• 보건행정학회지
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• 제34권2호
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• pp.103-105
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• 2024

인공지능(artificial intelligence, AI) 기술이 산업 전반으로 빠르게 확산되고 있다. AI를 활용하게 되면서 생기는 윤리적 이슈에 대한 관심도 높아지고 있다. 특히 건강과 생명을 주제로 연구하는 보건의료 분야에서 AI와 관련된 윤리적 이슈는 중요한 주제이다. 연구하고 출판하는 과정에서 AI 도구를 이용하였을 때 주의해야 할 연구윤리적 쟁점을 살펴보고자 한다. 연구과정에서 AI tool을 사용하여 번역하거나 인용하고 문장을 수정하는 과정에서 연구자가 의도하지 않은 표절이 생길 수 있어 주의가 필요하다. 현재 AI에게는 저작권이 부여되지 않기 때문에 AI 도구를 사용하여 생기는 연구윤리적 문제는 저자가 책임질 수밖에 없다. 연구자는 AI 도구를 활용하였을 경우 어떤 도구를 어떻게 활용했는지를 연구논문에 명시하도록 권고된다. 연구과정에서 AI 도구로 인한 연구윤리 쟁점 사례가 축적되어가면 다양한 지침들이 정비될 것으로 예상된다. 연구자는 연구출판과정에서 AI 도구의 사용과 관련된 국제적인 합의와 지침 동향에 대해 지속적으로 관심을 가져야 한다.

• 보건행정학회지
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• 제33권3호
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• pp.264-272
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• 2023

Background: Private health insurance supplements the coverage of national health insurance in Korea. In this situation, the subject of the study is to identify the healthcare utilization of people with physical and mental illnesses according to private health insurance. Methods: This study used data from the Korea Health Panel Survey 2018. The study population consisted of 813 individuals with physical and mental illnesses (PMI). Multiple logistic regression analysis and binominal logistic regression analysis were conducted about the utilization of emergency, inpatient, and outpatient medical services of people with PMI depending on enrollment in private health insurance (PHI). Results: The results of this study indicated that individuals with PHI utilized emergency and outpatient medical services less frequently compared to those without PHI. Conversely, having PHI was associated with a higher utilization of inpatient medical services compared to not having PHI. Binomial logistic regression analysis revealed that individuals with PMI who had PHI exhibited a higher frequency of visits to emergency and outpatient medical services compared to those without PHI. However, the significance of this trend was not observed in the case of emergency medical services. On the other hand, individuals with PMI who had PHI showed a lower frequency of visits to inpatient medical services compared to those without PHI. Conclusion: In conclusion, there was a significant relationship between having PHI and the utilization of medical services in people with PMI. There is a need for a follow-up study considering the type of mental illnesses, length of stay, and health outcome of people with PMI depending on having PHI.

• 보건행정학회지
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• 제31권2호
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• pp.180-187
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• 2021

Background: This study analyzed the effect of applying the diagnosis-related group (DRG)-based payment system, which was implemented in July 2012 for hospitals and clinics nationwide, on the cesarean section rate. Methods: The subjects of the study were divided into new groups that participated in the payment system after July 2012 and maintenance groups that participated in the payment system before July 2012. As an analysis method, a difference-in-difference analysis, which is a quasi-experimental design, was used. The risk-adjusted cesarean section rate was used as a dependent variable. Results: Seven risk factors (malpresentation of fetus, eclampsia, multiple pregnancies, problems in the placenta, previous Cesarean section, cephalopelvic disproportion, problems in amniotic fluid) were included in the final risk-adjustment model, and found to have a statistically significant relationship with the cesarean section rate. Results showed that the risk-adjusted cesarean section rate increased significantly in new groups after the application of the DRG-based payment system. Conclusion: Study results provided policy implications for the reorganization of the DRG-based system should that reflects the demands of obstetricians, such as organizing a consultative body with obstetricians and establishing a reasonable fee.

• 보건행정학회지
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• 제32권2호
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• pp.173-179
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• 2022

Background: This study aimed to identify patterns of elderly patients who transferred from long-term care hospitals to emergency rooms and provide the evidence of emergency medical systems to prepare for a super-aged society. Methods: The data source was the National Emergency Department Information System database from January 2014 to December 2019 in Korea. We performed a cross-sectional study among elderly patients (≥65 years) who transferred from a long-term care hospital to an emergency room. Trend analysis was conducted by year. Results: We identified 225,765 elderly patients who were transferred from long-term care hospitals to emergency rooms between January 1, 2014 and December 31, 2019. The proportion of the study population and their mean age were recently increased (p<0.001, respectively). The proportion of elderly patients being re-transferred (p=0.049) and the patients re-transferred to long-term care hospitals is significantly increased (p=0.005). Conclusion: The establishment of efficient emergency medical services for an aging society is important. It is necessary to develop a healthcare network with the government, long-term care hospitals, and medical institutions in the community suitable for preventing disease deterioration.

• 보건행정학회지
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• 제32권2호
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• pp.164-172
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• 2022

Background: The purpose of this study was to the impact of the coronavirus disease 2019 (COVID-19) outbreak on emergency departments (EDs) in patients under the age of 18 years with respiratory disease. Also, we analyzed similarities and differences in patients including revisit before and after the COVID-19 outbreak. Methods: This study population was respiratory patients under the age of 18 years who visited all 403 EDs in Korea between January 1st, 2019 and December 31st, 2020, using the National Emergency Department Information System Database. The primary outcome was the number of respiratory patients according to age, sex, the type of EDs, season, Korean Triage and Acuity Scale (KTAS) levels, the result of ED, and length of stay. The secondary outcome was the number of revisit respiratory patients within 72 hours. We calculated the risk-adjusted revisit rates according to the KTAS level using a multiple logistic regression model. Results: The number of ED visits decreased from 274,526 in 2019 to 79,007 in 2020; this number was 71.2% lower than that before COVID-19. In spring 2020, this number was 90.1% lower than during the same period in 2019. For the revisit rate in the study population, the adjusted odds ratio (95% confidence interval) was 1.22 (1.05-1.41) in 2019 and 1.39 (1.07-1.81) in 2020. Conclusion: Implementing appropriate emergency care policies in severe respiratory patients would have contributed to improving the safety of reducing in revisit rate.

• 보건행정학회지
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• 제1권1호
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• pp.27-41
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• 1991

The purpose of this study is to estimate cesarean section rate in Korea and analyze characteristics of health care institution which affect regional variation in the rate. We have searched vaginal and cesarean section deliveries among Diagnosis Related Group dat based upon insurance claim bills which have been submitted to Korean Insurance Corporation for two years since March, 1985. The results are as follows: 1. Out of all delivery cases of 87,500, cesarean section rate was 16.3% (14,299 cases). 2. Cesarean section rate varied according to size and ownership of health care institutions. In above 6- bed sized hospitals, the rate was at about 20% higher than small sized institutions, but rather in hospitals that have more than 500 beds, it was somewhat low. Classified by the hospital ownership, the rate was low at 18.4% in hospitals of religious organization and highest at private or corporate hospitals. 3. This study shows large regional variation in cesarean section rate; there are two times differences between region with the highest and lowest rate. Strongly related factors in that variation was the ownership of health care institution and urbanization variables. Low level of cesarean section rate in a region is explained by high proportion of delivery cases at institutions of religious organization and at insitutions in county level site. This result shows that apart from medical conditions of patients, indications of cesarean section differs from health care providers, and especially ownership of institution strongly affect them. Cesarean section rate in Korea is supposed to be at high level and development of utilization review programs to keep appropriate cesarean section rate is needed.

• 보건의료산업학회지
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• 제12권4호
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• pp.103-113
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• 2018

Objectives: The study aimed to compare the indicators of infrastructure of the whole country with those of Busan through National Medical Care Psychiatric (hospital level) Quality Assesment and to provide the basic evidence for presenting vision and strategies of mental health policy. Methods: National Medical Care Psychiatric (hospital level) Quality Assesment Data was used from 2011 to 2015. A total of 8 indicators were analyzed including facility and workforce. Results: The median value of the capacity per ward was decreasing with years both whole country and Busan. The number of beds out of total inpatient occupancy was improved over the years. There was no clear change in the number of inpatients per toilet in the hospitalized ward, but the indicator was decreasing obviously. Therefore, the median value of whole country and Busan was same with 10.2 in 2015. Conclusions: We confirmed that indicators for infrastructure were improving in a generally positive change over the years. The infrastructure is related to the patient-centered treatment environment, and the workforce is related to the quality of care. Therefore, the structural area should be continuously evaluated and improved.

• 보건행정학회지
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• 제32권3호
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• pp.330-333
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• 2022

Korea's quarantine response to the novel coronavirus (coronavirus disease 2019 [COVID-19]) pandemic is based on the sacrifice of health professionals, especially public health doctors (PHDs) who were called out first and put in the first place in the country. PHDs performed major quarantine tasks, such as collecting samples from screening clinics and epidemiological investigations, in various parts of the country, including the Daegu area, where the first large-scale COVID-19 confirmed cases in Korea and explosively increased. Because of their position as fixed-term civil servants, however, PHDs' professionalism as doctors was ignored, and they were not properly compensated for their work. They were also exposed to problems such as a high risk of infection, mental suffering, and various human rights violations. We must prepare concrete measures to improve the fundamental treatment of PHDs and protect their human rights in order to prepare for a possible infectious disease pandemic in the future.

• 대한통합의학회지
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• 제10권2호
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• pp.61-72
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• 2022

Purpose : This study aimed to identify the educational effects of the International Development Cooperation and Healthcare course from 2018 to 2020. Methods : Changes in awareness of international development cooperation (understanding international development cooperation as well as government Official Development Assistance [ODA], thoughts on aid, and thoughts on government's aid scale) were analyzed using web-based surveys. The pre-course survey was conducted 1-2 weeks before the semester started, and the post-course survey was conducted 1-2 weeks after the semester ended. All data were analyzed using the SPSS 26.0 program, and statistical significance was set at p< .05. Results : A total of 314 people participated in the survey before taking the course, and 286 people participated in the survey after taking the course. Analysis of the changes in students' awareness of international development cooperation showed that all items (understanding international development cooperation and government ODA, as well as having thoughts on aid and government's aid scale) were improved. Regarding changes in awareness according to general characteristics, thoughts on aid were statistically significant according to all characteristics except for 2018. Regarding government's aid scale, awareness scores increased after taking the course in students who majored in healthcare, fine arts and athletics, broadcasting and media studies, and digital contents. Conclusion : This study showed that changes in awareness of international development cooperation were largest in second-year students. Compared to changes regarding international development cooperation, government ODA, and thoughts on aid, changes regarding thoughts on government's aid scale were minor. In the future, it is necessary to develop class content suitable for the first-year level and to supplement and operate content that can change the way of thinking on government's aid scale.

• 보건행정학회지
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• 제33권2호
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• pp.157-165
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• 2023

Background: We aimed to provide basic data for improving the effectiveness of the invitational training and reflecting it in the program in the following year by identifying the satisfaction level of trainees who participated in the "Dr. LEE Jong-wook Fellowship Program" funded by the Korea Foundation for International Healthcare. Methods: A qualitative study was conducted using a questionnaire interview. In the first stage of analysis, only the interview contents related to the research topic were classified by the researcher for the conversations recorded at the interview site, and in the second stage of analysis, the interview contents classified in the first stage were classified into each of those mentioned in this study. Results: The longer the trainees participated in the program and the better the accessibility, the higher the satisfaction with the program. In addition, the level of achievement of the trainees' goals and the level of improvement in their competence affected their satisfaction, and their difficulty in language communication during the training period was identified as a factor affecting the trainees' satisfaction level. In addition, competency improvement and satisfaction were positively correlated (r=0.75, p=0.03). Conclusion: When organizing a rehabilitation workforce capacity training program, it is important to identify trainees' needs, ensure accessibility, organize courses effectively, enhance English proficiency, and expand practical lectures to increase trainees' knowledge and understanding of rehabilitation.