• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.21 no.2
• /
• pp.470-478
• /
• 2020

In this paper, a theoretical model that separates one single conversion factor into two conversion factors for both outpatients and inpatients is introduced. By using hypothetical numbers, two conversion factors and an adjustment factor were calculated. The major implications are as follows. Firstly, by introducing two conversion factors, a minimum incentive mechanism for admitting outpatients to a clinic and high risk inpatients to a hospital was installed. Secondly, the introduction of two conversion factors decreased the drive to admit outpatients to a hospital by reducing the economic benefits for the hospital. Thirdly, it is possible to make explicit contracts for several factors rather than a single conversion factor, so that it can be used as an appropriate management tool for rapidly increasing medical expenses. Finally, this research can be used to set up policy tools to establish a proper healthcare delivery system in Korea by inducing behavioral changes in healthcare institutions.

• Quality Improvement in Health Care
• /
• v.15 no.1
• /
• pp.79-87
• /
• 2009

문제: 본원의 외래 상황은 진료의가 짧은 시간 내에 많은 환자를 진료해야 하고, 진료 환자 모두에게 충분히 만족하도록 설명해주는 것은 매우 어려운 실정이었다. 2007년의 의료기관 본 평가에 앞서 병원 자체 평가 결과 외래환자의 설명 만족도는 57점으로 저조하였다. 목적: "이해하기 쉽게 설명하는 서울대학교 병원" 이라는 슬로건 하에 설명간호사 제도를 운영하기 시작하여, 설명간호사실 운영 활성화를 통한 외래 환자 만족도를 향상시키고자 한다. 의료기관: 서울시 종로구에 소재한 대학병원 질 향상 활동: 설명간호사실 방문율 증가 및 one-stop service care을 실현할 수 있는 방안을 모색하였고, 검사 시행 이유, 귀가 후 주의사항 검사 결과, 검사일정 외래 진료 안내 브로셔 및 표준화된 교육 자료를 개발하였다. 또한 설명간호사의 역할 및 업무의 확립을 위한 업무기술서를 개발 및 설명간호사실 환경을 개선하였다. 개선효과: 설명간호사실의 방문율이 내과는 2배, 신경과는 3배 정도 증가하였다. 표준화된 교육 자료 개발로 설명 요구도를 충족시켰고, '환자의 알 권리'와 '설명을 들을 권리'를 보장하였다. 업무기술서 개발로 설명간호사의 업무 및 역할을 확립하였으며 설명간호사실의 환경 개선으로 개인 신상 비밀을 보호받을 권리를 보장하였다. 외래 설명만족도가 2007년 57점에서 2008년 74점으로 향상되었다. 설명간호사실 자체 설문조사에서도 97%가 만족한다고 답하였고, 100% 모두 재방문 의사를 보였다. one-stop service care를 제공함으로써 외래가 복잡하다는 부정적인 이미지를 긍정적인 이미지로 변화시켰다.

• Journal of the Korean Institute of Traditional Landscape Architecture
• /
• v.31 no.2
• /
• pp.1-19
• /
• 2013

This study was carried out to analyze distribution situation of alien plants and to propose management plan in the 3 Folk village in Gyeongsangbuk-do which is Cultural property designated by the State; Hahoe, Yangdong and Hangae. This research is for improve of sincerity of historical site and provide basic information which use about administration of preservation. The results are as follows. 1. Overall flora and alien plants appearance The total flora in the 3 folk villages were listed total 752 taxa including 127 families, 430 genera, 614 species, 5 subspecies, 100 varieties and 33 forms. Among them, woody plants take 263 taxa(35.0%) and herbaceous plants take 489 taxa (65.0%). Flora in the Hahoe, Yangdong and Hangae village were total 534, 479 taxa and 408 taxa and exotic plant index was 30.1%, 38.2% and 37.0% respectively. In types of exotic plants, ornamental exotic plants were 135 taxa, deciduous exotic plants were 21 taxa, cultivating exotic plants were 64 taxa, and naturalized exotic plants were 80 taxa and those result lead that the ornamental exotic plants is the highest ratio. According to the villages, Hahoe village had 161 taxa(30.1%), Yangdong Village had 183 taxa(38.2%), and Hangae village had 151 taxa(37.0%) that Yangdong village showed the most number of exotic plants. 2. Planting of landscape exotic plants in the unit cultural assets Meanwhile, Ornamental exotic plants in old house's gardens in Andong Hahoe village which is designated as a unit assets, those are total 30 taxa; followed by the Okyeon house(8 taxa) is highest and the Yangjindang(7), the Hadong house(6) and the Chunghyodang(5). Magnolia denudata appears the most as for 4 times and Campsis grandiflora etc. each took 2 times. Based on the Yangdong village, Gyeongju, that are found total 51 taxa; followed by the Dugok house(16 taxa) the Sujoldang(14), the Mucheondang(13), and the Sangchunheon (12). High appearance rate of ornamental exotic plants were Viburnum opulus for. hydrangeoides, Lycoris squamigera, Caragagna sinica and Magnolia denudata etc. Based on the Hangae village, Seongju, that are designated total 62 taxa; followed by the Jinsa house(35 taxa), the Gyori house(25), the Hanju head family house(20), and the Hahoe house(16). Taxa with high appearance rates were Caragana sinica, Juniperus chinensis var. horizontalis, Magnolia denudata, Viburnum opulus for. hydrangeoides, Chaenomeles speciosa etc. 3. Problems of exotic plant landscapes in the outer spaces of the folk villages Problems of exotic plant landscapes in the outer spaces of the Hahoe village are as follows. In lower of the Mansongjeong forest, Ambrosia artemisifolia, which are ecosystem disturbance plants designated by the Ministry of Environment, live with high dominance value. This should be have a remove with Sicyos angulatus immediately. In the Nakdong river bed around the Mansongjeong forest is covered with a riparian vegetation forest belt of Robinia pseudoacacia L. forest, Populus nigra var. italic community, and Populus x tomentiglandulosa community colony. Based on the Yangdong village, the planted or naturally distributed Ailanthus altissima colony, sporadically distributed Robinia pseudoacacia as well as Amorpha fruticosa are detected all over the village and ecotones. Based on the Hangae village, Ailanthus altissima and Robinia pseudoacacia are sporadically distributed around the village and there is a sign of spreading. similarity of exotic plantsis 47.0% to 48.6% and a reason why this happened is all of research site in Gyeongsanbuk-do and that is why growth norm of plant is similar, exotic plant which is sales for ornamental and it infer to require related countermeasure of each villages and joint related countermeasure.

• Quality Improvement in Health Care
• /
• v.1 no.2
• /
• pp.44-59
• /
• 1994

Medical consumers(patients) want evening-clinic because of busy work. For patient's convenience and improving service, hospital should accept it. Considering payment system and patient's demand, personnel expenses, hospital can not accept. The practice of shift system to accept patient's demand and hospital's economic aspect was made. To analysis the effect of the system and probability to alternative to evening clinic this study was done. This study was composed of basal study, intervention, evaluation of effect. The basal study were composed of studying demand on evening clinic, the number of beds, doctors employee, the time table of practice and work, and the number of patients at arrival time. The intervention composed of changing of practice time, changing of working time by the number of patients at arrival time, increasing of employee. The evaluation of effect were composed of evaluating the number of patient at time, the effect of shift system, the comparison of the number of in and out patients and questionnairing the practice of shift system. In the practice time at 2 shift system First team works 7-15 hours and Second team 12-20 hours. there are no lunch and supper time. At 18-20 hours the number of patients were 25-30. The number of patient a depart were 6-7. The number of out-patient increase in 13% and inpatient increase in 10% before the system. Doctors(100%), employee(94.6%), and patients(86.4%) approved this system. The advantage of this system were utilization of surplus time, lengthen the practice time, even distribution of patients and shortening of waiting time, rapid treatment of emergent patients. The disadvantage of this system were shortage of manpower, not all depart practice, continuity of practice, no lunch and supper time, irregular rounding. At present because of small Demanding on evening clinic, this shift system was economical. To succeed this study more effectively all depart in hospital participate. But because of economical reason it is impossible for hospital to do it. If the government assist the economic loss that all depart participate in this system it is very helpful for hospital to succeed in implementing this system more early.

• Korean Journal of Environment and Ecology
• /
• v.34 no.5
• /
• pp.396-401
• /
• 2020

As the world becomes more globalized, the non-native species issue has emerged as a problem that is growing internationally. In particular, the number of non-native turtles found in the wild has been increasing sharply in South Korea. At least 15 species of non-native turtles, including the red-eared slider (Trachemys scripta elegans) first imported in the 1970s, have been found in Korea. On October 15, 2019, an alligator snapping turtle (AST, Macrochelys temminckii) was found in a stream located in Gwangju city, South Korea. The discovery of AST became a big issue in South Korea as the animal is known for its large body size and aggressiveness and was featured widely in the mass media. In this study, to learn the public's perception of non-native species, we examined comments (opinions) to the online news articles about the AST. We collected 1,100 comments from the Internet news articles on the AST. Out of the 1,100 comments, 342 (31.1%) comments were related to non-native species' issues. Most of the respondents (97.7%, n=334) stated that the non-native species are a problem. Forty two comments mentioned potential threats posed by non-native species: non-native species' aggressive nature (n=11, 26.2%) and ecological disturbance (n=31, 73.8%). Lack of responsibility (n=122, 51.7%) was the major causative factor for the introduction of non-native species, and followed by indiscriminate pet trade (n=99, 42.0%), absence of relevant legislation (n=13, 5.5%), and absence of treatment (n=2, 0.8%). Animal registration (n=59, 45.7%) was the most commonly mentioned as the way to deal with the issue of the non-native species' invasion. Our results show that the public is aware of the seriousness of the invasion of non-native species, including AST. This study highlights that researchers and government officials need to consider the public's perception and opinions. We believe that our study can serve as an essential reference for the policy direction and the management of non-native species.

• Journal of Environmental Impact Assessment
• /
• v.25 no.5
• /
• pp.319-332
• /
• 2016

Alien turtles belonging to Genus Trachemys have been designated as Invasive Alien Species since 2001 and their import has been banned in Korea. However, current status of import and distribution of the other alien turtles have not been reported. In this study, we aimed to investigate the taxa of alien turtles introduced into Korea, to assess their potential risks to the natural ecosystems and to suggest the future management directions of them in Korea. We identified 73 species of alien turtles belonging to 9 families. Since 2008, more than 6,000 kg of turtles have been imported annually and widely distributed through the pet shops, traditional markets and individual transactions. From the survey of natural habitats, we found that 8 species belonging to 3 families including Chrysemys picta, Pseudemys concinna, P. nelsoni, P. peninsularis, P. rubriventris, Mauremys sinensis, Macrochelys temminckii and Trachemys scripta have inhabited in 12 study sites. Out of 73 alien turtles, the potential adverse impacts of 13 species to ecosystems are serious when we considered status of designation of invasive alien species in other countries. For the management of alien turtles, it is required to register alien turtles in the import list and share general information such as import purpose, distribution and management condition among relevant authorities. The breeders and distributors must be obliged to identify turtles and to record management. The government must check transfer and migration of turtles periodically to prevent their introduction and spread into natural environments. The change of alien turtle populations in natural habitats should be monitored and their management plan should be developed to control the alien turtles in areas where the impacts are significant.

• Ecology and Resilient Infrastructure
• /
• v.2 no.4
• /
• pp.274-283
• /
• 2015

The reservoir shores seem to be vulnerable to biological invasion. The purpose of this research was to find out the floristic composition of alien plants and their relationship between environmental factors on reservoir shorelines in Korea. We investigated flora of alien plants and environmental factors of geomorphology, hydrology, water quality and soil on the shoreline of a total of 35 reservoirs with different water level managements. There were 56 species of alien plants, which was 15% of the total plant species identified in the study of reservoirs. A total of 57% of these alien species were the species which were introduced shortly after opening the port from 1876 to 1921 in Korea. More than 80% of the alien plants on the reservoir shores originated from America and Europe. The current distribution of Ambrosia trifida and Paspalum distichum were restricted in the central part and the southern region of the Korean Peninsula, respectively. The water level fluctuation, flood frequency at the median water level, water pollution index, coverage of rock exposure and mean degree of shoreline slope were determined as important environmental factors that have an effect on the characteristics of shoreline alien flora. Our results suggest that the reservoir shore was in danger of being invaded by alien plants due to the water level management and other human disturbances. For effective conservation of the reservoir ecosystem, periodic monitoring systems are required for the early detection of alien species on the reservoir shore.

• The Korean Society of Law and Medicine
• /
• v.19 no.1
• /
• pp.23-80
• /
• 2018

Since the 1960s, the United States' (U.S.) deinstitutionalization policy has reinstated people with mental illness into communities. Unfortunately, when untreated, some people with psychiatric disorders become homeless, and some commit serious crimes during a psychological crisis. Assisted Outpatient Treatment (AOT), also known as Kendra's Law in New York and Laura's Law in California, provides treatment, services and support to people with mental illness in the community. AOT has repeatedly been found effective and is recognized as an evidence-based practice. The response to the mental health crisis (crisis intervention) in the U.S. has also been successful in preventing worsening mental illness and related criminality and other issues. This paper provides an opportunity to create a platform from which to learn how to successfully apply the AOT and crisis intervention of the U.S. to South Korea within the cultural and societal context when establishing social services for people with mental illness in South Korea's communities.

• Korean Journal of Psychosomatic Medicine
• /
• v.25 no.1
• /
• pp.46-55
• /
• 2017

Objectives : Outpatient treatment orders refer to a mandatory social program in which mentally ill persons are ordered by the court to participate in specified outpatient treatment programs. This study aimed to investigate the factors that affect outpatient treatment orders and adherence to outpatient treatment in mental health patients. Methods : A survey on outpatient treatment orders and adherence to outpatient treatment was conducted on 60 psychiatrists between October and November 2016. The questionnaire items were drafted based on a literature review, and they were then evaluated by 3 psychiatrists and 1 law school professor before being finalized. Answers from the respondents were analyzed using descriptive statistics, and the median, maximum, and minimum values of the effectiveness scores of outpatient treatment orders were calculated. Results : Among the 60 psychiatrists, 45(75.0%) were aware of outpatient treatment orders; however, only 2 out of the 45(4.0%) had actually used the program in the last 12 months. The subjective effectiveness was very low, with only 40 points out of 100. Furthermore, of the readmitted patients, 37.7% had received continued outpatient treatment, whereas 53.1% chose to quit the outpatient treatment programs, meaning that the number of dropouts was higher. Among the discharged patients, approximately two-thirds were receiving continued treatment. With regard to follow-up for dropouts, majority of the responses were either "Not taking any action"(n=27) or "Not following up"(n=15). Only two respondents answered "Contact the community mental health promotion center," meaning that this response was very rare. Meanwhile, when asked about efficient measures to be implemented for dropouts, a vast majority of the respondents(n=30) selected the answer "Work with the community mental health promotion center." Conclusions : The outpatient treatment orders currently being administered were found to be ineffective, and the associated adherence to outpatient treatment was also found to be extremely poor. Hence, the effectiveness of the therapeutic interventions could benefit from institutional as well as administrative improvements. Community mental health promotion centers are expected to have an important role in the future.

• 보건세계
• /
• v.56 no.6
• /
• pp.19-23
• /
• 2009

외래에서 흔히 이용하는 결핵 진단법으로는 객담 도말과 배양검사, 엑스선 검사가 있다. 일단 활동성 결핵으로 진단되면 환자의 과거력 등을 참조하여 치료를 하게 되는데, 초치료인 경우 아이나, 리팜핀, 에탐부톨, 피라진아마이드를 이용한 6개월 단기 초치료 처방으로 치료를 한다. 4제 처방의 효과는 강력하여 규칙적으로 약을 복용한다면 대부분 완치되며, 완치 판정은 치료 중 추구 객담검사를 이용한다. 대부분의 환자들은 진단, 치료에 어려움이 없지만 실제 외래 치료시에는 진단, 치료에서 어려운 문제가 발생하기도 한다. 이에 외래에서 부닥칠 수 있는 상황과 적절한 대처법을 알아보기로 한다.