• Clinical and Experimental Pediatrics
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• v.48 no.8
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• pp.813-819
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• 2005

Purpose : Medicolegal problems start when the patient asserts the mistake of doctor and doctor does not accept it. The purpose of this study is to assess the actual condition of medicolegal problems and to provide solutions of medicolegal problems in the pediatric field. Methods : There is not official statistical data about medicolegal problems in our country. We gathered data of legal insurance program of Korean Medical Association(KMA) and court cases and other fragmentary data. Results : Between 1981 and 1995, of total 2,338 cases reported to legal problem insurance program of KMA, most common ones were 748 cases of obstetrics and gynecology. Pediatric case was ranked at the 5th, 74 cases(3.1%). According to analysis of 41 medicolegal cases' after 1990, maltreatment of patient had the highest incidence of 14 cases, injection and medication were related to 12 cases, misdiagnosis was 9 cases, patient management were related to 4 cases, and others were 2 cases. The trial result of the medicolegal cases was that 31 cases were compensated, and 8 cases were defeated, and 2 cases were still in the process. Conclusion : The aspect of medical legal problem has the tendency of radicalism and systematization. This brings an economic destitution in the patient and gives damage to a doctor. In order to reduce medicolegal problem, doctor should offer a duty of explanation and efforts to his best to satisfy patient and endeavor to make an intimate doctor-patient relationship.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.163-194
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• 2017

Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

• Journal of dental hygiene science
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• v.6 no.2
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• pp.133-138
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• 2006

To find out influence of water fluoridation program on the economic benefit effect, this study analyzed comparatively dental treatment indicators obtained from dental clinics at Sangdang-gu in Chenongju City, fluoridated community and Manan-gu in Anyang City, non-fluoridated community, from January 1, 2003 to the end of June, and the results are as follows: 1. If water fluoridation program is carried out in Anyang, non-fluoridated community, the number of treatment from caries and disease of tissues around dental pulp and root apex from age 6 to 18 for the first half of year 2003 is expected to decrease by 1,272, 636 for low estimation, and 1,908 for high estimation. And the treatment cost is expected to decrease by 40,888,000 Wons, 20,444,000 Wons for low estimation, and 61,333,000 Wons for high estimation. 2. Assuming that water fluoridation program is spread to all over the country, the number of treatment per year is expected to decrease by 2,492,018, 1,246,009 for low estimation, and 3,738,027 for high estimation. And the treatment cost is expected to decrease by 80,105,075,000 Wons, 40,052,537,000 Wons for low estimation and 120, 157,612,000 Wons for high estimation respectively. 3. For Yeong-un water supply management office which has 48,925 water supply personnel, the benefit/cost rate was 2.9 times, and for Jibuk water supply management office which has 239,751 water supply personnel, the benefit/cost rate was 9.0 times. As the water supply personnel increased, the cost increase of water fluoridation program was little and as the scale got large, the economic effect was very large. Improving national oral health is thought to be associated with expense retrenchment of oral health insurance financial. So it may need to extend using tap water to all the area of the country and additionally establish confidence through an active public relations and education of water fluoridation program.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.1
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• pp.28-34
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• 2018

Purpose With regard to the use of radioiodine in domestic medical institution, the case of exceeding the allowance of nuclear safety Act about radioactive concentration in drainage was found. Through understanding the cause of exceeding case and analyzing radioactive concentration in drainage, evaluating the relationship of the public waters in surroundings and usefulness. Materials and Methods From November 1, 2014 to April 30th, 2015, the research is aiming at domestic twenty hospitals for six months. By using a HPGe gamma-ray spectrometer(Canberra DSA-1000) and GENIE-2000 Analysis software for comparative analysis, measuring a radioactive concentration of radioiodine in drainage. Consequently, we confirm the excess of radioactive concentration of radioiodine in seven medical institutions. Results Conducting a survey of twenty hospitals and average radioactive concentration of radioiodine in drainage appears $42,100Bq/m^3$. The features of domestic hospitals where show a high radioactive concentration are a number of medical treatment patient when using radioactive iodine and the absence of private rest room. During I-131 whole body scan, the pretreatment procedure of urinating is considered emission of residual Iodine. In public waters, the cause of exceeding detect on radioactive concentration in drainage suppose a diagnostic radioactive iodine. Conclusion We confirm the importance of enhanced education, providing a safety control instructions and installing a private rest rooms for patients who injected a low capacity radioiodine. Also, constructing institutional and legal management system is considered about the Emission management standard in drainage.

• Journal of dental hygiene science
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• v.8 no.4
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• pp.241-246
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• 2008

he purpose of this study was to examine the awareness of dental hygienists about medical malpractice and dispute. The subjects in this study were 206 dental hygienists at dental clinics, on whom a survey was conducted. After SPSSWIN 14.0 program was utilized to analyze the collected data, the following findings were given: 1. As for experiences of being complained from patients by age, the dental hygienists who were at the age of 21 to 23 made up the largest age group (39.2%) who had ever meet patients who had grievances. By career, those who had worked for less than a year constituted the greatest group (30.4%) who had the same experiences. It indicated that the dental hygienists who were younger and had a less career had been more complained from patients. 2. In terms of problems posed by patients, scaling came into question the most (14.5%), followed by diagnosis (14.4%), impression (12.9%) and radiography (11.0%). 3. Regarding perception of scaling treatment, 90.8 percent, the greatest percentage, kept records of patients about scaling. As to how to do that, 34.5 percent, the largest percentage, wrote it down and then signed their name. Concerning the way of explaining how to take care of oral health, 82.5 percent gave an explanation without any prints. 4. As to knowledge on the medical law, they got a mean of 12.34 out of possible 16 points. 5. Concerning the necessity of education about the prevention of medical accidents and countermeasures, 70.4 percent felt the strong and urgent need for that.

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.53-66
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• 2003

Objectives: To investigate the state of medical care around health sub-centers, public health doctors' participation and opinion in the process of district public health programs. Methods: The study included 1,036 public health doctors who worked at health sub-center all over the country. The data were collected for Feb, 2002 using self-administered questionnaire by mail. Results: One or two doctors were working at health sub-center and 33.5% of health sub-centers was located in the region of the separation of prescription and dispensing. There were another medical facilities in 45.9% of the administrative district(eup or myon) where health sub-centers were located. The count of medical utilization went down to 14.8${\pm}$14.8 per a day in Nov, 2001 from 18.0${\pm}$15.6 in May, 2000, and the decline was much more in the region of the separation of prescription and dispensing. Among public health programs in health sub-centers, public health doctors participated mostly in preliminary medical examination for vaccination and least in health education. They participated in implementation rather than planning or evaluation of health program. Over a half of public health doctors were found to be positive that health programs implemented in their health sub-centers would promote the level of health in community people and they were willing to participate in district public health program if community people were in need. Conclusions: Recently health sub-centers are required to turn into health promotion facilities rather than medical practice facilities. Health program in health sub-centers will be advanced in both quality and quantity by turning the role of public health doctors who have provided medical services mainly into managing health program. Persistent education about managing health program and the policy to motivate participation in health program should be provided for public health doctors.

• The Journal of the Korea Contents Association
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• v.9 no.6
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• pp.196-206
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• 2009

The profitability of a hospital refers to business administration results achieved through its medical care and other management activities during applicable fiscal year. This study focused on operating margin as a measurement index of hospital profitability, which is a genuine medical return obtained by subtracting medical expenses from medical profits achieved during business administration of hospital. Based on the index, this study could deduce certain factors on hospital profitability in terms of various indices affecting profitability. And based on those factors, this study sought to provide more useful reference materials which allow us to devise possible ways to improve hospital profitability. As a result, it was found that public hospitals attained lower profitability than private ones. To analyze profitability depending on each index, this study divided hospitals broadly into deficit group and surplus group. As a result, it was found that there were significant differences in hospital profitability between two groups depending upon relevant indices such as labor cost ratio, maintenance expense ratio, number of operations per medical specialist and medical instrument turnover. According to analysis on potential effects of relevant indices upon profitability, it was found that each index had its explanatory power ranging from 25% to 74.5% depending on given model.

• Korean Journal of Clinical Laboratory Science
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• v.54 no.1
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• pp.73-77
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• 2022

Blood products (BPs) can only be obtained through blood donation and hence represent a finite resource. BPs should therefore be used conservatively. However, BPs are being used indiscriminately without evidence. The purpose of this study was to evaluate the reasons for the use of BPs and their appropriateness. The investigation was carried out based on hemoglobin levels. Data were obtained from Nov 1, 2020, to Oct 31, 2021, from a hospital's OCS/EMR systems. The BPs were dispensed in 21,303 cases, and the number of hemoglobin levels >7.0 g/dL or higher among red blood cell drugs used by each treatment department was 1,173 (>7.0 g/dL). The misuse of blood transfusions is increasing social costs, with the adequacy of transfusion becoming increasingly important. Hence, each medical institution should review the transfusion guideline evaluation index, check the status of the release of BPs, and institute educational programs covering transfusion guidelines and continually evaluate their adequacy.

• Journal of Preventive Medicine and Public Health
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• v.26 no.2 s.42
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• pp.222-230
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• 1993

Industrial glues, known as 'Bonds' in Korea, contain many kinds of organic solvents, and glue sniffing of youths became one of the social problems in Korea. Mixed exposures to solvents by glue sniffing may induce chronic toxicities different from those by exposures to solvents of single component. To test effects of the glue sniffing on weight gain or central nervous system, two groups of 20 male Sprague-Dawley rats were exposed to air(control group) or vapors of the glues to narcotic status(exposed group), and weight check, tail flick test, hot plate test, rotarod treadmill test were done on the 14th,24th, 36th, 45th, 53rd, 86th, 102nd, 117th, 134th and 151st days after the first exposure. On the 188th day, their brains were excised and examined by a pathologist. Weight gain, controlled against time change, showed significant difference between the groups, but response times in tail flick test, hot plate tests, and rotarod treadmill test didn't. In pathological examination with blind method, no macroscopic or microscopic differences were found between the two groups. These results suggests that organic lesion in central nervous system may not ensue glue sniffing, but, before firm conclusion, more studies in various exposure conditions should be followed.

• Health Policy and Management
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• v.34 no.2
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• pp.163-177
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• 2024

Background: This study aims to examine changes in fraudulent claim counts and total reimbursements before and after enhancements in counterfeit claim controls and monitoring of provider claim patterns under the "Proactive self-audit pilot program of fraudulent claims." Methods: This study used the claims data and hospital information (July 2021-February 2022) of the Health Insurance Review and Assessment Service. The data was collected from 1,129 hospitals assigned to the pilot program, selected from the providers who filed a claim for reimbursement for intravenous injections. Paired and independent t-tests, along with regression analysis, were utilized to analyze changing patterns and factors influencing claim behaviors. Results: This program led to a reduction in the number of fraudulent claims and the total amount of reimbursements across all levels of hospitals in the experimental groups (except for physicians below 40 years old). In the control group, general hospitals and hospitals demonstrated some significant decreases based on the duration since opening, while clinics showed significant reductions in specified subjects. Additionally, a notable increase was observed among male physicians over the age of 50 years. Overall, claims and reimbursements significantly declined after the intervention. Furthermore, a positive correlation was found between hospital opening duration and claim numbers, suggesting longer-established hospitals were more likely to file claims. Conclusion: The results indicate that the pilot program successfully encouraged providers to autonomously minimize fraudulent claims. Therefore, it is advised to extend further support, including promotional activities, training, seminars, and continuous monitoring, to nonparticipating hospitals to facilitate independent improvements in their claim practices.