ABSTRACT
OBJECTIVE: The purpose of this study was to improve accessibility to nursing care by clarifying the relationship between patient characteristics and the amount of nursing care for the Diagnosis Procedure Combination system (DPC). METHOD: The subjects included 528 lung cancer patients; 170 gastric cancer patients; and 91 colon cancer patients, who were hospitalized from July 1, 2008, to March 31, 2010, at a university hospital. The patients were categorized into groups according to factors that could affect the amount of nursing care. Next, the relationship between the patient characteristics and the amount of nursing care was analyzed. Then the results from this study were used to classify patient characteristics according to the patient type and the amount nursing care required. RESULTS: The patient characteristics, which affected the amount of nursing care, varied according to each DPC code. The major factors affecting the amount of nursing care were whether the patient had received a surgical (under general anesthetics) treatment or a non-surgical treatment and the level of activities of daily living (ADL) of the hospitalized patients. For those who had received a surgical operation for colon cancer, the patient's age also affected the amount of nursing care. CONCLUSIONS: The findings show that the method for the visualization of the amount of nursing care based on the classification of patient characteristics can be implemented into the electronic health record system. This method can then be used as a management tool to assure appropriate distribution of nursing resources.
Subject(s)
Colonic Neoplasms/nursing , Health Services Accessibility/statistics & numerical data , Hospital Information Systems , Lung Neoplasms/nursing , Nursing Staff, Hospital/statistics & numerical data , Stomach Neoplasms/nursing , Activities of Daily Living/classification , Age Factors , Aged , Current Procedural Terminology , Female , Health Services Accessibility/classification , Hospitals, University , Humans , Japan , Male , Middle Aged , Nursing Assessment/classification , Nursing Assessment/statistics & numerical data , Nursing Records/classification , Nursing Records/statistics & numerical data , Patient Care Planning/standards , Patient Care Planning/statistics & numerical data , Resource Allocation/classification , Resource Allocation/statistics & numerical dataABSTRACT
OBJECTIVES: To develop a data warehouse system for cost analysis, based on the categories of the diagnosis procedure combination (DPC) system, in which medical costs were estimated by DPC category and factors influencing the balance between costs and fees. METHODS: We developed a data warehouse system for cost analysis using data from the hospital central data warehouse system. The balance data of patients who were discharged from Kagoshima University Hospital from April 2003 to March 2005 were determined in terms of medical procedure, cost per day and patient admission in order to conduct a drill-down analysis. To evaluate this system, we analyzed cash flow by DPC category of patients who were categorized as having malignant tumors and whose DPC category was reevaluated in 2004. RESULTS: The percentages of medical expenses were highest in patients with acute leukemia, non-Hodgkin's lymphoma, and particularly in patients with malignant tumors of the liver and intrahepatic bile duct. Imaging tests degraded the percentages of medical expenses in Kagoshima University Hospital. CONCLUSIONS: These results suggested that cost analysis by patient is important for hospital administration in the inclusive evaluation system using a case-mix index such as DPC.
Subject(s)
Costs and Cost Analysis , Databases as Topic , Diagnosis-Related Groups/economics , Health Care Costs , Hospital Administration/economics , Computers , Humans , Japan , Liver Neoplasms/economics , SoftwareABSTRACT
We report two sisters with hereditary deficiency of the third complement component (C3) and a homozygous mutation at C3303G (Tyr1081Stop) of the gene. They developed systemic lupus erythematosus-like symptoms during adolescence. Their C3 were not detected in serum immunochemically. Their mother and a brother had half of the normal C3 levels and a heterozygous mutation in the same position. Western blot analysis of murine L-cells transfected with the mutant C3 cDNA showed no C3 protein, however mRNA was detectable using reverse-transcriptase polymerase chain reaction. To the best of our knowledge, this is the first report of C3 deficiency due to a stop codon in the gene.
Subject(s)
Codon, Terminator/genetics , Complement C3/deficiency , Complement C3/genetics , Mutation , Adolescent , Adult , Blotting, Western , Cysteine/metabolism , Female , Glycine/metabolism , Homozygote , Humans , Lupus Erythematosus, Systemic/genetics , Molecular Sequence Data , RNA, Messenger/analysis , Reverse Transcriptase Polymerase Chain Reaction , Transfection , Tyrosine/metabolismABSTRACT
Out university hospital, includes a LAN (Local Area Network) and uses network services such as WWW(World Wide Web). We have constructed an MRI diagnostic reporting system on the Internet in which interactive date management was established on WWW by using CGI (Common Gateway Interface) software. Linking database information such as MRI reports with WWW browsers using by CGI provides easy data access to the database and offers hypertext and searching. This system suggests the possibility of creating a cheaper and more flexible network using Internet technology.
