• Title/Summary/Keyword: 환자중심의료

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Status and Characteristics of Applying Medical Use Analysis of intervertebral Disc Disorder Patients - Focusing on cervical spinal disease (추간판 장애 환자의 의료이용 현황 및 특성 -경추질환을 중심으로-)

  • Seo, Young-Woo;Park, Cho-Yeal
    • Journal of the Health Care and Life Science
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    • v.9 no.1
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    • pp.103-115
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    • 2021
  • The purpose of this study is to understand the annual trend of patients with cervical vertebrae disability and improve their health service utilization in the general description (200 TABLE) of patients with cervical vertebrae disability.The main results of this study are as follows. All patients with cervical vertebrae disability were women aged 50 to 59. Compared to 2010, the proportion of patients with disease increased year by year in all subjects in 2018, with men under 30-39 years of age and women under 19 years of age increasing the highest.

Geographical Characteristics and Patients' Determinants of Online Referrals : A Case Study of Choongbook, Korea (온라인 협진에 대한 지리적 특성과 환자의 결정에 관한 연구 : 충청북도 사례를 중심으로)

  • Park, Soo-Kyung
    • Journal of the Korean association of regional geographers
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    • v.17 no.5
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    • pp.617-637
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    • 2011
  • This study employs qualitative approaches to examining geographical characteristics and patients' determinants of online referrals in terms of regionalization. In this light, I conducted interviews with 20 patients receiving online referrals in Choongbook, Korea, and investigated their behaviors regarding these referrals between July and August 2009. I found that many patients who suffered from various levels of illness preferred tertiary care centers outside of Choongbook and did not enjoy their experience with the local medical institutions as the online referral service sites. This result might be because patients choose online referrals for psychological considerations such as quality and level of health care services, personal stakes in online referral service sites, acceptability and credibility of good tertiary care centers, and easy access to and use of medical institutions. Meanwhile, immediate benefits with regard to the technological value of online referrals, such as convenience, utility, and original purpose associated with regionalization, did not influence patients' decision-making. Therefore, the social and public networks affiliated with online referrals plus the effect of Korean medical laws play hostage to private decisions made by citizens, who prefer high-level medical institutions. Accordingly, the technological contribution of online referrals does not halt the outflow of patients from local, tertiary care centers. Especially, the existing health care system and patients' behaviors are deeply related to referrals in the online system. To protect regionalization, the improvement of health care services from the present state of affairs is required.

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Legislation Status and Legal Issues of Non-Face-to-Face Treatment (비대면진료 관련 입법 현황과 법적 쟁점)

  • Jinsuk, Kim;Eol, Lee
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.131-160
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    • 2023
  • An amendment to Medical Law allowing permanent face-to-face treatment has been proposed in the 21st National Assembly, with five different bills introduced. However, each proposed amendment focuses on different aspects, and the issue is currently in a state of 'ongoing review' due to factors such as opposition from the medical profession and political considerations. However, from the perspective that the introduction of non-face-to-face treatment should be institutionalized and legislated prioritizing patient safety, certain directions are proposed. These include focusing on returning patients as the primary target, chronic diseases as the focal conditions, outpatient medical institutions as the implementing agencies, restricting non-face-to-face means primarily to video systems, and legally exempting healthcare professionals from responsibility for incidents beyond their control. The proposed directions also emphasize establishing the right to demand face-to-face treatment. It is suggested to legislate initial standards that ensure a minimum level of safety and gradually expand the scope of non-face-to-face treatment through future research, evaluation, and similar step-by-step approaches.

Health Economic Approach to End-of-Life Care in the US: Based on Medicare (말기의료의 경제적 요소에 관한 논의: 미국 메디케어 상황을 중심으로)

  • Suk, Ryan
    • The Korean Society of Law and Medicine
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    • v.15 no.1
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    • pp.335-373
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    • 2014
  • According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

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Development of Abnormal Situation Managenet System in Process-centric Way for Enhancing Patient Safety (환자 안전 제고를 위한 프로세스 중심적인 이상상황 관리 시스템 개발)

  • Moon, Junho;Kim, Dongsoo
    • Journal of Information Technology and Architecture
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    • v.11 no.1
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    • pp.89-97
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    • 2014
  • As ubiquitous computing technologies have advanced rapidly, context awareness technology has been used in the medical part in order to improve patient safety. Nevertheless, as there is no method for managing context awareness information effectively and managing healthcare processes for handling abnormal situations systematically, it is highly required to enhance patient safety in hospital. We propose an innovative system to solve these problems. The proposed system has three main functionalities. Firstly, it enables all situations to be recognized in medical organizations. Secondly, it extracts the meaningful data from data flood by defining data patterns of recognized situations and designing a rule-based system. Lastly, it can manage patients' abnormal situations in process-centric way by integrating the business process management system. It is expected that the proposed system contributes to the improvement of patient safety in u-hospital.

Analysis of the Emergency Medical Service Area Using GIS: the Case of Seoul (GIS를 이용한 응급의료 진료권 분석: 서울시를 사례로 하여)

  • 이희연;박미영
    • Spatial Information Research
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    • v.12 no.2
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    • pp.193-209
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    • 2004
  • The purpose of this study is to analyze the service area of emergency medical centers using GIS-based spatial analysis methods in Seoul, focusing on the behaviour of patients on the choosing of emergency centers. For this analysis, six emergency centers were selected to collect data for the information on the addresses of patients from September to November hi 2003. Analysis on the service area, which was carried out by measuring the distribution of patients in terms of distance from emergency medical centers, clearly reveals that the majority of patients was located within or adjacent districts at the emergency medical center. However, the size of the primary service area f3r six emergency medical centers was much different, implying that the decision to visit specific emergency medical center by patients was closely related to the size, perception, and preference of the emergency medical center. Based on the results of the spatial characteristics of emergency medical service area, this research tries to construct the surface map of the emergency medical service level supplied by 32 regional emergency medical centers located in Seoul. Considering the levels of infrastructure for emergency medical centers, the coverage for the degree of supply of emergency medical service by each emergency medical center was constructed in terms of a distance decaying in the distribution of patients from emergency medical center imposing different weights on distance bands. Spatial overlay utilizing map algebra function was performed in order to calculate total supply level of emergency service. The results clearly show that spatial inequality exists in the supply levels of the emergency medical service among local areas of Seoul.

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Blockchain-based Electronic Medical Record Sharing FrameworkUsing Ciphertext Policy Attribute-Based Cryptography for patient's anonymity (환자의 익명성이 보장되는 암호문 정책 속성중심 암호를 활용한 블록체인 기반 전자의무기록 공유 프레임워크)

  • Baek, Seungsoo
    • Convergence Security Journal
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    • v.19 no.1
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    • pp.49-60
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    • 2019
  • Medical record is part of the personal information that values the dignity and value of an individual, and can lead to serious social prejudice and disadvantage to an individual when it is breached illegally. In addition, the medical record has been highly threatened because its value is relatively high, and external threats are continuing. In this paper, we propose a medical record sharing framework that guarantees patient's privacy based on blockchain using ciphertext policy-based attribute based proxy re-encryption scheme. The proposed framework first uses the blockchain technology to ensure the integrity and transparency of medical records, and uses the stealth address to build the unlinkability between physician and patient. Besides, the ciphertext policy attribute-based proxy re-encryption scheme is used to enable fine-grained access control, and it is possible to share information in emergency situations without patient's agreement.

Review of Responsibility in Case of Medical Tour Disputes (의료관광 분쟁시 책임주체에 대한 검토)

  • Moon, Sang hyuk
    • The Korean Society of Law and Medicine
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    • v.17 no.1
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    • pp.107-135
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    • 2016
  • Medical tour can be said to be a new high added-value tour industry of 21st century. The development of varied and distinguished medical tour products by each country will further vitalize the medical tour industry. As the interest in such medical tour increases, it is necessary to analyze the demand and interests of tourists accurately and prepare medical tour products to be provided in order to develop and promote medical tour products. The government considers the medical tour industry as an industry with high expected effects in job creation through promotion of experts in global healthcare industry and national economy development through high added-value creation, and has expanded aid policies in medical tour field with improvement of medical tour immigration system, one-stop service system for medical tourists, and medical tour labor force promotion system. Nevertheless, there are disputes between foreign patients and medical tour inviting businesses, along with medical accident disputes between foreign patients and medical staff and disputes with those working in the tourism industry. This article reviews the types of disputes occurring around the inviting businesses related to medical tours and tried to review the resolutions. Through this, it was found that medical tour inviting businesses have the responsibility to connect the mediated benefits and risks and also the responsibility to process the tasks. Thus, in case dispute occurs due to passive actions from establishing agency agreement to active mediation results, it is difficult to escape the liabilities. Also, in a medical tour agency contract, the inviting business must be aware that it bears the responsibility to explain and advise the details on benefits and risks to foreign patients. The "Guide to arbitration system for resolution of medical disputes with foreign patients" by Korea Health Industry Development Institute Act presents a method to resolve disputes according to the [laws on medical accident damage relief and medical dispute arbitration] in case a dispute due to medical accidents occurs to foreign patients when the foreign patients prepare diagnosis agreement, Whether such method is sufficient to protect foreign patients, however, is thought to require discussions from more diverse perspectives. In order to vitalize medical tourism, the development of diverse products is also important, but the countermeasures against related disputes should also be prepared. Such is expected to contribute to a greater advancement based on trust of foreign medical tourists alongside excellent medical technologies.

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A Clinical Protocol Development Methodology for Ubiquitous Healthcare Service (유비쿼터스 헬스케어 서비스를 위한 태스크 중심의 임상 프로토콜 개발 방법론)

  • Hwang, Kyoung-Soon;Kim, Wun-Jea;Lee, Chan-Hee;Lee, Keon-Myung
    • Journal of the Korean Institute of Intelligent Systems
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    • v.20 no.1
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    • pp.66-75
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    • 2010
  • With the advances in ubiquitous service infrastructure, healthcare services have drawn attention as one of promising application domains. In ubiquitous healthcare services, patients or care-givers as well as medical personnel are asked to play their roles and, in addition, the information system is supposed to have active roles. In medicine, clinical protocols have been developed and put into practice in order to reduce treatment variances and assure the service quality. In the same token, clinical protocols on ubiquitous service practices are need to be developed which takes into account both the clinical details and the ubiquitous service functionality. This paper introduces a clinical protocol modeling methodology which pays attention to participants and their tasks including contextual information. The proposed method has been successfully applied to a real application domain, OAB(overactive bladder) syndrome patient care to see how it builds a clinical protocol.