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KMID : 0377619740260060657
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Korean Jungang Medical Journal
1974 Volume.26 No. 6 p.657 ~ p.664
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An Analysis of Mortality for Inpatients at the Severance Hospital:1971~1972
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Lee Dongwoo
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Abstract
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This study presents some results of a statistical analysis of mortality for hospitalized inpatients at the Severance Hospital during the period of 19711972.
The objectives of this study are mainly two-fold
Firstly, the immediate objective is a better understanding of the implications of the probabilities of being discharged as cured or dead from _the Hospital, and Secondly, the underlying consideration is to provide a base for building probabilistic models of the distribution of short-stay hospitalized patients.
As the probability of being discharged as dead is a functional variable of the probability of being discharged as cured from the same hospitalized population, measurement of the level of the mortality is estimated in terms of the probability of being discharged as cured in order to provide a better understanding of the impact of hospitalization.
The principal method for measuring the probability of being discharged as cured is from applying a life table model of single decrement.
The total death ratio was 2.6 percent in 1971, and 2.4 percent in 1972. More than half of these deaths (57.6 percent in 1971, 50.8 percent in 1972) occurred within two days of hospitalization. On the other .hand, the probability of being discharged ,as cured during the first week after hospitalization was found as 0. 50505 in 1971 and 0. 45589 in 1972. The average expectation of remaining in the hospital was 1.8 weeks (or 12 days) in 1971 and 1. 9 weeks (or 13 days) in 1972. During the first fourteen days after hospitalization, the probabilities as cured were 0. 7519 in 1971 and 0.7251 in 1972.
The modal lengths of short-stay were six days for males and : four days for females in both 1971 and 1972. Arithmetic average lengths of short-stay were seven days for males and six days for females in both 1971 and 1972.
Various analyses of the short-stay hospital records and measurement of theprobability of being discharged as cured or dead provide not only basic data for planning, management and evaluation of hospital administration, but also indirectindices needed in assessing improvement of medical techniques and facilities.
One of the effective ways of analyzing medical records for measurement of´ the probability of being discharged as cured or dead is to develop a probabilisticmodel for generating hospital admissions, durations of stay, and discharges for - a given population. This approach could lead to relatively inexpensive evaluation of the effects of alternative procedures and eventually to more efficient and accurate procedures for the continuous collection and estimation of hospital. admission and discharge statistics.
The initial probability model for hospital admission was developed by Chiangin 1965, which was primarily due to an exposure to research on a mathematical model of an index of health. Later, a simplified model was fitted as a Poisson_
process by assuming the probability of the individual being hospitalized for a short time interval is independent of the number of previous hospital admission for the individual. The Department of Health, Education and Welfare of ´theUnited States´ government recently developed a log-normal distribution model to. obtain an appropriate theoretical distribution for duration of hospital short-stay.
The life table model, in general, is applicable to measure probability of an event decreasing over time by movements outwards of a particular type with no. returns. Therefore, this technique has been applied extensively to other situations in recent years. Examples are: mortality from specific diseases, first marriageby age, lengths of time in hospital, survival after operation, wearing out of equipment, and so on (Case, 1956; Johnson, 1956; Potter, 1967).
In Korea, Lee (1970) measured probabilities, by applying the life table model, of being discharged as cured from the Severance Hospital for short stays during the period 1967 to 1969.
This study attempts to analyze deaths and to measure the probability of being discharged as cured from the same hospital for the period 1971-1972.
MATERIAL
The principal source of information in this report is the Severance Hospital´s file´ of existing patient medical discharge records. From this record?a census was undertaken for the whole existing records in order to obtain the patient´s statistical information on the characteristics- of his hospitalization from April. 1972 to March 1973.
However, the scope of the survey is limited to consider the length of short stay.
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