• Title/Summary/Keyword: 진료향상

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The Effect of Doctor's Payment Method on Patient's Medical Care Use: Revisit of the Patient's Asymmetric Information Problem (환자의 의료이용에 대한 의사의 지불방식의 효과: 재방문 환자의 비대칭적 정보의 문제)

  • Jo, Changik;Lim, Jae-Young
    • KDI Journal of Economic Policy
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    • v.33 no.1
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    • pp.125-148
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    • 2011
  • Although the patient's problem with access to health information has been improved due to rapidly developing information technologies, such as the internet, some patients still do not have enough ability to understand, interpret, and analyze the health information. Given this view on the patient's asymmetric information problem, if a doctor provides sufficient effort to help patients understand and interpret medical information, the efficiency of patient's medical care use could be improved. This paper shows firstly that the patient's inefficient use of medical care originates from his information problems, such as the misperception of the effectiveness of medical care and secondly suggests that if the doctor makes sufficient effort to correct patient's information problems, the inefficiency can be ameliorated. This paper also suggests the manipulation of a doctor's payment method can lead a doctor to provide optimal level of efforts which can in turn lead patients to use the optimal level of medical care. With an optimal level of effort, a doctor can more easily achieve a patient's compliance with the newly recommended amount of medical care.

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A Job Analysis on Oral Health Education Task in Dental Hospitals and Clinics (치과 병·의원에서의 구강보건교육업무에 대한 직무분석)

  • Ji, Min-Gyeong;Park, Young-Nam
    • The Journal of the Korea institute of electronic communication sciences
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    • v.7 no.5
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    • pp.1235-1243
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    • 2012
  • This study was attempted in order to offer basic data for performing systematic and desirable task through improving job by surveying the actual condition and the task weight in dental hygienists. As a result of analyzing daily task weight in subjects of this study, the ratio of medical-cure cooperation task was indicated to be highest with 35.45%. It was indicated to be in order of periodontal therapy service with 21.54%, of administration & management task with 16.08%, of oral health education task with 15.88%, and of preventive treatment service with 11.23%. As for kind-based utilization ratio of the oral health education contents and oral health education data, a toothbrushing education method by subject was indicated most highly with 3.70 points. It was indicated to be in order of usage on oral hygiene device with 3.51 points, of educational method on regular check-up with 3.26 points, of educational method of preventing dental disease with 3.13 points, and of educational method on diet control with 1.39 points. Jaw-plate model was indicated to be used the most with 38.0%. It was indicated to be in order of orally explaining with 23.9% and of camera inside the mouth with 12.2%. Thus, establishment of a system is considered to be necessary in order to promote quality of oral health education for patients in the future by performing diverse programs with high utilization value in addition to a steady interest.

Comparison of Health Care Utilization and Morbidity of Children With and Without Disabilities in Korea (장애아동과 비장애아동의 의료이용 및 질병특성 비교)

  • Kim, Eu-Gene;Kim, Kyung-Mee;Yoo, Dong-Chul
    • The Journal of the Korea Contents Association
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    • v.17 no.7
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    • pp.696-706
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    • 2017
  • This study is to examine health care utilization and morbidity of disabled and non-disabled children in Korea to evaluate the health disparities. We used medical claim data of 2010 from the National Health Insurance Service-National Sample Cohort data. As a result of the analysis, the disabled children are not in good health condition because they have more frequency of medical service use, hospitalization rate, and more number of diseases and spent more on medical expenses than non-disabled children. Patterns of the most frequent disease differ from significantly between disable and non-disabled. Disabled children had a higher prevalence of selected birth defects and selected health conditions associated with physical disability and a lower prevalence of selected infection disease than children without disability. In conclusion, Health policy changes that would extend the access to health service for children with disabilities characterized by frequent medical care, hospitalization, excessive medical expenditure and complex diseases.

Effects of an Experiences Sharing Self-management Program for Hypertension and Diabetes Patients in Primary Public Health Center (보건진료소 중심 고혈압, 당뇨병 환자의 경험공유 자가관리 프로그램 효과)

  • Im, Jeong Ja;Yun, So Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.7
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    • pp.331-341
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    • 2020
  • This study examined the effects of an Experience Sharing Self-management Program (ESSP) on physiological indexes, knowledge, and self-management implementation among hypertension and diabetes patients in a primary public health center in G city. A quasi-experimental research was conducted with a non-equivalent control group pretest-posttest design. The experimental group (n=30) participated in a 12-week ESSP, and the control group (n=25) received only general services of a primary public health center between May 1 and October 31 in 2018. Data were analyzed with x2 test (Fisher's exact test), Mann-Whitney test, and Ranked ANCOVA using SPSS/WIN 22.0 program. The results showed significant differences in systolic blood pressure (F=14.56, p<.001), diastolic blood pressure (F=7.05, p=.012), knowledge (F=14.30, p=.001), self-management implementation (F=29.73, p<.001) of hypertension patients, knowledge (F=7.92, p=.010), and self-management implementation (F=4.54, p=.044) of diabetes patients between the two groups. Therefore, the ESSP was effective for reducing the blood pressure of hypertension patients and improving the knowledge and self-management implementation among hypertension and diabetes patients in a primary public health center.

A Design of Key Generation and Communication for Device Access Control based on Smart Health Care (스마트 헬스케어 기반의 디바이스 접근제어를 위한 키 생성 및 통신기법 설계)

  • Min, So-Yeon;Lee, Kwang-Hyong;Jin, Byung-Wook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.11
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    • pp.746-754
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    • 2016
  • Smart healthcare systems, a convergent industry based on information and communications technologies (ICT), has emerged from personal health management to remote medical treatment as a distinguished industry. The smart healthcare environment provides technology to deliver vital information, such as pulse rate, body temperature, health status, and so on, from wearable devices to the hospital network where the physician is located. However, since it deals with the patient's personal medical information, there is a security issue for personal information management, and the system may be vulnerable to cyber-attacks in wireless networks. Therefore, this study focuses on a key-development and device-management system to generate keys in the smart environment to safely manage devices. The protocol is designed to provide safe communications with the generated key and to manage the devices, as well as the generated key. The security level is analyzed against attack methods that may occur in a healthcare environment, and it was compared with existing key methods and coding capabilities. In the performance evaluation, we analyze the security against attacks occurring in a smart healthcare environment, and the security and efficiency of the existing key encryption method, and we confirmed an improvement of about 15%, compared to the existing cipher systems.

Caring Experiences of the Nurses Caring for Foreign Inpatients of non-English Speaking (비영어권 외국인 입원환자를 돌보는 간호사의 경험)

  • Jang, Hye-Young;Lee, Eun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.415-426
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    • 2016
  • With a rapidly increasing number of foreign patients in Korea, it is necessary to manage and enhance the quality of nursing care for foreign inpatients through the promotion of studies on practical nursing care experience. This study is a qualitative study conducted to understand and describe the care experiences of nurses responsible for non-English speaking foreign inpatients. There were 10 nurses with a clinical career of more than two years included in this study for analysis. Data were collected through in-depth individual interviews and analyzed using qualitative content analysis. Five themes emerged from the analysis. 'Aware of cultural differences', 'establish trusting relationships through all my heart', 'additional nursing task', 'empathy for genuine nursing', 'sorriness and relieved'. The results of this study provided the understanding on the experiences of nurses, who do not speak English, but still responsible for providing care to foreign inpatients. Despite the language barrier, cultural differences, and work overload, nurses caring for foreign patients struggled with authenticity in nursing. On the other hand, as there was a lack of system resources, such as manuals and training materials in various languages other than English, institutions should put forth greater effort and resources to be prepared to care for foreign inpatients.

EUS 도입에 따른 언더라이팅 효율극대화 방안

  • Jo, Seok-Hoon
    • The Journal of the Korean life insurance medical association
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    • v.24
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    • pp.79-96
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    • 2005
  • 1. 연구배경과 문제제기 - 보험시장의 환경변화 : 보험업법 개정, 방카슈랑스 도입, 고(高)보장성 생존급부(CI, LTC)상품의 등장, 통신판매 전문보험회사의 설립 허용 - 현행 언더라이팅 시스템의 문제점 : 위험난이도와 판매 채널별 특성이 고려되지 않고 언더라이터에 전건 배정 되어 업무의 효율성이 낮음 - 보험시장의 환경변화에 맞는 EUS(Expert Underwriting System) 도입으로 언더라이팅의 효율성을 증대하고자함 2. 국내/외 생보사 언더라이팅 시스템 현황 비교 및 개선방안 - 국내 언더라이팅 시스템 현황 : 청약서 입력/스캔 후 진단 및 적부 유무(有無)에 따라 자동으로 언더라이터에게 심사가 배정됨 - 미국 언더라이팅 시스템 현황 : EUS에 의한 1차 전산승낙여부 결정 후(後)언더라이터에게 심사가 배정됨 - 위험난이도의 고저(高低)와 관계없이 언더라이터에 배정되는 심사시스템의 문제점을 극복하고 체계적인 위험평가를 위해 EUS도입이 필요함 3. EUS 선행요건 - 고객정보의 확보 - 국내 생보사의 고객정보 수집원 : 청약서, 모집인 보고서, 건강진단서,적부조사, 보험사고정보조회시스템 (ICPS), 고액보험 및 상해보험 중복가입자에 대한 정보 교환제도 - 북미 생보사의 고객정보 수집원 : 청약서, 모집인 보고서, 의사소견서 및 진료기록서, 건강검진, 적부조사, 정보교환제도( 북미보험사간 의료정보 공유-MIB) - 정확한 고객정보의 확보방안 : 법률/제도의 정비, 청약서 질문 내용의 세분화, 의료정보교환제도의 구축 4. EUS 개요 및 현황 - EUS의 정의: 고객의 정보를 입력하여 청약부터 보험증권 발행 단계까지 One-Stop 서비스를 제공하는 것으로 언더라이터가 청약서를 가지고 언더라이팅 하는 것과 동일한 업무를 할 수 있는 전문가 시스템 - EUS의 장점: (1) 비용절감 및 인력의 효율적 활용 (2) 업무별 시스템화 되는 조직속성에 적합함. (3) 언더라이팅 정책이 경영 환경 변화에 대처하는데 신속함 - 국외 EUS 현황 (예: Cologne Re) 및 사례연구 5. 위험분류 및 EUS 개요현황 (언더라이팅 시스템 도입) - 위험관리 선행요건으로 위험요소별 분류가 체계적으로 수립되어야 함. - 데이터웨어하우스 (의사결정을 목적으로 설계된 조회와 분석이 가능한 통합된 정보저장소) 시스템 사용 - EUS 도입을 통한 언더라이팅 프로세스: 데이터마이닝 과정을 통해 "자동승낙, 언더라이터에게 심사배정, 적부의뢰, 진단의뢰, 텔레 언더라이터, 보완지시"등이 결정됨. 6. 판매채널별 EUS 활용방안 - 대면채널: 효용성 높은 정보제공과 정확한 위험분석이 가능한 시스템으로 고(高)보장, 고(高)위험 상품에 대해 언더라이터가 집중 심사 할 수 있게 함. - 방카슈랑스: 3S(간결, 신속, 서비스)의 특성에 맞는 전과정 무인자동심사시스템 - 비대면채널: 판매상품과 타겟시장을 명확히 한 후 도덕적 위험과 재무적 위험에 대한 평가시스템 및 의사결정 시스템을 도입 7. 결론 - EUS 도입의 기대효과 (1) 심사기일의 단축으로 고객만족 실현 (2) 체계적 과학적 리스크 관리로 위험률차익 증대에 기여 (3) 업무효율의 증대와 언더라이터의 역량강화 (4) CRM 활용증대와 모바일 청약시스템 구축의 근간 - EUS 도입시 경제적 법률적 제도적 문제 극복과 생보 업계 공동의 관심과 노력이 필요함 - EUS를 활용하여 종합적.체계적 리스크 관리가 가능한 금융회사로의 경쟁력 향상에 기여함.

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Pulmonary Embolectomy for Treatment of Pulmonary Embolism (폐색전증의 수술적 치료)

  • Park, Byung-Joon;Park, Pyo-Won;Shim, Young-Mog;Lee, Young-Tak;Park, Kay-Hyun;Kim, Jhin-Gook;Kim, Wook-Sung;Sung, Ki-Ick
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.492-496
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    • 2009
  • Background: The treatment of acute pulmonary embolism is difficult, and it can be lethal when cardiogenic shock is involved with major pulmonary embolism. In the past, pulmonary embolectomy was considered as the last choice for patients with pulmonary embolism. Accordingly, we analyzed our experience with seven cases of pulmonary embolectomy as an alternative option for the early treatment of pulmonary embolism. Material and Method: A retrospective analysis of medical charts of all patients who underwent pulmonary embolectomy at our hospital over the past eight years was performed. The patients were observed during their hospital stay and followed until their last visit to the outpatient department. Result: Among 7 patients (4 men and 3 women), 4 had massive pulmonary embolism, and 3 had sub massive pulmonary embolism. An extracorporeal membrane oxygenator was inserted in 3 patients before surgery. There was no mortality, and postoperative echocardiography showed no pulmonary hypertension in 6 patients. Conclusion: Pulmonary embolectomy can be performed with minimal mortality. We think that the use of an extracorporeal membrane oxygenator in patients with cardiogenic shock before surgery improves survival.

THE TREATMENT RESULTS OF A DAY TREATMENT PROGRAM FOR CHILDREN WITH DEVELOPMENTAL DISORDERS (발달 장애 아동에게 시행된 주간 치료실 프로그램의 치료 결과에 대한 고찰)

  • Kwak, Young-Sook;Kang, Gyung-Mi;Lee, Hae-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.100-109
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    • 2000
  • Objective:This was conduced to evaluate the effect of early intervention to promote the development of children with developmental disorders. Methods:49 children(31 in PDD group and 18 in DLD group) participated in a one year day treatment program conduced from 1996 to 1999. They were performed PEP, CARS, and SMS. They were grouped by diagnosis, comorbidity, chronological age and CARS score at the beginning of the program and the treatment effect was compared. Results:The children who participated in the day treatment program showed significant increase in their PEP, SMS score, and decrease trend in their CARS score. When children were grouped by diagnosis, comorbidity, chronological age, and severity in CARS score we did not find out significant difference between groups. Conclusion:Our data suggest that the day treatment program which emphasis on development is effective in treating children with developmental disorders.

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A Study on Decisive Factors Impacting Business Profits of Regional Medical Centers (지방의료원의 경영수익성과에 영향을 미치는 결정요인에 대한 연구)

  • Lee, Jin-Woo;Kim, Young-Jong;Kim, Yong-Ha;Kim, Kwang-Hwan
    • Journal of Digital Convergence
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    • v.12 no.7
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    • pp.315-325
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    • 2014
  • This study is investigates decisive factors impacting business profits of regional medical centers by utilizing their environmental characteristics to provide useful basic data to seek for a method to establish financial soundness and profitability. The research objects are medical treatment record and management indicators of 31 regional medical centers for the past three years from 2010 through 2012. The method of analysis are ANOVA and Multiple Regression Analysis. The results revealed the debt and management ratio in the profit rate of total medical liabilities and net worth, current balance in the medical profit on medical revenue, and hospital bed turnover rate, emergency hospitalization rate, rate of labor cost, and rate of material cost in the business profits as the decisive factors. It is recommended to identify financial feedback and establish diversified management strategies through accurate management analysis to secure financial soundness and profitability in medical centers.