- Association Between Prophylactic Antibiotic Use and Surgical Site Infection Based on Quality Assessment Data in Korea.
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Kyoung Hoon Kim, Choon Seon Park, Jin Hee Chang, Nam Soon Kim, Jin Seo Lee, Bo Ram Choi, Byung Ran Lee, Kyoo Duck Lee, Sun Min Kim, Seon A Yeom
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J Prev Med Public Health. 2010;43(3):235-244.
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DOI: https://doi.org/10.3961/jpmph.2010.43.3.235
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 Abstract
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- OBJECTIVES
To examine the prophylactic antibiotic use in reducing surgical site infection. METHODS: This was a retrospective study for patients aged 18 years and older who underwent gastrectomy, cholecystectomy, colectomy, cesarean section and hysterectomy. The data source was quality assessment data of the Health Insurance Review & Assessment Service gathered from medical records of 302 national hospitals. Prophylactic antibiotic use was defined as: timely antibiotic administration or inappropriate antibiotic selection. We performed hierarchical logistic regression to examine the association between prophylactic antibiotic use and surgical site infection with adjustment for covariates. RESULTS: The study population consisted of 16 348 patients (1588 gastrectomies, 2327 cholecystectomies, 1,384 colectomies, 3977 hysterectomies and 7072 cesarean sections) and surgical site infection was identified in 351 (2.1%) patients. The rates of timely antibiotic administration and inappropriate antibiotic selection varied according to procedures. Cholecystectomy patients who received timely prophylactic antibiotic had a significantly reduced risk of surgical site infection compared with those who did not receive a timely prophylactic antibiotics (OR 0.64, 95% CI=0.50-0.83), but no significant reduction was observed for other procedures. When inappropriate prophylactic antibiotics were given, the risk of surgical site infection significantly increased: 8.26-fold (95% CI=4.34-15.7) for gastrectomy, 4.73-fold (95% CI=2.09-10.7) for colectomy, 2.34-fold (95% CI=1.14-4.80) for cesarean section, 4.03-fold (95% CI=1.93-8.42) for hysterectomy. CONCLUSIONS: This study examines the association among timely antibiotic administration, inappropriate antibiotic selection and surgical site infection. Patients who received timely and appropriate antibiotics had a decreased risk of surgical site infection. Efforts to improve the timing of antibiotic administration and use of appropriate antibiotic are needed to lower the risk of surgical site infection.
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Citations
Citations to this article as recorded by  - The effect of first- and third-generation prophylactic antibiotics on hospitalization and medical expenditures for cardiac surgery
Sung-Jin Bae, Inah Kim, Jaechul Song, Euy-Suk Chung
Journal of Cardiothoracic Surgery.2022;[Epub] CrossRef - Incidence and Risk Factors of Wound Infection in Women Who Underwent Cesarean Section in 2014 at King Abdulaziz Medical City, Jeddah
Roaa Gadeer , Nada Y Baatiah, Nourah Alageel, Mohammed Khaled
Cureus.2020;[Epub] CrossRef - Pay-for-performance reduces healthcare spending and improves quality of care: Analysis of target and non-target obstetrics and gynecology surgeries
Seung Ju Kim, Kyu-Tae Han, Sun Jung Kim, Eun-Cheol Park
International Journal for Quality in Health Care.2017; 29(2): 222. CrossRef - Comparing the Postoperative Complications, Hospitalization Days and Treatment Expenses Depending on the Administration of Postoperative Prophylactic Antibiotics to Hysterectomy
Mi Young Jung, Kyung-Yeon Park
Korean Journal of Women Health Nursing.2017; 23(1): 42. CrossRef - Risk Factors for Surgical Site Infections According to Electronic Medical Records Data
Young Hee Kim, Young-Hee Yom
Journal of Korean Academy of Fundamentals of Nursing.2014; 21(2): 151. CrossRef - Morbidity and risk factors for surgical site infection following cesarean section in Guangdong Province, China
Shi‐Peng Gong, Hong‐Xia Guo, Hong‐Zhen Zhou, Li Chen, Yan‐Hong Yu
Journal of Obstetrics and Gynaecology Research.2012; 38(3): 509. CrossRef - Overview of Antibiotic Use in Korea
Baek-Nam Kim
Infection & Chemotherapy.2012; 44(4): 250. CrossRef - The effect of surgical site infection on the length of stay and health care costs
Jin-Hee Chang, Kyoung-Hoon Kim, Soon-Man Kwon, Seon-A Yeom, Choon-Seon Park
Korean Journal of Health Policy and Administration.2011; 21(1): 44. CrossRef - Risk factors for surgical site infection in children at the teaching hospital Gabriel Touré, Bamako
A. Togo, Y. Coulibaly, B.T. Dembélé, B. Togo, M. Keita, L. Kanté, A. Traoré, I. Diakité, H. Ouologuem, G. Diallo
Journal of Hospital Infection.2011; 79(4): 371. CrossRef - The Feasibility of Short Term Prophylactic Antibiotics in Gastric Cancer Surgery
Jun Suh Lee, Han Hong Lee, Kyo Young Song, Cho Hyun Park, Hae Myung Jeon
Journal of Gastric Cancer.2010; 10(4): 206. CrossRef
- Cost-of-illness Study of Asthma in Korea: Estimated from the Korea National Health Insurance Claims Database.
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Choon Seon Park, Hye Young Kang, Il Kwon, Dae Ryong Kang, Hye Young Jung
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J Prev Med Public Health. 2006;39(5):397-403.
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We estimated the asthma-related health care utilization and costs in Korea from the insurer's and societal perspective. METHODS: We extracted the insurance claims records from the Korea National Health Insurance claims database for determining the health care services provided to patients with asthma in 2003. Patients were defined as having asthma if they had > or =2 medical claims with diagnosis of asthma and they had been prescribed anti-asthma medicines. Annual claims records were aggeregated for each patient to produce patient-specific information on the total utilization and costs. The total asthma-related cost was the sum of the direct healthcare costs, the transportation costs for visits to healthcare providers and the patient's or caregivers' costs for the time spent on hospital or outpatient visits. RESULTS: A total of 699,603people were identified as asthma patients, yielding an asthma prevalence of 1.47%. Each asthma patient had 7.56 outpatient visits, 0.01 ED visits and 0.02 admissions per year to treat asthma.The per-capita insurance-covered costs increased with age, from 128,276 Won for children aged 1 to 14 years to 270,729 Won for those aged 75 or older. The total cost in the nation varied from 121,865 million to 174,949 million Won depending on the perspectives. From a societal perspective, direct healthcare costs accounted for 84.9%, transportation costs for 15.1% and time costs for 9.2% of the total costs. CONCLUSIONS: Hospitalizations and ED visits represented only a small portion of the asthma-related costs. Most of the societal burden was attributed to direct medical expenditures, with outpatient visits and medications emerging as the single largest cost components.
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- Association of Hospital Procedure Volume with Post-Transplant Survival for Allogeneic Bone Marrow Transplantation.
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Choon Seon Park, Hee Kyung Moon, Hye Young Kang, Yoo Hong Min, Woo Hyun Cho
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J Prev Med Public Health. 2004;37(1):26-36.
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To examine the association between hospital procedure volume and treatment outcomes following allogeneic bone marrow transplantation (allo-BMT). METHODS: Out of 1, 050 patients who received allo-BMTs between 1998 and 2000 in 21 Korean hospitals, 752 with first allo-BMT and complete data were included in this study. Study subjects were divided into the following three groups according to cumulative hospital experience of all-BMTs during the study period: low (< 30 cases), medium (30-49) and high (> or =50 cases) volume. Patient outcome was defined as early survival at day 100 and one-year survival. Multiple logistic regression analyses were performed to examine the association between hospital experience and survival at day 100 and one year. RESULTS: When the low volume group was defined as the reference group, the adjusted relative risks (RR) of survival at day 100 for the high volume group were 2.46 (95% CI, 1.13-5.36) for all patients, 2.61 (1.04-6.57) for those with leukemia, and 2.20 (0.47-10.32) for those with aplastic anemia. For one-year survival, adjusted RR for the high volume group were 2.52 (1.40-4.51) for all patients, 1.99 (1.01-3.93) for leukemia, and 6.50 (1.57-26.80) for aplastic anemia. None of the RR for the medium volume group was statistically significant. Patient factors showing significant relationship with survival were donor-recipient relation, human leukocyte antigen matching status, time from diagnosis to transplant, and disease stage. CONCLUSION: The study results suggest that the cumulative experience of hospitals in providing allo-BMT is positively associated with patient survival.
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- Current Status of Hospital-based Health Promotion Programs in Korea and the Factors Influencing Their Introduction.
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Sang Gyu Lee, Choon Seon Park, Myung Guen Kang, Myung Il Hahm, Soon Young Lee, Woo Hyun Cho
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Korean J Prev Med. 2001;34(4):399-407.
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To investigate the current status of hospital-based health promotion programs in Korea and to elucidate the factors which affect to the process of implementation. METHODS: We conducted a mail survey of all 875 hospitals in Korea from March to May 2001. In reference to 12 specific kinds of health promotion programs, hospital CEOs were asked whether their hospital have such programs, whether they are fully staffed and whether the program is paid for by the patients. Contextual factors(location, hospital type, number of beds, length of operation, public/private status, economic level of the community, the level of competition) and organizational factors (the extent of market, compatibility with vision, formalization), strategic types of the CEOs (defender/analyser/prospector) were also surveyed. The relationships between each variable and the implementation of health promotion services, activation of services, and the target groups(patient/community resident) were analyzed by univariate analysis and the independent effects of these variables were examined with multiple logistic regression. RESULTS: 106 of 125 hospitals responding (84.8%) had more than one health promotion program. However, they showed fluctuations in the adoption rate of each programs, meaning that comprehensive health promotion services were not provided. Many programs were not fully staffed and few hospitals had paid programs. In factors affecting health promotion service implementation, private hospitals showed a higher rate in implementation than public hospitals. In contrast, when the competition among nearby hospitals was intense, the level of implementation of service lowered. In the strategic type of the CEOs, the prospectors were shown to have instituted more health promotion programs in their hospitals and the analysers had a greater tendency to have programs for community residents than the defenders. CONCLUSION: Considering the above results, contextual factors may contribute greatly to the introduction of health promotion services in Korean hospital, although the CEO's personal preference and organizational factors play a larger role in the activation of services. Additionally, the CEO's personal preference may be the major influencing factor in the introduction of programs for community residents.
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