• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제27권1호
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• pp.7-15
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• 2021

Purpose: This study analyzed the architectural planning factors of the ward in infectious disease hospitals, such as functional unit planning, ward configurations, spatial compositions & circulation, and detailed architectural planning. Through these, the facility guidelines of infectious disease hospitals are summarized, focusing on the differences from the wards of non-infectious hospitals. Methods: This study was conducted by literature review of research reports, papers, design cases, and guidelines, based on the experiences of field surveys for infectious disease hospitals. Results: The result of this study can be summarized into a few points. 1) Infectious disease hospitals need to establish an operation plan with the concept of continuity of care, as an extension of existing facilities. 2) The types of ward configuration for infectious disease hospitals has many variables, so an appropriate type should be selected according to the hospital's operating policy. 3) Various spatial composition types of the ward can be planned by the arrangement of traffic cores and areas of patient groups. At this time, the main planning considerations are safety, efficiency, and comfort. 4) As elements of the detailed plan, It is necessary to consider the types & dimensions of patient rooms, the relationships between nursing stations & sub-stations, and supplementations of medical support functions & convenience facilities. Implications: Since there are many differences in function from the ward of non-infectious hospitals, appropriate facility guidelines for infectious disease hospital are required.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제27권4호
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• pp.29-39
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• 2021

Purpose: As the need for a hospital specializing in infectious diseases has increased, construction is being promoted. Hospitals specializing in infectious diseases receive some state subsidies, but in the case of private hospitals, hospital operation efficiency should be considered to prevent cost loss. Therefore, we aim to derive a building plan for a general ward in a hospital specializing in infectious diseases that can be used not only in normal times but also in times of crisis. Methods: In this study, relevant literature review and field interviews were conducted with medical staff working in facilities designated as infectious disease hospitals. Results: The general ward building plan of the hospital specializing in infectious diseases was classified into three categories and presented. 'Spatial composition' for nursing unit and ward zoning, 'Spatial plan' for ward space conversion in normal times and crises, 'Bedroom plan' for effective dimensions and area of the ward. Implications: It can be used as a guideline when designing an infection-facility ward. And it can be a basis for inducing improvements to prevent infection in the ward of existing medical facilities.

• 한국농촌건축학회논문집
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• 제26권2호
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• pp.73-84
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• 2024

This study investigated the outpatient departments of Infectious Disease Hospitals by Region, which play an important role in establishing regional medical networking, to find a spatial structure that can provide a safe environment for efficient diagnosis and treatment, as well as a rational medical procedure in case of crisis. Department layout and adjacencies were derived by considering the access procedures according to patient classification, medical procedures by department, and connectivity with other departments. Based on the results derived by setting up zones according to infection control, activities, and objects, and analyzing the division of zones, the composition of areas by activities, movement flows by objects and treatment units, it can be used as basic data for the architectural plan of the Infectious Disease Hospital. Also, there are implications that can be used as basic data for planning related facilities by analyzing spatial relationships according to user behavior.

• 월간당뇨
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• 통권216호
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• pp.19-23
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• 2007

신장내과를 전문 과목으로 선택하여 대학병원에서 10여년 가까이 환자를 진료하면서 아침에 회진을 할 때면 저는 전공의 들에게 "어제 입원한 환자는 당뇨병성 신증 환자인가"라고 먼저 묻는 경우가 많습니다. 그 이유는 당뇨병으로 합병된 신장병, 혹은 당뇨병환자에서 혈관질환과 감염 질환이 동반될 경우 치료도 어렵고 임상 경과가 악성 경과를 밟으며 예후가 좋지 않기 때문입니다. 또한 당뇨병으로 인한 말기 신부전증이 최근 무섭게 증가되고 있기 때문이기도 합니다. 따라서 당뇨병성 신증의 조기 발견과 적절한 치료는 아무리 강조해도 지나침이 없습니다. 저는 여기서 최근 가장 가슴이 아팠던 사례를 간단히 소개하고 당뇨병성 신증의 원인, 예방과 치료를 서술하고자 합니다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권2호
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• pp.17-29
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• 2022

Purpose: In terms of efficiency and safety, this study attempted to organize data on the operation methods and architectural planning of infectious diseases hospitals. Methods: The results obtained through on-site and interview surveys with hospital officials and medical staffs at four infectious diseases hospitals under construction were summarized based on those original business plans and facility guidelines. Results: First, the operational methods to secure safety and operational efficiency were summarized for each department which are major hospital functions of infectious disease hospitals. Second, as the architectural planning, the characteristics of space and circulation of each department are summarized. For safety of medical staff, negative pressure and non-negative pressure zone have to completely separated. In addition medical staff wears PPE and enters the negative pressure zone and returns in the order of admiral, shower, and gowning in the PPE undressing room after patient treatment. In case of operational efficiency, flexible operation is required in normal and crisis situations. For example, it is important for The Ward to gradually switch to negative pressure beds in times of crisis from normal situation and the outpatient department considers the composition of negative pressure and non-negative pressure outpatient spaces that can operate in parallel even in crisis situations. Implications: Infectious disease hospitals require flexible operation and appropriate facilities for normal and crisis situations.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권3호
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• pp.27-38
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• 2022

Purpose: This study tried to present basic data for establishment of facility guidelines and facility certification standards for the comprehensive prevention of infectious diseases in buildings. Methods: This study examines the concept of architectural countermeasures for the prevention of infectious diseases through literature reviews, and then classifies and organizes the countermeasures by viewing the infectious diseases hospitals as the top-level facility in terms of responding to infectious diseases. Results: At first, this study categorized and organized infection prevention countermeasures of infectious disease hospitals, which are the highest level facilities in terms of response to infectious diseases. And by presenting the concept of step-by-step setting of countermeasures for general buildings such as welfare facilities and multi-use facilities, which are lower-level facilities in the aspect of prevention of infectious diseases, this study tried to present basic data for establishing facility guidelines and facility certification standards for comprehensive prevention of infectious diseases in buildings. Implications: In the future, it is expected that spatial changes for the prevention of infectious diseases will spread to general constructions such as public buildings, private buildings, and multi-use facilities, and comprehensive infection prevention facility guidelines are needed.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제29권3호
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• pp.17-28
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• 2023

Purpose: This study aims to provide basic data for the future construction plans of the Infectious Disease Hospitals by analyzing the area composition and required room ratios in the wards and ICU of currently under-construction infectious disease hospitals. Methods: 3 Methods have been used in this paper. 1) This study conducted a literature review on major considerations and related guidelines for hospitals specializing in infectious diseases using existing data. 2) Based on the objects and activities of the hospital space, zones and areas were set for each department according to infection control. 3) Based on the established zones and areas, basic plan drawings of three hospitals specializing in infectious diseases currently under construction were collected and architectural drawing analysis was performed. Results: 1) Infectious Diseases Hospital must have a spatial organization that can accommodate patient isolation, infection control, efficiency of medical service, and changes. 2) Zones for infection control are divided into negative pressure and non-negative pressure zones based on airborne precaution isolation. It is divided into clean and contaminated zone according to class of cleanliness by Aseptic technique. Areas are classified by objects (patients, healthcare workers, supplies) and activities (access, medical treatment, support), and a system for organizing space is established based on this. 3) By analyzing the area composition of each departmental area, each required room, and each required space in the wards and intensive care units, it provides basic data for the spatial organization for architectural planning of the infectious disease hospital. Implication: It can be used as basic data when planning related facilities by analyzing the characteristics of the space plan of the required room according to the relationship between activities, movement lines, and operation plans based on user behavior.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제25권4호
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• pp.81-91
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• 2019

Purpose: Since infectious disease hospitals are premised on emergency operations, the operational efficiency of secured personnel, equipment, facilities, etc. is relatively low. In order to increase such normal operational efficiency, it is necessary to flexibly operate facilities and operations during normal and emergency times. The purpose of this study is to suggest the architectural planning method focusing on the space composition and circulation of the regional infectious disease hospital which can increase the operational efficiency in the private hospitals. Methods: Through literature review, functional requirements of infectious disease hospitals were identified, and related personnels inter-views and field surveys were conducted to understand the spatial composition and circulation requirements of infectious disease hospitals. Results: Through the complete separation between the negative pressure zone and the general zone, even when the negative pressure zone is completely closed, the general zone should be operated separately to achieve operational efficiency. In addition, the separation of the negative pressure zone and the general zone should simultaneously consider the optimal space configuration and movement for each function while the zone settings match in the floor plan of each department and the overall cross-sectional configuration of the hospital. Implications: Infectious disease hospitals intended to be installed in private hospitals should not apply excessive space just for safety reasons and should plan to ensure their operational efficiency.

• 의료법학
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• 제16권2호
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• pp.263-291
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• 2015

2015년 5월 중동 사우디아라비아와 아랍에미레이트를 다녀온 68세의 남자가 고열, 근육통, 기침 호흡곤란으로 자택부근 2개 병원)과 삼성서울병원(SMC) 응급실을 거치면서 시작된 메르스(MERS)라는 전염병은 거의 3개월에 걸쳐 최근까지 대한민국을 유행성 전염병의 공포로 몰아넣었다. 특히 이 전염병은 중동지역 아라비아 반도를 중심으로 2012년 9월부터 현재까지 총 26개국에서 1,392명에게 발생하여, 538명의 사망환자가 보고(유럽질병센터, 2015.7.21. 기준)되었고, 우리나라의 경우에도 총 확진자 186명, 사망자 36명(치사율 19.4%) 격리자 16,693명이라는 기록을 남기고 점차 우리의 뇌리에서 사라져가고 있다. 이 전염병의 파급으로 인하여 현 정부의 전염병 관리체계에 대한 많은 비판과 문제점을 제기하는 계기가 되었다. 특히 병원내 감염문제, 민간의료기관-지역 보건소-질병관리본부를 연결하는 감염병 관리전달체계의 미작동, 정부의 전염병과 관련된 정보 공개 거부, 냉난방 공조설비의 환기 등과 관련된 시설문제, 감염병 격리병상의 절대부족 문제, 지역보건소의 기능 및 권한의 제한문제, 격리자 및 의료기관에 대한 보상문제, 제도적으로는 감염병에 대한 건강보험 수가 개선문제, 법정감염병 재분류 문제, 질병관리본부의 역할 재정립 문제, 전염병 관련 전문인력 양성을 위한 제도적 보완문제, 병원 이용문화의 개선으로서 다인실 조정과 간병인 대체문제, 사회적 후유증을 치유하기 위한 정책적 배려문제 등이 있으며, 이에 대한 광범위한 논의와 해결방안이 필요한 때이다. 국민들은 2015년 5월 이전에는 아주 낯설었던 메르스라는 외부유입 전염병에 국가 방역체계가 흔들리는 모습을 보고 극도의 공포감을 느꼈으며, 외국에서는 중동지방을 제외하고는 전세계적으로 유례가 없는 메르스라는 전염병이 대유행하는 대한민국에 발길을 끊었다. 국민의 건강권이 심각하게 위협받았음은 물론이고 관광산업과 유통업계 등의 경제도 얼어붙었다. 정부는 메르스라는 전염병 확산의 초기대응 실패를 인정하고, 사태를 악화시킨 점에 대한 책임을 통감하여야 한다. 국민들에 대한 신뢰상실을 반성하고 향후 각종 필요한 정보를 공개함으로써, 메르스와 같은 전염병에 대한 정부정책을 투명하게 집행하고, 지방자치단체와 국민들이 지역사회 감염에 대처하고 확산방지에 나설 수 있도록 제도를 개선하며, 변경된 제도를 홍보하여 전염병 전파 예방에 노력해야 할 것이다.

• 지역연구
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• 제37권1호
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• pp.3-14
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• 2021

코로나19 이후 공공의료시설, 특히 감염병전문병원의 중요성이 높아졌다. 그러나 메르스 사태 이후 정부의 강력한 정책의지에도 불구하고 공공의료시설과 감염병전문병원의 공급은 충분히 이뤄지지 않았다. 여러 가지 이유가 있겠지만 가장 큰 문제로 대두된 것이 바로 사회·경제적 변화와 시대의 흐름을 충분히 반영하지 못한 예비타당성조사이다. 본 연구의 목적은 공공의료시설과 관련된 현행 예비타당성조사제도의 문제점을 도출하고 그 대안을 제시하는 것이다. 본 연구는 그 대안으로 '선택가치'를 제안한다. 선택가치는 불확실한 상황에 대한 지불의 사이므로 감염병에 대비한 공공의료시설의 편익항목으로 반영하는 것이 학술적으로 가능하다. 선택가치는 비시장 재화이므로 조건부가치추정법과 선택모형을 통해 추정가능하다. 본 연구에서는 두 가지 방법론의 장단점과 활용대안을 제시하였다. 일상에서는 그 존재가치가 보이지 않지만 위기 상황에서 나타나는 것이 바로 의료와 보건시스템이다. 따라서 의료·보건분야의 예비타당성평가에서도 보이지 않는 편익을 찾고, 후생변화를 반영할 수 있는 방법론 개발이 지속적으로 이뤄져야 할 것이다. 본 연구가 그 촉매제가 될 것으로 기대한다.