• Proceedings of the Korean Information Science Society Conference
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• 2003.10b
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• pp.760-762
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• 2003

HL7(Health Level 7)은 보건의료 분야에서 ANSI에서 승인한 SDO(Standards Developing Organization)들 중의 하나이다. 대부분의 SDO들은 약제. 의료 장비 이미지, 보험 처리 등과 같은 보건의료 분야에서의 표준을 만든다. HL7의 영역은 진료와 병원 행정적인 부분이다. HL7에서는 Version2.3, Version2.4, Version3.0 등을 포함해 Data Model. Arden Syntax, CCOW(Common Context Object Workgroup) CDA(Clinical Document Architecture) 등의 표준을 만들어 나간다. 본 논문에서는 이 표준들 중 CCOW에 대해 알아보고. 기존 Agent System에 좀 더 지능적이고 자율적인 CCOW 서비스를 제공하는 방안을 알아본다.

• Journal of the Health Care and Life Science
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• v.9 no.1
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• pp.1-9
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• 2021

In this study, a model in which certification standards were added to the health information management practice program was studied and presented in order to understand the EMR certification standards implemented by the Korea Health and Medical Information Service. In the practice program, the certification standard function for patient information management was added to the health information management education system to practice and understand patient information management that corresponds to the functional standard of the EMR certification system. The EMR certification standard practice program for patient information management is composed of the following certification standards. registration number and personal information management, treatment reservation schedule management, personal information revision history management, identification of people with the same name, integrated management of multiple registration numbers, patient search by identification information, patient search by health care type, surgical procedure consent record and inquiry, record/inquiry of consent form for personal information use, display of life-sustaining medical decision information, registration/inquiry of external medical institution documents, registration and inquiry of external examination results. In this way, by operating and practicing the functions of the health information system according to the certification standards, it is possible to understand and practice the certification standards and details of patient information management in the functional area of the certification standards. In addition, since the function of the EMR certification standard can be checked, it will be possible to improve the management ability of the electronic medical record system of the health information manager in the medical institution.

• Health Policy and Management
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• v.4 no.1
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• pp.138-175
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• 1994

The objectives of this study are (i) to review current situations and problems of the occupational health care system with emphasis on reforming the organizations and services, (ii) to find out a disirable occupational health system model based on integration of the occupational health system and the general health system, and finally, (iii) to suggest policy implications in occupational health services in the light of objectives of the newly emerging national health insurance reform in Korea. The major policy implications of this study are as follows: 1. In the long-run, within the occupational health system, preventive occupational health services such as employees' physical check-up, working environment examination, etc should financially be integrated with industrial accident compensation insurance. Currently separately paying expenses for each different category of services by the owner of an enterprise should be disbursed once through the payment of contributions of industrial accident compensation insurance. And then, it is necessary to strengthen and expand the role and function of industrial accident compensation insurance to cover preventive occupational health services. 2. The occupational health system should be integrated with general health system for its effective management. For the short-term policy, it is necessary to eliminate fiscal and access barrier between industrial accident compensation insurance and national health insurance by means of ex post facto settlement of accounts. The duplication of employees' physical check- ups between under the health insurance program and under the industrial health services must be coordinated in a manner either through mutual authorization by the two parties concerned or through merge into the health insurance. 3. The intent of current employees' physical check-up system focused on detection of occupational diseases, should be converted to an idea of medical surveillance system or biological moritoring system. The introduction of medical surveillance or biological monitoring system is a necessary condition to build a positive, effective and inexpensive occupational health care system.

• Health Policy and Management
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• v.3 no.1
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• pp.53-83
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• 1993

A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the elderly patients. They have spent 814.126won per on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Goverment should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.

• Health Policy and Management
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• v.33 no.1
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• pp.19-28
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• 2023

Background: With the enactment of the Hospice, Palliative, Care, and Life-sustaining Treatment Decision-Making Act in February 2018, legal guidelines for physician orders for life-sustaining treatment (POLST) were presented. This study was conducted to analyze the association of writing POLST on the use of health care before death. Methods: The study analyzed the electronic medical records and POLSTs of 1,003 adult patients who died at a tertiary hospital located in Seoul from February 4, 2018 to February 4, 2019. Results: Of the deaths, 80% (n=804) completed POLST. Among patients who completed POLST before death, 51% (n=412) were written 1-7 days before death, and only 31% (n=246) were completed by patients themselves. 99% (n=799) decided to withdraw or withhold cardiopulmonary resuscitation. As a result of analyzing the effect of POLST on medical use before death, it was found that POLST and inpatient cost had a significant negative correlation, and POLST completion significantly reduced death in the intensive care unit (ICU). However, both inpatient costs and death at ICU increased when the POLST was completed by surrogate decision-makers rather than patients themselves. Conclusion: The enactment of the Hospice, Palliative, Care, and Life-sustaining Treatment Decision-Making Act provided a legal basis for withdrawing and withholding meaningless life-sustaining treatment. By specifying the treatment to be received at the end of one's life through the POLST, inpatient treatment costs and death at the ICU were decreased. However, the frequent decision-making by the surrogates and completion of POLST close to death may hinder the original purpose of the law.

• Health Policy and Management
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• v.29 no.1
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• pp.82-85
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• 2019

Unmet healthcare needs are being used as an important indicator of the accessibility of healthcare services worldwide. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHANES, 2007-2017); the Community Health Survey (CHS 2008-2017); the Korea Health Panel Survey (KHP 2011-2015); and the Korean Welfare Panel Study (KOWEPS 2006-2017). The proportion of individual reporting unmet healthcare needs as of 2017 was 8.8% (KNHANES), 10.6% (CHS), and 12.4% (KHP as of 2015). The proportion of households reporting unmet healthcare needs due to cost was 0.5% (KOWEPS). Annual percentage change was -19.2%, -13.3%, -5.8%, and -13.3% respectively. Low income populations had more unmet healthcare needs than high income populations. However, unlike the last two studies, the main reason for unmet medical reasons was that there was no time regardless of income level.

• Health Policy and Management
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• v.31 no.2
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• pp.217-224
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• 2021

The objective of this study is to investigate the healthcare status of South Korea and other member countries of the Organization for Economic Cooperation and Development (OECD) using OECD health statistics 2020. We employed the position value for relative comparison index to measure the healthcare status in five following components: demand, supply, accessibility, quality, and cost. The Mann-Kendall test was used to analyze for increasing or decreasing trend of the position value for relative comparison values from 2000 to the recent year. Results showed that Korea was positioned above than the OECD median values in most of components, but lower than the median values in certain indices including healthcare employment, primary care, and mental health care. This study sheds some light on healthcare issues to be improved and the policy-makes can take into account for prior setting process.

• Journal of Digital Convergence
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• v.17 no.4
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• pp.159-166
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• 2019

This paper investigated convergent factors to turnover intention among some Administrative Staff in Medical Institutions(ASMI). The survey used self-administered questionnaires for 320 administrative staffs of 27 medical institutions in the J region, selected arbitrarily from July 2, 2018 to July 27, 2018. The hierarchical multiple regression analysis shows the following results. The turnover intention of respondents turned out to be significantly higher in following groups: a group in which organizational commitment is lower, a group in which organizational loyalty is higher, a group in which exhaustion, cynicism, reduced professional efficacy, sub-areas of job burnout are higher. The results show explanatory power of 50.9%. The results of the study indicate that the efforts, to increase organizational commitment and organizational loyalty, and to decrease exhaustion, cynicism, reduced professional efficacy, sub-areas of job burnout, are required to improve the turnover intention among ASMI. These results could be used in hospital organization personnel management and industrial health education to lower the level of turnover intention in ASMI, vocational aptitude education of health care college students. In following studies, it is necessary to present and analyze the structural model affecting the turnover intention of ASMI.

• Korean Journal of Social Welfare Studies
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• v.42 no.2
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• pp.303-322
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• 2011

The increased needs for medical cost containment and the quality of life improvement for the low-income elderly with chronic disease require the complementary relationship between hospital care and community health services. This study investigated the current status of the linkage between Korean hospital care and community services using Seoul Welfare Panel Study(SWPS) data. Logistic regression analysis was used to examine the effects of experiences of hospitalization and outpatient health services on use and needs of community health services. The analysis results indicated that the elderly with chronic disease who have not experienced outpatient health services were unlikely to receive health and social services in the community. Even those who have experienced hospitalization were not provided complementary health services in the community despite the increasing demand.

• The Journal of Korean Society for School & Community Health Education
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• v.23 no.2
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• pp.25-38
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• 2022

목적: 본 연구의 목적은 대사증후군 주의군 대비 대사증후군의 위험요소를 식별하여 예방을 위한 중재방안을 마련하기 위한 것이다. 방법: 한국의료패널 2015년도 데이터를 활용하여 당뇨만 앓고 있는 사람을 주의군으로 당뇨, 고혈압, 이상지질혈증을 모두 앓고 있는 사람을 대사증후군으로 구분하여 추출한 다음 가중치를 부여하여 총 1,559,884명을 대상으로 하였다. 주의군 대비 개인적 특성, 건강생활습관 특성, 삶의 질 특성, 의료이용 특성에 대한 대사증후군의 영향요인을 분석하였다. 결과: 개인적 특성에서는 40대미만 연령대에 비해 연령에 비례하여 대사증후군 위험이 증가하다 70대에 40대미만과 유사한 수준으로 떨어졌다. 남성보다는 여성, 고졸이하보다는 대졸이상, 중소지역에 비해 서울시 거주자, 장애가 없는 군보다는 있는 군, 의료급여가입자보다는 건강보험 가입자, 경제활동을 안하는 군보다는 경제활동 군의 대사증후군 위험이 높았다. 건강생활 습관 특성에서는 비흡연자보다는 흡연자, 술을 안마시는 군보다는 주 2-3회 이상 음주자, 운동을 하는 군보다 안하는 군, BMI가 정상인 군보다는 30 이상인 군에서 대사증후군 위험이 높았다. 삶의 질 특성에서는 일상 활동에 지장이 없는 군보다 있는 군, 통증이나 불편이 없는 군보다 있는 군, 주관적 건강상태가 보통이상보다는 나쁜 군, 섭식문제가 없는 군보다 있었던 군에서 대사증후군 위험이 높았다. 의료이용 특성에서는 미충족 의료이용 경험이 없는 군보다 있었던 군, 약제비가 부담이 안되는 군보다 부담이 되는 군에서 대사증후군 위험이 높았다. 결론: 당뇨를 앓고 있는 그룹 중 본 연구를 통해 확인된 대사증후군 위험 요소가 많은 이들에 대해 우선적으로 대사증후군 예방 보건교육을 집중하는 방안을 제언한다.