The Variation Factors of Severity-Adjusted Length of Stay in CABG

Kim, Sun-Ja; Kang, Sung-Hong; Kim, Won-Joong; Kim, Yoo-Mi

Journal of Korean Society for Quality Management > Volume 39(3); 2011 > Article

Journal of Korean Society for Quality Management 2011;39(3): 391-.

관상동맥우회술 시행환자의 중증도 보정 재원일수 변이에 관한 연구

김선자¹, 강성홍², 김원중², 김유미³

¹서울아산병원
²인제대학교 보건행정학과
³상지대학교 의료경영학과

The Variation Factors of Severity-Adjusted Length of Stay in CABG

Sun-Ja Kim¹, Sung-Hong Kang², Won-Joong Kim², Yoo-Mi Kim³

¹Asan Medical Center
²Department of Health Policy and Management, Inje University
³Department of Health Policy and Management, Sangji University

ABSTRACT

Our study was carried out to analyze the variation factors of severity-adjusted length of stay(LOS) in coronary artery bypass graft(CABG). The subjects were 932 CABG inpatients of the Korean National Hospital Discharge In-depth Injury Survey from 2004 through 2008. The data were analyzed using $x^2$ test and the severity-adjusted model was developed using data mining technique. The results of the study were as follows: male(71.1%), older than 61 years of age(61.6%), more than 500 beds(92.8%) and admitting via ambulatory care(70.0%) appeared to have higher rate than otherwise. In-hospital mortality of CABG inpatients was 2.8%. In addition, 46.4% of the patients received their care in other residence. The angina pectoris(45.6%) was found to be the highest in principle diagnosis, followed by chronic ischemic heart disease(36.9%) and acute myocardial infarction(12.0%). We developed severity-adjusted LOS model using the variables such as gender, age and comorbidity. Comparison of adjusted values in predicted LOS revealed that there were significant variations in LOS by location of hospital, bed size, and whether patients received the care in their residences. The variations of LOS can be explained as the indirect indicator for quality variation of medical process. It is suggested that the severity-adjusted LOS model developed in this study should be utilized as a useful method for benchmarking in hospital and it is necessary that national standard clinical practice guideline should be developed.

Key Words: Coronary Artery Bypass Graft;Data Mining;Decision Tree;Length of Stay;Severity-Adjustment;