• Title/Summary/Keyword: 공공의료기관

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A study on the accessibility and utilization satisfaction of health centers in rural area, Paraguay (파라과이 농촌지역의 보건소 건립 후 접근성과 이용만족도에 관한 연구)

  • Kim, Ji Eon;Chung, Min Ah;Nam, Eun Woo
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.29 no.2
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    • pp.17-26
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    • 2023
  • Purpose: The purpose of this study is to identify policy implications for the construction of public health facilities in the field of international cooperation, by examining the case of establishing a health care delivery system using a public health center in a rural area of Paraguay. Methods: Firstly, to map the capacity of the 20 public health centers that were studied, we used the WHO Capacity Mapping tool to select and analyze relevant items. Secondly, to assess the utilization of public health centers, we conducted a direct visit survey and analyzed the results using the M-survey tool. Results: The floor plan of each public health center, the structure of the health center, the size of the population served by each health center, the number of monthly visitors, medical human resources, and the budget were classified by health center for comparative analysis. In addition, by utilizing the M-survey tool, we analyzed the general characteristics of the respondents, their perceptions of the purpose and accessibility of public health centers, their satisfaction with using public health centers, and the level of demand for public health centers to play a role in promoting community health. Implications: The results of this study suggest that access to public health facilities for residents in the research area was improved. By classifying public health centers into two types, these centers can perform the functions and roles of primary health facilities. A patient request and evacuation system was established in the research area. Finally, a network, such as a social prescribing program, is needed so that public health centers can function as a "setting" for community members to live together.

Effects of Periodontal Disease on Cardio-Cerebrovascular Disease: A Focus on Personal Income and Social Deprivation (치주질환이 심뇌혈관질환 발생에 미치는 영향: 지역결핍과 개인소득을 중심으로)

  • Kim, Min-Young;Shin, Hosung
    • Journal of dental hygiene science
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    • v.17 no.4
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    • pp.375-381
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    • 2017
  • The study aimed to investigate the effects of differences between personal income and social deprivation on the association between cardio-cerebrovascular disease (hypertension, stroke) and periodontal disease. This study used 12 years of cohort data from the Korea National Health Insurance Service covering the years 2002 to 2013. Among the patients aged more than 40 years who had received treatment for periodontal disease 224,067 and 284,730 who had not received treatment for hypertension and stroke, respectively, were included in the analysis. The Kaplan-Meier analysis revealed differences in the rate of treatment for cardio-cerebrovascular disease (hypertension, stroke) according to regional differences, the rate of treatment increased as the composite deprivation index value increased. The difference in treatment rates for cardio-cerebrovascular disease (hypertension, stroke) according to income was found to be higher in the treatment group with low income. This study empirically proved that the association between systemic disease and periodontal disease varies depending on personal income and the regional socioeconomic deprivation level. This shows that the clinical influence of periodontal illness on systemic disease differs according to the personal socio-demographic characteristic and residential area and that an individual's characteristic (income and the regional) needs to be considered along with the patient's clinical intervention in the disease treatment process.

Health Economic Approach to End-of-Life Care in the US: Based on Medicare (말기의료의 경제적 요소에 관한 논의: 미국 메디케어 상황을 중심으로)

  • Suk, Ryan
    • The Korean Society of Law and Medicine
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    • v.15 no.1
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    • pp.335-373
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    • 2014
  • According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

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Probleme nach geltendem Recht „Richtlinien für die Verwendung von Gesundheitsdaten" ('보건의료 데이터 활용 가이드라인'의 현행법상 문제점)

  • Lee, Seok-Bae
    • The Korean Society of Law and Medicine
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    • v.22 no.4
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    • pp.3-35
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    • 2021
  • Inmitten der Flut der privaten und öffentlichen Information gilt die riesige Informationsmenge als Schlüsselressource im Zeitalter der 4. industriellen Revolution, repräsentiert durch Big-Data. Das Interesse an diesen wächst weltweit. Es gibt eine aktive Diskussion darüber, wie man Daten sichert und akkumuliert und wie man die gesammelten Daten sicher und effektiv nutzt. Gesundheitsdaten werden vor allem als die wertvollste Ressource bewertet, für die Big-DataTechnologie eingesetzt wird. Um Gesundheitsdaten sinnvoll zu nutzen, müssen verteilte Gesundheitsdaten integriert und den Benutzern in einer Form zur Verfügung gestellt werden, die für Forschung oder Inspektion verwendet werden kann. In einer Situation, in der große Länder um den Aufbau bzw. die Führung der Datenwirtschaft konkurrieren, wurden im August 2020 auch in Südkorea die sog. „3-Daten-Gesetze" geändert, die das Datenschutzgesetz(DSG) enthälten. Das DSG führte das Konzept der pseudonymen Informationen ein und baute eine Rechtsgrundlage für deren Verwendung auf. Als Folgemaßnahme kündigte die, Kommission für den Schutz personenbezogener Daten(Personal Information Protection Commission: PIPC)' die „Richtlinien für die Bahandlung mit pseudonymen Informationen" und, Ministerium für Gesundheit und Wohlfahrt' die „Richtlinien für die Verwendung von Gesundheitsdaten" an. Gesundheitsdaten stehen direkt in Zusammenhang mit Leben und Körper des Menschen und damit enthalten viele sensible Daten. Es handelt sich also um ein System, das aus einer vorsichtigeren und konservativeren Sicht unter der Voraussetzung verwendet werden kann, personenbezogene Daten sicherer zu schützen. Um die Hauptinhalte der „Richtlinien für Verwendung von Gesundheitsdaten" zu analysieren, überprüften wir zunächst die Hauptinhalte des überarbeiteten DSG. Danach durch die Analyse der wesentlichen Inhalte der „Richtlinien für Verwendung von Gesundheitsdaten" wurden Probleme wie Konflikte mit anderen Gesetzen und Verbesserungsmaßnahmen überprüft.

Conflicts of Interest in Research and Clinical Practice (연구 및 진료에서의 이해상충)

  • Ji Hoon Shin
    • Journal of the Korean Society of Radiology
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    • v.83 no.4
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    • pp.771-775
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    • 2022
  • Recently, doctors and researchers are establishing relationships with interested parties from companies, research institutes, health care institutions, and academic journals, instead of conducting independent medical care or research work. They may have multiple interests as an advisor or a shareholder in the relevant company. Such a situation can foster a conflict of interest when their interests influence one's decision or judgment. Conflict of interest is an extremely important issue because it can infringe the integrity of research, endanger subjects or patients, pose a risk to the public, and deteriorate public perception of science. This brief review explores the definition, examples, and solutions to conflict of interest.

A Study on the Performance Indicator Development of Public Hospital (공공의료 책임운영기관의 성과지표 개발에 관한 연구)

  • Kim, Young-Hoon;Choi, Young-Jin
    • Journal of Digital Convergence
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    • v.6 no.4
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    • pp.13-23
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    • 2008
  • Changed the business environment, private sector focuses on the performance management, so to manage the performance he uses BSC that overcomes the limitation of financial indicators. Also, it is getting emphasized to evaluate the performance about services that the public sector provides and obliged for the public sector to be responsible for managing and improving its performance as the private sector has been doing. But lacks of knowledge and experience on performance management and evaluation are blocking the public sector from introducing and implementing new performance management systems. To solve those problems, this study has derived general guidelines and KPIs that public sector should keep in mind when BSC is introduced new management system. This study focused on the public hospital which is the performance management and evaluation system of Government administration.

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개인정보보호 참조 아키텍처와 국제표준화 동향

  • Shin, Yong-Nyuo;Kim, Hak-Il;Chun, Myung-Geun
    • Review of KIISC
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    • v.21 no.5
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    • pp.12-20
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    • 2011
  • 개인정보보호법이 전면적인 법 시행을 앞두고 있고 지금까지 규제대상이 아니던 기업 종업원의 개인정보는 물론, 종이 문서형태의 개인정보까지를 규제대상으로 삼고 있어 개인정보보호 시장이 크게 확대될 것으로 전망된다. 규제범위도 정보통신, 교육, 의료, 금융 분야까지 다루고 있어서, 정부/공공기관 및 민간기업의 철저한 사전준비가 필요한 시점이다. 개인의 프라이버시 보호에 대한 이러한 발전추세에는 국내외 표준화가구를 통한 활발한 표준화작업이 밑바탕이 되고 있으며, 특히 미국, 영국, 독일, 일본, 한국 등의 나라를 중심으로 국제표준화를 활발히 추진하고 있다[1]. 표준화의 분야에는 개체의 신분확인을 위한 표준, 개인식별정보와 바이오인식 정보가 같이 사용되는 상황에서 이들의 바이오인식 프라이버시 및 보안요구조건을 위한 표준, 프라이버시 프레임워크, 프레임워크 기반 구현을 위한 프라이버시 레퍼런스 아키텍쳐 등 다양한 표준화 분야가 있다. 본 논문에서는 프라이버시 표준화를 위한 국외 표준화 동향을 소개하고, 향후 추진해야할 중점 표준화 항목을 도출한다.

The Effect of Leadership on Organizational Effectiveness in Public Hospital: Transformational-Transactional Leadership (공공의료기관장의 리더십이 조직유효성에 미치는 영향 : 변혁적-거래적 리더십을 중심으로)

  • Jung, Byung-Eul;Ahn, Sang-Yoon
    • Korea Journal of Hospital Management
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    • v.15 no.3
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    • pp.97-122
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    • 2010
  • This research investigated the effect of leadership on organizational effectiveness in the public hospital. As a result of multi-regression analysis based on the data of 384 employees in 5 public hospitals in Korea, transformational leadership positively affected organizational commitment and job satisfaction. Transformational leadership had a significantly negative effect on turnover intention. Transactional leadership had a significantly positive relationship with organizational commitment and job satisfaction. This study has means that was first analysed relationship between the leadership style and organizational effectiveness of public hospital in Korea. The difference that demographic variables have on organizational commitment, job satisfaction, and turnover intention examined. Variables like gender and type of occupation have a significant difference.

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Moving Patterns of Patients and Its Implication for Regional Unbalance in Health Resources (환자이동현황을 고려한 병상공급 방향)

  • Yun, Heesuk
    • KDI Journal of Economic Policy
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    • v.29 no.1
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    • pp.41-78
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    • 2007
  • Due to the concern of regional unbalance relating to healthcare resources, the government has set up a plan to expand public healthcare services and a policy to manage the supply of hospital beds. However, it is not clear what standards are needed to measure the degree of unbalance, and to what extent the gap needs to be narrowed. Unlike the previous methodology comparing the proportions of patients who move out from their administrative district to receive medical services, this study examines the inconvenience gap patients experience when they have to move out from their actual living area. The logit and multinomial logit models are employed. The regional unbalance decreases when the degree of movement is measured based on the living area. This result implies that essential standard for achieving regional balance relating to medical services need to be based not on the even distribution of medical resources, but the complications of regional people that require proper medical services.

PRESENT STATE AND PROSPECT OF PUBLIC DENTAL HEALTH SERVICE FOR CHILDREN AND ADOLESCENTS IN KOREA (우리나라 어린이와 청소년의 구강건강을 위한 공공서비스의 현황과 전망)

  • Lee, Kwang-Hee;Kim, Jee-Young;Song, Ji-Hyon;Kim, Yun-Hee;Im, Kyeong-Uk;Jeong, Seung-Yeol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.3
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    • pp.578-588
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    • 2008
  • To achieve the dental health of children and adolescents which is the objective of the pediatric dentistry, the role of the public service should be increased. The basis of the public service is established by many laws of which the Dental Health Law is most important. The percentages of primary schools that had the school dental health clinic, that implemented the fluoride rinsing program, and that implemented the group toothbrushing after lunch were 7.2%, 57.5%, and 46.9%, respectively, and the percentages of primary school children that received the dental health education and that received the fissure sealing were 48.0% and 12.4%, respectively(2006). About 42% of infants and preschool children from 0 to 6 years received preventive dental care in the last one year, at the nursery or kindergarten(18%) or at the health center(1%)(2005). The percentage of the health centers that implemented water fluoridation was 11.3%, and the percentage of the population who drank the fluoridated water was 5.7%(2006). It was suggested that the school dental health administration should be unified, that dental health teachers should be employed, and that the comprehensive dental health care should be supplied to all the children and adolescents through the circuit school dentists and the school dental hospitals in the long term. Also, the dentist in charge system for the children and adolescent was suggested.

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