• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.516-539
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• 1998

The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilzers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's $\alpha$ coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care-preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a univisity hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demanad side such as the developement and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be neccessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.

• Journal of Society of Preventive Korean Medicine
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• v.13 no.3
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• pp.55-71
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• 2009

Background : Traditional Korean medicine(TKM) has gained in popularity among chronic patients in recent years. The use of TKM among patients with chronic diseases is common, with about two thirds of patients using some form of TKM in Korea. Objectives : The purpose of this study is to analyze the use of TKM and determine what factors affect to use TKM among patients with chronic diseases. The study also aims to provide information on TKM therapies and assist therapy selection among various TKM therapies for patients with chronic diseases. Methods : The design of the study was descriptive cross-sectional, and data were collected using a 21-item questionnaire. This study was conducted with subjects with confirmed diagnosis of chronic diseases, who live in Jeju Province, Korea. Results : Among the participants, past or current TKM use was 66.7%, with a statistically significant difference in gender and level of health status groups(p<0.05), but no difference in age, marital status, education, occupation, and income groups. The most common therapies of TKM used by the patients included acupuncture(51.1%), physiotherapy(16.8%), cupping(13.5%), and herbal medicine(4.8%). The main benefits from TKM perceived by the patients were chronic diseases management and health promotion. In a logistic regression analysis, significant influencing factors related to TKM use were gender, family income level, the extent of recognition of efficacy, heath status, and health security program. Conclusions : In this study the socio-demographic and health status, recognition of TKM efficacy factors associated with TKM use among patients with chronic diseases were similar to those found in the general population. The findings suggest that due to the relatively high use of TKM among patients with chronic diseases in Korea, this topic should be taken into account in the development of a holistic approach for patients with chronic diseases and an efficient chronic disease management system. Additionally proactive and consistent management of TKM is necessary in the health care system in Korea.

• Journal of Hospice and Palliative Care
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• v.4 no.2
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• pp.154-160
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• 2001

Purpose : This study, as the first year project of setting up a community based management system, was attempted for the cancer patients and their family to improve their quality of life; investigating and managing the cancer patients, educating volunteers and connecting the patients with the volunteers were performed. Method and result : The education of managing cancer patients for the volunteers was done once in lune for 2 days to the 80 volunteers. Questions about education effect, volunteer motivation and so on were made up. The survey showed, generally, education satisfaction level was high and a longer education and an intensive course were needed and was suggested that organizing a volunteer community be needed for the continuous further education and systematic management. As the result, after the public health center and volunteers deliberated, a volunteer community consisting of 4 teams, 28 members was organized, launched in Oct. and operated for the cancer patients and their family. For investigating and enrolling the patients, advertising on a local information paper, recommending of local doctors, publicizing by educating the heads of a subdivision of the city, the heads of a neighborhood association and the people in charge of the related local communities such as women's society, and surveying the community by volunteers were performed and the total, 41 patients were registered. Management of cancer patients was carried out by volunteers in a community and in a nursing school. A regional volunteers' community is composed of 23 members and they have worked 87 times, that is 3.8 times per capita on an average. The content of duties is attending the education (41.1%) the most. A volunteers' community of nursing students composed of 12 members have worked 135 times, that is 11.3 times per capita on an average. The content of duties - consulting with patients and home visiting (37.8 %) were the most and survey for investigating the cancer patients was the second. Conclusion : This study has the meaning that this is the guiding attempt in building a community based management system, and especially the achievement of this study is that a regional society organized a volunteer community for the cancer patients by itself and went into action for the cancer patients and their family. Furthermore, to activate this volunteering, it is necessary to keep managing volunteers and running continuing education or the intensive course of the volunteers. Indeed we should let the patients have good impression on this program through publicity and education for the residents to keep track of more cancer patients. For that, systematic and powerful cooperation of a self-administrative organization is required.

• Journal of radiological science and technology
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• v.32 no.1
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• pp.1-15
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• 2009

Newly published IEC 60601-1-3 ; 2008 2nd Edition has two important meanings. First, Radiation Quality and Dose should make sure for safety of patient and staff in manufacturing diagnostic X-ray equipment. Second, it should be minimized of Leakage Radiation, Residual Radiation, and Stray Radiation. The requirement to make enactment or revision of national standard for diagnostic X-ray Equipment is as follows : 1. It should be adjusted the new standard to the recent IEC Publication under the consideration of the Korea medical circumstances. 2. For focus to the Radiation Safety, IEC 60601-1-3 (General requirements for radiation protection in diagnostic X-ray equipment) could be applied to the new regulation. It should be compact sentence. 3. A sudden Notification change should not be desired. It needs a enough time to make easy the circumstances.

• Korea Journal of Hospital Management
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• v.25 no.2
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• pp.45-56
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• 2020

Purpose: The purpose of this study is to investigate medical care behaviors influencing accuracy of the payment based New diagnosis-related groups (DRG) compared to fee for service (FFS) in hospitalized patients with medical illness. Methodology: In order to estimate the difference in medical costs between New DRG and FFS depending on medical care behaviors, medical records and hospital claims data (n=4,232) were utilized, which were collected from a single public hospital during the first-half of 2018. Data were analyzed by descriptive statistics, t-test, chi-square test, and multivariate binary logistic regression. Findings: The average difference in medical costs between New DRG and FFS were KRW 506,711±13,945 with incentives and KRW -51,506±12,979 without incentives, respectively. Forty-four point two percent (44.2%, n=1,872) of total subjects were shown to have negative compensation in overall medical costs with New DRG compared to the costs with FFS. Medical care behaviors that affected on the negative compensation were the presence of severe bed sores on admission, medical consultations, death, operations, medications and laboratory or imaging tests with unit price over KRW 100,000, hospital-acquired complications or underlying comorbidities, elderly patients (≧65 years), and hospitalized for more than average inpatient days defined by New DRG (p<0.001). The difference in average medical cost between New DRG and FFS for a group with mild illness was KRW -11,900±10,544, whereas it was KRW -196,800±46,364 for a group with severe illness (p<0.0001). Practical Implications: These findings suggest that New DRG payment model without incentives may incompletely cover the variation of medical costs in real clinical practice. Therefore, policy makers need to consider that the current New DRG reimbursement should be focused and refined to improve accuracy of payment on medical care resources utilized in severe and complex medical conditions.

• Journal of the Korean Society of Radiology
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• v.10 no.5
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• pp.367-373
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• 2016

This study conducted an analysis to compare the differences in the properties of the magnetic field and the generation of artifacts because of the difference in the magnetic field between 1.5 T equipment and 3.0 T equipment, centering around four types of pulse sequences, mainly applied to the abdominal Magnetic Resonance Imaging (MRI). With data on 500 persons transmitted to the PACS, this study analyzed the SNR value, quantitatively and carried out a qualitative evaluation, dividing MSA, CSA, and DA into three steps. As a result of the quantitative evaluation, the SNR value was significantly higher in the 1.5 T equipment; however, there was a factor deteriorating the image quality, too, as artifacts were generated in the images. The 1.5 T equipment generated fewer artifacts than the 3.0 T equipment did, so it could compensate the image quality for 3.0 T. In conclusion, based on these findings, this study could understand the differences in the properties of the magnetic field and the generation of artifacts occurring because of the difference in the magnetic field and could provide a measure for them. This study would be guidelines for MRI users who directly examine the patients in abdominal MRI using the two types of equipment in the clinical setting in the future.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.117-126
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• 2004

In general, the patients who transferred to the hospital by 119 rescue service at night go to the emergency room(ER) of general hospital rather than that of their nearby the 1st(clinic) and 2nd(local hospital) hospital. And the hospital is mainly selected not by 119 EMST but by patients or his/her conservators. Therefore we had studied retrospectively with emergency situation diary and medical chart for 697 patients of being transferred to one emergency medical center for 6 months since January 2004, and results are as follows. 1. The 280 patients(42.5%) of being transferred hospital at night by 119 rescue service were not emergency case and their average staying time in hospital was about $7.15{\pm}10.06$ minutes. 2. Transfer time was distributed in each time intervals of 1819, 2021, 2223, and 2401 and patients ratio in each intervals were 15.1%, 17.8%, 16.4%, and 15.2%. 3. In response of ambulance, the average time from the spot to the hospital was $14.53{\pm}9.27min$. and average distance of that was $7.95{\pm}9.21km$. 4. Diseases rather than traffic accidents or traumatic injury were main causes of ambulance calling and its value was 533(76.5%), and accidents were mainly occurred in patients' house and its value was 479(68.7%). 5. In time of transfer by 119 rescue service, hospital was mainly selected by patient/conservator and its value was 648(93.0%). In result. the hospital was selected not by EMST but by patient/conservator. 6. The case that the 1st grade EMT was rode in ambulance was 161(23.1%), and the case that 2nd EMT and emergency team member who educated for emergency were rode in ambulance were 504(72.3%). So the number of the 1st grade EMT was short in fire station of Kwangju metropolitan city than other city. 7. The first aids for patients before reaching hospital were limited to oxygen inhalation, airway control, and BLS for maintaining limbs and spine. So it seems to be a simple patients transfer. Consequently, to establish an efficient emergency medical system, it has been thought that it should be advanced a moderate education and public information about the appropriate use of emergency medical system toward citizen, and also need the hospital selection by the patients categorizing standards for 119 rescue service member, securing the 1st grade EMT, appropriate first-aids education, and securing professional human power in emergency room of the Ist(clinic) and 2nd(local hospital) hospital at night.

• Journal of radiological science and technology
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• v.40 no.3
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• pp.469-484
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• 2017

Radiological Technologists deals with the life of a person which means professional competency is essential for the job. Nevertheless, there have been no studies in Korea that identified the job competence of radiologists. In order to define the core job competencies of Korean radiologists and to present the factor models, 147 questionnaires on job competency of radiology were analyzed using 'PASW Statistics Version 18.0' and 'AMOS Version 18.0'. The valid model consisted of five core job competencies ('Patient management', 'Health and safety', 'Operation of equipment', 'Procedures and management') and 17 sub - competencies. As a result of the factor analysis, the RMSEA value was 0.1 and the CFI, and TLI values were close to 0.9 in the measurement model of the five core job competencies. The validity analysis showed that the mean variance extraction was 0.5 or more and the conceptual reliability value was 0.7 or more, And there was a high correlation between subordinate competencies included in each subordinate competencies. The results of this study are expected to provide specific information necessary for the training and management of human resources centered on competence by clearly showing the job competence required for radiologists in Korea's health environment.

• Health Policy and Management
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• v.29 no.4
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• pp.482-495
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• 2019

Background: An important function of the regional public hospital is to satisfy the basic medical needs of the community through the stable provision of high-quality medical services. The purpose of this study was to identify the relevance index (RI) of the regional public hospital and to identify the factors that affect the RI. Methods: Data were obtained from the 2017 regional public hospital operation evaluation report and 2017 medical monitoring report for vulnerable area. RI of the regional public hospital was a dependent variable, and multiple regression analysis was performed with observed variables of medical supply-demand condition, medical supply, and medical supply structure. Direct effects and indirect effects were confirmed by the analysis of structural equation models (SEM) to see if there were mediating effects. Results: The RI was 13.1%, and the average of all percentage refined diagnosis-related group (RDRG) was 29.4%. Factors affecting RI were medical supply-demand conditions, medical supply, and medical supply structure. As a result of multiple regression analysis, RI was higher when high percentage RDRG of the regional public hospital (t=4.117, p<0.05), the size of regional public hospital location (t=-2.554, p<0.05), and the population of regional public hospital location (t =-2.415, p<0.05) were smaller. The results of the SEM analysis show that the higher the medical supply-demand conditions, the more direct effect of decreasing the RI and the indirect effect of decreasing the effect of reduction through the medical supply (direct effect=-1.322, total effect=-0.573, p<0.01). The higher the medical supply structure, the more direct effect on the RI (direct effect=1.047, p<0.05) and the higher the medical supply, the more indirect effect of RI through the medical supply structure (total effect=direct effect=0.619, p<0.05). Conclusion: It has been confirmed that the provision of medical services can affect the RI the regional public hospital which should be considered in carrying out future policies.

• Journal of the Korean Society of Radiology
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• v.10 no.3
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• pp.215-222
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• 2016

X-ray mammography is the most effective method for the diagnosis of calcified lesions of various breast diseases. To reduce patient dose and to obtain optimal image required for diagnosis, the performance of the mammography system should be maintained continuously. Because the target (anode) angle of the X-ray tube is measured from the central X-ray, the effective angle can be slightly different in view of the position on the detector, which can result in degrading spatial resolution of the imaging within the field of view. In this study, we measured the MTF to examine spatial resolution for positions on the detector in the digital mammography system. For a tungsten wire of $50{\mu}m$ diameter, the highest spatial frequency was obtained. It meant that a wire diameter for measuring MTF through LSF should be small compared to the pixel size of the detector used in the mammography system. The spatial resolution showed slightly different performance according to positions on the detector. The center position gave the best spatial resolution and positions away from the center showed the degraded performance although the difference of the spatial resolution was small. The effective focal spot size of the full width at half maximum also showed similar result. It concluded that the slightly increase of the effective focal spot size gave the degradation of the spatial resolution for positions on the detector.