• Title/Summary/Keyword: 의료중재원

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The Medical Disputes and Its Alternative Dispute Resolutions in Germany (독일의 의료분쟁과 대체적 분쟁 해결 기구)

  • Kim, Jang Han;Lee, Seok-Bae
    • The Korean Society of Law and Medicine
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    • v.17 no.1
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    • pp.139-168
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    • 2016
  • Two alternative dispute resolutions for medical dispute have been operated under the States of German Medical Associations. The first is the medical mediation committee of North german area, the other is the advisory committee on medical errors in North-Rhine area. The former has focused on the mediation itself, the latter commission has focused on the expert review itself whether the physician has maintained reasonable care in diagnosis and treatment. Even though these organizations have maintained under the medical associations, to maintain the neutrality on legal and medical decision, the North German mediation committee is composed of a lawyer and a medicine doctor respectively and North-Rhine advisory committee has a lawyer chair person and four medicine doctors. The main difference of Korean Medical Dispute Mediation Agency in respect from the german system is that expert review is subordinated to the mediation process. The neutrality of expert review is suspected from the medicine doctors. The neytrality and the efficiency should be improved to treat the medical disputes. To do so, lawyer and medicine doctor work together in mediation process and lawyer should manage the expert review process but not involved. Mediation process and expert review should be checked and balanced, and they could be developed as a separated process itself.

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Eine Studie $\ddot{u}$ber $\ddot{A}$rztliche Konflikte in Deutschland und die alternative Beilegung von Rechtsstreitigkeiten - Deutsche Schlichtungsstellen und Gutachterkommission - (독일의 의료분쟁과 대체적 분쟁해결방안(ADR) - 독일 의료중재원과 의료감정위원회를 중심으로 -)

  • Nam, Jun-Hee
    • The Korean Society of Law and Medicine
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    • v.10 no.2
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    • pp.407-426
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    • 2009
  • Kennzeichnend f$\ddot{u}$r die $\ddot{a}$rztlichen T$\ddot{a}$tigkeiten, wenn Konflikte in medikament$\ddot{o}$sen Behandlungen auftreten, passiert es oft, dass es wegen unn$\ddot{o}$tigen Missverst$\ddot{a}$ndnissen oder Mangel an Verst$\ddot{a}$ndnis zwischen Arzt und Patient als extremes Ph$\ddot{a}$nomen zum impulsiven Strafprozess oder physischer Gewalt von Seite des Patienten kommt. In diesem Falle verteidigt sich der Arzt mit Schutzbehandlung und Behandlungsablehnung um die Folgen der $\ddot{a}$rztlichen Behandlung zu entweichen. Es ist dadurch auf beiden Seiten, Arzt und Patient, eine schwierige Sache. Denn der Versuch solche F$\ddot{a}$lle in Konflikten durch Zivilklage zu kl$\ddot{a}$ren, ist die Beweisf$\ddot{u}$hrung des Patienten und die dadurch in Lange gezogene Anklage meist durch die $\ddot{a}$rztliche Fachlichkeit und Behutsamkeit nicht wirklich m$\ddot{o}$glich. Infolgedessen ist es n$\ddot{o}$tig alternative Streitbeilegungsmethoden wie Schlichtung, Regelung oder Vermittelung einzuf$\ddot{u}$hren, anstatt von Gerichtsverfahren. Konflikte in einer $\ddot{a}$rztlichen Behandlung sind f$\ddot{u}$r den Patienten und auch f$\ddot{u}$r den Arzt eine Plage, denn physischer und geistiger Schaden wird dadurch verursacht. So ist eine schnelle Einf$\ddot{u}$hrung vertrauensw$\ddot{u}$rdiger Methoden in diesem Bereich notwendiger als in anderen. In diesem Aufsatz wird eine m$\ddot{o}$gliche Einf$\ddot{u}$hrung von einer passenden alternativen Beilegung von Rechtsstreitigkeiten in S$\ddot{u}$dkorea und ein Plan zur Aktivierung von dieser vorgef$\ddot{u}$hrt. Derzeitig wird in Deutschland als Alternative f$\ddot{u}$r Anklagen in den jeweiligen Bundesl$\ddot{a}$ndern die von den $\ddot{A}$rztevereinen erstellten und beaufsichtigten Schlichtungsstellen und Gutachterkommission in Rat genommen. Schlie$\ss$lich sollten wir aufgrund der vorliegenden Fakten und die Vor-und Nachteile dieser Schlichtungsmethoden auffassen und als Vorbild unserer anwenden und versuchen diese in Aktion zu bringen.

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A Study on Legal Liability and Efficient Planning for Alternative Dispute Resolution in Medical Disputes (의료분쟁의 법적책임과 ADR제도의 효율적 운영방안)

  • Nam, Seon-Mo
    • Journal of Arbitration Studies
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    • v.26 no.4
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    • pp.129-149
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    • 2016
  • Medical dispute means the dispute between the hospital and the patient due to a medical accident. In general, medical accidents must be in accordance with the terms that are used in the medical dispute adjustment method stated in Article 2 (definition). In relation to this, there is a need to discuss an efficient operation scheme for Alternative Dispute Resolution (ADR) in medical disputes. In addition, it is necessary to look at issues of civil liability and criminal liability. In particular, in the consumer dispute arbitration committee, there is a case to make a "decision not to adjust" in aggressive intervention in the process of conflict resolution. The medical staff, on the basis of its "decision," can use this as a proven material for civil and criminal cases. This is rather upon the determination of the consumer council as a typical side effect to defend the user's perspective. This is the "decision" as was expressed from an order, "not adjusted." It is also determined to be easy and clearly timely. In the medical litigation, it is requesting the burden of proof of a patient's cause-and-effect relationship with the doctors committing negligence and medical malpractice. This seems to require the promotion of legislation in the direction to reduce future cases. It is determined that the burden of proof of medical accidents must be improved. The institution receiving the medical accident should prevent a closure report. Further, it is necessary to limit the transition to a franchise point. In this paper, we understand the problems of the current medical dispute resolution system, trying to establish a medical dispute resolution system desirable through an efficient alternative. In addition, it wants help in the protection and realization in medical consumers' and patients' rights. The relevant authorities will take advantage of these measures. After all, this could contribute to the system for a smooth resolution of a medical dispute.

The Bitter Counsel for Activation of the Korea Medical Dispute Mediation and Arbitration Agency (한국의료분쟁조정중재원의 활성화를 위한 고언(苦言))

  • Roh, Sang-Yup
    • The Korean Society of Law and Medicine
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    • v.17 no.1
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    • pp.169-208
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    • 2016
  • "Act on Remedies for Injuries from Medical Malpractive and Mediation of Medical Disputes)" has been enacted to solve medical dispute. In addition, mediation and arbitration procedures have started since April 8th, 2012 from the Establishment of Korea Medical Dispute Mediation and Arbitration Agency. The average initiation rate of mediation for the past three years turned out to be 43%. Hereupon, Establishment of Korea Medical Dispute Mediation and Arbitration Agency has created a solution for automatic initiation if relevant to particular conditions to improve initiation rate of mediation procedures and passed it through the Assembly plenary session in May, 2016 and promulgated on the 30th of the same month. However, even if mediation procedure initiation rate is increased, there is no guarantee for mediation establishment rate to be improved according to current law. If Establishment of Korea Medical Dispute Mediation and Arbitration Agency intends to increase aforementioned value, automatic initiation is not the only solution. Instead, it seems to be a major assignment to identify fundamental reasons for why major health care facilities have not participated in it and to restore reliability on them. In addition, among crimes specified on the Article 268 of Criminal Act in the Article $51^*$ of "Act on Remedies for Injuries from Medical Malpractive and Mediation of Medical Disputes)", revision must be made so that the clause of clue and death by occupational or gross negligence is applied. Furthremore, it is suggested to supplement previously insufficient policies with the operation so that mediation procedures created by Establishment of Korea Medical Dispute Mediation and Arbitration Agency are stably settled in the perspective of medical institutions including the establishment of new conditions for medical institutions founders or health and medical service personnel to claim the proxy payment for damage.

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A study on the mediating effects of teamwork in the care team (진료팀에 있어 팀워크의 중재효과에 관한 연구)

  • Yu, Byung-Nam
    • Journal of the Korea Safety Management & Science
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    • v.14 no.3
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    • pp.291-298
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    • 2012
  • 의료조직의 팀제는 산업계의 팀과는 다르다. 산업계의 팀 구성원들이 팀원으로서 단일의 지위, 책임, 직무를 가지고 있고, 팀장에 의하여 평가받을 것이다. 그러나 의료조직의 진료팀 구성원들은 일반적으로 팀 구성원과 기능적 부문의 구성원으로서 이중의 지위, 책임과 의무를 유지하고 있다. 그렇기 때문에 진료팀에 있어서는 상호간의 의사소통을 활성화시킬 수 있는 더욱 향상된 노력이 필요하고 다양한 분야의 전문가들을 통합할 수 있는 임파워먼트된 리더십이 필요한 것이다. 실증분석은 대학병원에 소속되어 있는 진료팀 구성원들에 대한 조사를 통하여 수집되었다. 실증분석 결과는 정교하게 설계된 팀 전략이 적용되어야 함을 제시하고 있다. 팀 구성원들은 팀 요인이 확인되어야 하고 리더십과 의사소통에 의하여 검토되어야 하는 개념으로 인식하는 것으로 분석되었다. 즉, 팀 요인은 필요조건이고 팀 요인에 기반한 팀 과정이 팀 성과를 향상시키는 충분조건이라는 것이다.

Improvement in the Medical Dispute Mediation System of Korea Consumer Agency (한국소비자원 의료분쟁 조정제도의 개선방안)

  • Jeon, Byong-nam
    • The Korean Society of Law and Medicine
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    • v.16 no.1
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    • pp.255-288
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    • 2015
  • It is desirable to prevent medical accidents because they bring about irretrievable outcomes to patients, as they are directly related to each patient's life, and health. However, once medical accidents occur, it is appropriate to resolve them quickly without conflict before the feelings of directly involved people are intensely confronted with each other. Korea Consumer Agency carries out medical dispute mediation to address such disputes quickly, fairly, and efficiently, and so does Korea Medical Dispute Mediation and Arbitration Agency. Although there has been constant debate on a merge between the two agencies because of duplicated work and consequent inefficiency, it is desirable to maintain the two agencies to ensure consumers' options and to promote the mutual development of the agencies through competition. Therefore, there should be legal and systematical support for Korea Consumer Agency to have fair competition with Korea Medical Dispute Mediation and Arbitration Agency. This is not for Korea Consumer Agency, but ultimately for consumers.

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Hospital-based home care reinbursement and service use for the elderly (노인의 의료기관 가정간호 급여청구 및 서비스 이용 현황)

  • Chin, Young-ran
    • 한국노년학
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    • v.29 no.2
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    • pp.645-656
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    • 2009
  • The purpose of this study was to address the current status of hospital-based home care(HBHC). We analyzed the data on HBHC from national electronic data information of Health Insurance Review Agency. Beside, we surveyed 75 hospital-based home care agency. In 2006, 20,343 elderly(64.0% from all HBHC user) used 333,889 visits(76.8%from all visits). Medical diagnosis was composed of circulatory disease including cerebrovascular diseases 41.3%, endocrine system disease including Diabetes mellitus 10.4%, neoplasm 9.7%. Some of subjects used HBHC in excess of maximum covered 8 visits a month by National Health Insurance, decubitus 7.0%, the cancer 5.4%, the diabetes 2.5%, the hypertension 1.1%, and the stroke 0.9%. This results will contribute to expand the coverage of hospital-based home care by National Health Insurance. There was distribution difference in medical diagnosis and nursing intervention between HBHC and Public health center-based home care(PBHC) subjects. Therefore, HBHC subjects had more severe medical diagnosis, and were intervened more injections, examinations, than PBHC subjects. These differences must be considered to set up functional role among the three types of home visit care.

Pain Nursing Intervention Supporting Method using Collaborative Filtering in Health Industry (보건산업에서 협력적 필터링을 이용한 통증 간호중재 지원 방법)

  • Yoo, Hyun;Jo, Sun-Moon;Chung, Kyung-Yong
    • The Journal of the Korea Contents Association
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    • v.11 no.7
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    • pp.1-8
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    • 2011
  • In modern society, the amount of information has been significantly increased according to the development of Internet and IT convergence technology and that leads to develop information obtaining and searching technologies from lots of data. Although the system integration for medicare has been largely established and that accumulates large amounts of information, there is a lack of providing and supporting information for nursing activities using such established database. In particular, the judgement for the intervention of pains depends on the experience of individual nurses and that leads to make subjective decisions in usual. In this paper, a pain nursing supporting method that uses the existing medical data and performs collaborative filtering is proposed. The proposed collaborative filtering is a method that extracts some items, which represent a high relativeness level, based on similar preferences. A preference estimation method using a user based collaborative filtering method calculates user similarities through Pearson correlation coefficients in which a neighbor selection method is used based on the user preference.

Association Between Lifestyle and Medical Expenses of Older Adults With Mental Illness: Using Korea Older Adults' Cohort Database (노인 코호트 DB를 이용한 정신과 질환 동반 노인의 생활 습관과 의료비 지출 크기의 연관성 분석 연구)

  • Jeong, Jiin;Bae, Suyeong;Yoo, Eun-Young;Hong, Ickpyo
    • Therapeutic Science for Rehabilitation
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    • v.12 no.1
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    • pp.51-63
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    • 2023
  • Objective : This study aimed to analyze the association between lifestyle and medical expenses of older adults with mental illness using claims data. Methods : We conducted secondary data analysis using the older adult cohort database provided by the Korea National Health Insurance Service. The lifestyle and medical expense variables were extracted from the cohort database. We used a generalized linear model to examine the association between lifestyle and medical expenses. Results : In total, 32,853 records were extracted. The results showed that smokers had medical expenses (estimate = -218,255, p = .037). As the number of days of walking increased, medical expenses significantly decreased (estimate = -58,843, p < .0001). Furthermore, as the number of days of drinking decreased, medical expenses increased (estimate = 692,289, p < .0001). Conclusion : This study analyzed the estimates of medical expenses according to lifestyle among older adults with mental illness. Smoking and exercise were negatively associated with medical expenses. These results suggest the importance of a healthy lifestyle for older adults with mental illness. In addition, this study can be used as clinical evidence for lifestyle management programs to improve physical and mental health.

산림환경에서의 크나이프(Kniepp) 요법

  • 홍금나;신방식;송규진;손정희;김현석;최민주
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2022.09a
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    • pp.3-3
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    • 2022
  • 배경: 독일 크나이프 요법을 국내에서 적용하기 위해 검증 연구가 필요하다. 목적: 국내 산림 환경에서 적용한 크나이프 요법이 자율 신경계 및 회복탄력성에 미치는 영향을 규명하기 위함이다. 방법: 크나이프 요법 중 4가지 요소('움직임', '삶의 질서', '음식 섭취', '치유 식물')를 고려한 중재 프로그램을 구성하여, 성인 40명을 대상으로 적용했다. 중재 전과 후에 맥파측정기(uBioMacpa)를 이용하여 HRV(TP, VLF, LF, HF, LF/HF, CSI: Cumulative Stress Index)와 회복탄력성 지수를 측정하고 비교 분석했다. 결과: HRV를 분석한 결과, 프로그램 중재 후 연구 대상자의 TP(8.64%, p<.001), VLF(6.96%, p<.05), LF(15.86%, p<.001), HF(8.46%, p<.01), LF/HF(5.77%, p<.05)는 유의하게 증가하였고, CSI는 유의하게 감소하였다(16.06% p<.001). KRQ-53 평균 점수는 191.56점에서 206.22점으로 14.66점 증가한 것으로 나타났다. 결론: 국내 산림 환경에서 적용한 크나이프 요법은 자율신경계를 전체적으로 활성화하고, 교감과 부교감신경의 활성도를 높여 심장 활동을 촉진시키며, 누적 스트레스를 감소시켜 주었다. 그리고 회복탄력성을 개선하는 것으로 나타났으며(p<.05), 특히 자기 조절 능력 요인에서 그 효과가 큰 것으로 확인되었다. 본 연구의 결과는 크나이프 요법이 국내 산림 환경에서 치유 프로그램으로 활용되어 스트레스 해소를 포함한 자율 신경계의 긍정적인 효과를 제시한 초기적인 최초의 증거라 할 수 있다.

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