차지하며 가장 高率을 나타내고 있었다. 2. 平均入院期間은 6.5~8.9日로서 年度에 따라 약간 길어지는 傾向을 나타내고 1日이나 2日의 짧은 入院期間을 除外하고는 對數正規分布(log-normal distribution)를 나타내고 있었다. 性別入院期間은 女子患者보다 男子患者에서 약간 길었다. 3.退院 當時 患者의 治療結果는 完治 또는 回復되는 患者가 87.4%~92.2%를 차지하여 대부분이 好轉狀態로 退院되는 것을 觀察할 수 있었다. 4. 治療中斷 및 治療變更率은 1971年에 있어서는 入院期間 1週 以內에서는 變更率이 9.5%로 가장 높았고, 1972~1975年에서는 1週 以內에 變更率이 4.4~5.7%로 分布되어 있었다. 全體年度에 있어서는 入院期間 1週以後부터는 變更率이 低下되는 것을 관찰할 수 있었다. 5. 回復 및 完治의 退院確率은 1週初에 退院하는 患者數가 全體年度에 있어서 60.4~66.9% 차지하고 있음을 관찰할 수 있었다. 平均殘餘入院期間은 1971年에 있어서는 入院期間 0~4週까지(각 週別에 있어서) 약 1週間이나 入院期間 5週以後 부터는 平均殘餘入院期間이 1~3週로 延長되었으며, 1972~1975年에 있어서는 入院 1週 初에서만이 平均殘餘入院期間이 1週間이고, 1週 以後부터는 2~3週間의 平均殘餘入院期間을 가지는 것을 보아 年度에 따라 入院期間이 약간 길어지는 傾向을 나타내고 있었다. 6. 入院期間別 死亡比率은 全體年度에 있어서 1週 以內에 死亡者가 1.5%~1.6%로 가장 高率을 나타내고 있었으며 年度에 따라 死亡者의 比率이 약간 높아지는 傾向을 보였다. ; The purpose of studying the nature and trend of hospital utilization of inhabitants in a given community is to find better and more efficient methods of hospital management in order to provide logical avenues to promote our national health. The proper analysis of short stay hospital records and measurement of the probability of discharged as cured provide not only the basic data for planning, management and evaluation of hospital administration but also give indirect suggestions needed in assessing improvement of medical techniques and facilities. The author deals with the case records of 20,969 patients hospitalized from January 1, 1971 to December 31, 1975 at Ewha Womans University Hospital. The study is focused on the general characteristics of the patients, length of stay and the discharge status. The statistical analysis of the study shows: 1) As for the sex ratio of the patients in this period 1971 and 1975, female patients outnumber male. Examining the sex ratio in each year the study period, the highest female admission rate was 77.8% and the lowest 64.6% as compared with 35.4% for the highest male rate and 22.2% for the lowest. As for age distribution, the largest age group which is between 25-29, represents a range of 22.7% to 30.4% in any one year. Both males and females are included in each group. 2) Though the statistics show a slight upward trend as the year goes by, on the whole the arithmetic average length of stay is calculated to be from 6.5 to 8.9 days. Except for cases of a short stay between 1 to 2 days, the theoretical distribution reveals that of log-normal. It is also noted that a male patient shows a little longer stay than a female patient does. 3) The discharge status of the majority of patients is satisfactory. At the time of discharge, from 87.4% to 92.2% of all discharged patients are classified as cured or recovered. 4) As for the number of patients withdrawing from treatment and transferring to other hospitals, the highest rate occurs in the first week. It was 9.5% in the year 1971 and 4.4% to 5.7% in the period 1972-1975. 5) As for time of discharge, the majority of patients are discharged in the first week. In the annual statistics covering the year of this study, the percentage of patients discharged within one week of admission was 66.9% at the highest and 60.4% at the lowest. There is evidence that the expectation of average length of hospital stay in 1971 is 1 week for patients whose actual hospital stay was from 1 to 4 weeks and 1-3 weeks for those whose actual hospital stay was 5 weeks or more; in the period 1972-1975, the expectation of average length of hospital stay was 1 week for the patients whose actual hospital stay was 1 week and 2-3 weeks for those remaining over 1 week. 6) As for the death rate of patients in terms of their length of stay, the highest rate is in the first week showing 1.5% to 1.6%. This rate increases slightly for each succeding year.