Critérios relacionados à alta hospitalar segura do recém-nascido: Uma revisão integrativa

Objetivo: Identificar os principais critérios evidenciados pela literatura científica envolvidos na alta hospitalar segura do recém-nascido. Método: Trata-se de uma revisão integrativa da literatura, realizada em dezembro de 2021 nas bases de dados Pubmed/ Medline, BVS, Scopus, Lilacs, utilizando-se os descritores "patient discharge summaries" OR "patient discharge" AND "newborn". O estudo foi fundamentado pelos procedimentos metodológicos PRISMA, foram adotados critérios de elegibilidade, critérios de inclusão: artigos disponíveis na íntegra, publicados nos últimos 5 anos, nos idiomas inglês, espanhol e português que versassem sobre cuidados ao recém-nascido, alta hospitalar ou alta do paciente neonatal. E de exclusão: todos os artigos que não atendiam ao objetivo da pesquisa e ou não possuíam relação com o tema em estudo. Resultados: Dos 94 artigos identificados entre 2017 e 2021 foram incluídos 12 estudos, sendo a maioria do Brasil e de abordagem qualitativa. Foram estabelecidas três categorias temáticas de análise: 1) Parâmetros biofisiológicos; 2) Comunicação e orientação aos pais: fragilidades e potencialidades da família; e 3) Cuidados pós alta e seguimento de rede. Conclusão: De acordo com a bibliografia selecionada está concluído que a alta hospitalar segura de recém-nascidos requer atenção aos aspectos fisiológicos, de comunicação com a família e intersetorial para seguimento de rede.

Objetivo: Identificar los principales criterios evidenciados por la literatura científica involucrados en el alta hospitalaria segura del recién nacido. Método: Revisión integrativa de la literatura, realizada en diciembre de 2021 en las bases de datos Pubmed/Medline, BVS, Scopus, Lilacs, utilizando los descriptores "patient high summaries" OR "patient high" AND "newborn". El estudio se basó en los procedimientos metodológicos PRISMA, se adoptaron criterios de elegibilidad y criterios de inclusión: artículos disponibles en su totalidad, publicados en los últimos 5 años, en inglés, español y portugués que versan sobre la atención del recién nacidos, el alta hospitalaria o el alta del paciente neonatal. Se excluyeron todos los artículos que no cumplieran con el objetivo de la investigación y/o no tuvieran relación con el tema en estudio. Resultados: De los 94 artículos identificados entre 2017 y 2021, se incluyeron 12 estudios, la mayoría de Brasil y con abordaje cualitativo. Se establecieron tres categorías temáticas de análisis: 1) Parámetros biofisiológicos 2) Comunicación y orientación a los padres: fragilidades y potencialidades de la familia y 3) Atención posterior al alta y seguimiento en red. Conclusión: Según a la bibliografía seleccionada, se concluye que el alta hospitalaria segura de los recién nacidos requiere atención a aspectos fisiológicos, de comunicación con la familia e intersectoriales para el seguimiento en red.

Objective: To identify the main criteria evidenced by the literature published on newborns' hospital discharge. Method: This is an integrative literature review, carried out in December 2021 in the PubMed/Medline, BVS, Scopus and LILACS databases, using the "patient discharge summaries" OR "patient discharge" AND "newborn" descriptors. The study was based on PRISMA methodological procedures, eligibility criteria were adopted, and the inclusion criteria were as follows: articles available in full, published in the last 5 years in English, Spanish and Portuguese and dealing with newborn care, hospital discharge or neonatal patient discharge. All articles that did not meet the research objective and/or were not related to the topic under study were excluded. Results: Of the 94 articles identified between 2017 and 2021, 12 studies were included, most from Brazil and with a qualitative approach. Three thematic analysis categories were established: 1) Biophysiological parameters; 2) Communication and guidelines for parents: weaknesses and strengths of the family; and 3) Post-discharge care: network follow-up. Conclusion: According to the selected bibliography, it is concluded that newborns' safe hospital discharge requires attention to the physiological, communication with the family and intersectoral aspects for network follow-up.

Development a New HL7 Interface Engine for Large-size Messages which Include Image Data based on Tree Structure and Streaming Algorithm / 대한의료정보학회지

The almost existing commercial HL7 interface engines apply the string array method which is run in the main memory to HL7 message parsing process. But, if the HL7 message is big, this method will be possible to cause the computer system to raise critical and fatal problems because a long string array can carry a too heavy load to the main memory and the processor. Therefore, the image and the multi-media data which are needed for the modern medical records could be limited to be included into a HL7 message because the size is usually too big in comparison with the main body of a HL7 message and in result, it make the size of the HL7 message expanded. The purpose of this study is to suggest a new HL7 interface algorithm which can solve this problem by the method of the 'Streaming Algorithm'. This new method for HL7 message parsing apply the character-stream object which process character by character between the main memory and hard disk device with the consequence that the processing load on main memory could be alleviated. The main functions of this new engine are generating, parsing, validating, browsing, sending, and receiving of message. And also, this can parse and generate XML-formated HL7 message. This engine had been practically tested in the Discharge Summary Information Exchange System between Kyungpook National University Hospital and Chonnam National University Hospital for the purpose of proofing its usability for a month. Overall, the preliminary results of this test is considered as good, but it is pointed out that some improvement is needed relating to the speed of parsing which was predicted because this engine partly used the memory of hard disk device instead of the main memory.

Hospital Database Marketing Using Discharge Summary DB: An Application of Data Mining Technique / 대한의료정보학회지

The environment of hospital management is becoming more turbulent as the government continuously puts pressure on hospitals to reduce medical expenditures while the public increasingly demands improved services. To survive in this turbulent environment, hospitals need to develop and apply various management techniques. Database marketing is considered as one of the useful tools. This paper applies the concept of database marketing by way of using discharge summary DB, and attempts to segment the customers (patients) to develop a differentiated marketing strategy for the target market. In particular, discharge summary DB for 1996-1999 of a university hostital located in Pusan, Korea, was utilized. The data were restructured for our study purpose and analyzed through the use of data mining technique. Major results are as follows: 1) Applying 'Decision Tree Model' suggests that the most important variable in determining the readmission(re-use of the hospital) was 'disease group. 2) Analyzing disease structure of readmitted patients reveals that the readmission rate was highest for the neoplasma patients; therefore, for this hospital, neoplasma patients can be considered as the target market. 3) Conducting cluster analysis on this target market shows that the neoplasma patients are classified into 4 groups: (1) 'Group I' can be named as 'sustaining customer(patient) group' in that they have visited the hospital until the most recent period. (2) 'Group II' is 'loyal customer(patient) group' in that frequency of admission and length of hospitalization are highest among the four groups. (3) 'Group III' can be named as 'departing customer(patient) group' in that the period between the discharge and the last visit of the hospital is shortest, which implies that they probably have changed the hospital or used other types of health care services after discharge. (4) 'Group lV' is 'average customer(patient) group' in that they show average loyalty in terms of frequency of admission, length of hospitalization, and the period between discharge and last visit.

Application of Survival Analysis to Data from Discharge Abstract of Medical Record Department: Focused on Readniission / 대한의료정보학회지

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.

Computerized Discharge Summary in University Hospital with Clinical Application / 대한의료정보학회지

University hospital environment requires well-structured database of discharge summary information, which is of convenient use for patient management and clinical research. The present study employed multimedia computer techniques to design a database system with application programs along with the standardized patient management flow. The usefulness of the present development was verified by practical application into the clinical environment in the Urology Department of our University Hospital. This database system included multimedia information items in various forms of image, voice, picture, graph, and chart as well as conventional text and numeric, which enabled integrated presentation of the discharge summary data of university hospital. It demonstrated a way of convenient and practical data supply for clinical diagnosis and management of patients.

Computerized Discharge Summary in University Hospital with Clinical Application / 대한의료정보학회지

University hospital environment requires well-structured database of discharge summary information, which is of convenient use for patient management and clinical research. The present study employed multimedia computer techniques to design a database system with application programs along with the standardized patient management flow. The usefulness of the present development was verified by practical application into the clinical environment in the Urology Department of our University Hospital. This database system included multimedia information items in various forms of image, voice, picture, graph, and chart as well as conventional text and numeric, which enabled integrated presentation of the discharge summary data of university hospital. It demonstrated a way of convenient and practical data supply for clinical diagnosis and management of patients.

Patient data management system for urology / 대한비뇨기과학회지

A new data management system for urologic patient was designed by composing revised discharge summary and a computer program. The revised .discharge summary consists of more detailed clinical records and maintenance of clinical records during the follow-up period post discharge. The computer program was written in FoxPro Version 2.0 and the urologic code system was developed by applying some modifications on the international classification of diseases. The present program takes major advantages in easy and errorless entry and retrieval of data. These include pull-down menus using simultaneous input and coding system without any needs of typing the required codes for problem, management, and diagnosis. Data search and case statistics can be easily obtained with any combinations of problem, management, and diagnosis. The authors consider the present system, in which the revised discharge summary and computer program were closely linked, is very useful in patient data management.