• Title/Summary/Keyword: 1차 의료

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Analysis of the Sociodemographic Characteristics and Desire for Employment of Job seekers in their Fifties and Sixties Using Portal Site (50·60세대 취업 포털 사이트 구직자의 특성 및 구직 요구 분석)

  • Kim, Ae-Kyoung;Kim, Ki-Sung
    • The Korean Journal of Health Service Management
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    • v.13 no.1
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    • pp.55-65
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    • 2019
  • Objectives: The purpose of this study is to analyze basic data on socio - demographic characteristics, occupational careers, and desire for employment of job seekers in their Fifties and Sixties using a portal site. Methods: For this research, secondary data were collected by the researcher from 704 job seekers and were statistically analyzed using the SPSS package. Results: The results of the analysis are as follows: Most job seekers want a job that suits their competence and career trajectory, but the reality is that as their age increases, jobs suitable for those in their fifties and sixties are hard to find; thus these job seekers accept simple labor or functional jobs. Conclusions: Differences were found in work conditions such as occupation level, job position, total career years, desired employment type, and expected salary depending on socio - demographic variables. Consequently, improvements should be made for various job searching paths for older adults as well as increasing the accessibility of job searching information.

Telemedicine Security Risk Evaluation Using Attack Tree (공격트리(Attack Tree)를 활용한 원격의료 보안위험 평가)

  • Kim, Dong-won;Han, Keun-hee;Jeon, In-seok;Choi, Jin-yung
    • Journal of the Korea Institute of Information Security & Cryptology
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    • v.25 no.4
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    • pp.951-960
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    • 2015
  • The smart screening in the medical field as diffusion of smart devices and development of communication technologies is emerging some medical security concerns. Among of them its necessary to taking risk management measures to identify, evaluate and control of the security risks that can occur in Telemedicine because of the Medical information interchanges as Doctor to Doctor (D2D), Doctor to Patient (D2P). This research paper studies and suggests the risk analysis and evaluation methods of risk security that can occur in Telemedicine based on the verified results of Telemedicine system and equipment from the direct site which operating in primary clinics, public health centers and it's branches, etc.

The Political Dynamics of Policy Networks and Advocacy Coalitions in South Korea's Healthcare Policymaking : The 20 Years of Debates to Inaugurate a Single-Payer System (한국에서의 의료보험조합 통합일원화 논의의 정치 : 정책 네트워크, 옹호연합, 그리고 보건의료 정책형성의 동태성)

  • Kim, Soon‐yang
    • Korean Journal of Social Welfare Studies
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    • v.42 no.4
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    • pp.61-102
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    • 2011
  • The purpose of this article is to anatomize the political dynamics of South Korea's healthcare policymaking through the integrative analytical framework combining the policy network perspective and the advocacy coalition theory. This framework is expected to be advantageous to the analysis of Korea's turbulent healthcare policy change from a systematic and process-driven point of view. A target of analysis is the two decades of turbulence to transform the health insurance system into a single payer system. Through the analysis, this article tries to illuminate the dynamics of Korea's healthcare policymaking, by connecting environmental context, policy networks, advocacy coalitions, and policy outputs. For a case study, this article classifies the debates to inaugurate a single payer system into four sub-phases and conducts longitudinal comparative research.

A Comparative Study on the Pattern of Outpatient Department Utilization at a Tertiary Level Hospital before and after Implementation of the Patient Referral System (의료전달체계 실시 전후의 3차 진료기관 외래환자 이용양상 비교)

  • Lee, Kyeong-Soo;Kim, Chang-Yoon;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.1 s.37
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    • pp.88-100
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    • 1992
  • This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1, 1988 to June 30, 1989 and the post-implementation period was from July 1, 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respectively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased from 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Departments of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments(from 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 2.2 to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased from 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.

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A Study on the Insurance Contribution and Health Care Utilization of the Regional Medical Insurance Scheme (1개 군지역 의료보험제도에서의 보험료 부담수준별 병.의원 의료이용에 관한 연구)

  • Lee, Sang-Il;Choi, Hyun-Rim;Ahn, Hyeong-Sik;Kim, Yong-Ik;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.578-590
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    • 1989
  • This study was conducted to assess the equity in the regional insurance scheme through analysis of the computerized data from one regional insurance society and National Federation of Medical Insurance. We analysed the insurance contribution and benefit by the classes based on total and income-related contribution per household. The major findings of this study are as follows : 1. The average proportion of income-related contribution among the total was 39.2% and the upper classes show higher proportion of the income-related contribution. 2. The upper classes show higher health care utilization rate than the lower classes. It suggests that the lower classes have relatively large unmet medical needs. 3. The analysis through the Lorenz curve reveals that there exists transference of contributions from the upper to lower classes. But the cumulative percentage of insurance benefit is smaller than that of the number of the insured. It implies that regional medical insurance scheme in Korea has still some inequity in the context of social security principles.

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A Study on the Status of Medical Equipment and Radiological Technologists using Big Data for Health Care: Based on Data for 2020-2021 (보건의료 빅데이터를 활용한 의료장비 및 방사선사 인력 현황 연구 : 2020-2021년 자료를 기준으로)

  • Jang, Hyon-Chol
    • Journal of the Korean Society of Radiology
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    • v.15 no.5
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    • pp.667-673
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    • 2021
  • As we enter the era of the 4th industrial revolution, it is judged that the scope of work of radiologists will be further expanded according to the innovation and advancement of radiation medical technology development. In this study, the current status of medical equipment and radiology technicians was identified, and basic data were provided for the plan for nurturing talents in the field of radiation medical technology in the era of the 4th industrial revolution, as well as career and employment counseling. Data from the second quarter of 2020 and the second quarter of 2021 were analyzed using health and medical big data. As a result of comparing the status of medical equipment by type in 2021 compared to 2020, C-Arm X-ray examination equipment increased by 5.83% to 6,638 units, followed by MRI examination equipment 1,811 units 5.29%, and angiography equipment 725 units 5.22% , general X-ray examination equipment 21,557 units increased 3.99%, CT examination equipment 2,136 units 3.03%, and breast examination equipment 3,425 units increased 3.00%. As a result of a comparison of the total number of radiologists in 2021 compared to 2020, the number was 29,038, an increase of 2.73%. As a result of comparing the status of radiographers by region, the increase was highest in the Gyeonggi region with 5.96%, followed by the Gangwon region with a 5.66% increase and the Chungnam region with a 3.81% increase. In a situation where the number of medical equipment and radiologist manpower is increasing, universities are developing specialized knowledge and practical competency through subject development related to the understanding and utilization of customized artificial intelligence and big data that can be applied in the medical radiation technology field in the era of the 4th industrial revolution. It is necessary to nurture qualified radiographers, and at the level of the association, it is thought that active policies are needed to create new jobs and improve employment.

A Study on the Development and Validation of the Local Clinic Medical Doctor Role Stress Scale: Focusing on Local Clinic Medical Doctor (개원의 역할스트레스 척도 개발 및 타당화 연구: 1차 의료기관 개원의를 중심으로)

  • Song, Young-Ah;Kim, Ji-Hyeon
    • The Korean Journal of Health Service Management
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    • v.12 no.1
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    • pp.23-34
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    • 2018
  • Objectives : This study developed and validated the local clinic Medical Doctor Role Stress Scale(MDRS). Methods : The interviews were conducted with 12 local clinic medical doctors to develop final preliminary questions. The scale was developed using statistical item analysis, exploratory and confirmatory factor analysis surveys with local clinic medical doctors in Seoul, Busan, Daejeon, and Gyeonggi province. Results : The MDRS developed in this study consisted of 14 items and three factors. The factors were role conflict, role ambiguity and role overload. The three factors explained 56.71% of the total variance, and the internal consistency of this scale was .90. The internal consistency for each factor was .81 ~ .90. Confirmatory factor analysis through a separate sampling met the fit criteria (CFI = .941, TLI = .927, RMSEA = .079, SRMR = .069). Conclusions : The results indicate that this scale is a reliable instrument for assessing local clinic medical doctor role stress.

The way to achieve Universal Health Coverage: Focusing on the Historical and Cultural Context of Health Care Sector in Vietnam (보편적 건강보장을 향한 노정 : 베트남 보건의료 부문의 역사·문화적 맥락을 중심으로)

  • BEAK, Yong Hun
    • The Southeast Asian review
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    • v.28 no.1
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    • pp.173-218
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    • 2018
  • This study focuses on the healthcare sector in Vietnam which is promoting universal health insurance for the achievement of Universal Health Coverage (UHC) under Sustainable Development Goals (SDGs). The purpose of this study is to examine the characteristics of the reform process of the health care system and the law on health insurance through the historical and cultural contexts and its implications from the perspective of development. Based on the three dimensions of UHC - extension of protection for population, provision of various medical services, and financial protection, the current status of the Vietnam healthcare sector is summarized respectively as follows. First, according to the revised Health Insurance law which came into effect in 2015, the mandatory health insurance premiums are calculated based on household units. Second, there is a medical network that can provide preventive and healthcare services centered on primary health care facilities, for example commune health stations (trạm y $t{\hat{e}}$ $X{\tilde{a}}$). Third, out-of-pocket expenditure is still a large proportion although public spending has increased and private spending has decreased since the enforcement of the health insurance law and various schemes. Vietnam is currently striving towards a universal health care system. The development of institutions and systems should be designed in a way that is appropriate for the members of the society rather than efficiency. This article findings shed light on the role of social values, family culture, and informal institutions.

A Study on the Patient-centered Medical Delivery System -Focusing on EU examples of strengthening primary care- (환자 중심의 의료전달체계 구축에 관한 연구 -일차 의료 강화와 관련된 유럽연합의 예를 중심으로-)

  • Kim, Yong-Min
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.235-262
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    • 2019
  • While traditionally threatening human infectious diseases are decreasing, chronic diseases such as cancer and diabetes, including cardiovascular diseases, are spreading rapidly. Reflecting the characteristics of chronic diseases that are difficult to treat, the management of risk factors and the preparation of health promotion policies corresponding to them have emerged as important concerns around the world. Providing so-called multi-sector approach such as health promotion and disease prevention policy and solution for community response, The value of primary care is once again highlighted in the changed medical environment. As the existing medical delivery system has become difficult to cope with the people's desire for rapid aging, disease paradigm change, and quality of life improvement, European Union countries have made various efforts to improve the quality of their primary medical system, which provides continuous, com- prehensive and coordinated management. This paper examines the current status and problems of the healthcare delivery system in Korea, draws implications from the European Union examples related to the strengthening of primary care, and discusses the plans for establishing a patient-centered future medical delivery system.

Decreasing the application rate of unnecessary physical restraint through the establishment of a guideline for restraint application (억제대 적용지침 개발을 통한 불필요한 억제대 적용율 감소 활동)

  • Kwak, Kyung-Sun;Kim, Sung-Eun;Bae, Eun-Kyoung;Lee, Eun-Sook;Lee, Eun-Hye;Choi, Yun-Jeong;Lee, Yun-Kyung
    • Quality Improvement in Health Care
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    • v.15 no.2
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    • pp.93-103
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    • 2009
  • 문제: 억제대 적용에 대한 구체적 적용 지침 없이 의례적으로 억제대를 사용함으로 인해 환자들의 신체적 또는 정신적 안전을 위협할 수 있다. 목적: 완전 진정 상태 이거나 근력이 약하여 발관 능력이 없는 환자에 대한 예방적 적용, 바빠서 환자를 볼 수 없는 경우, 간호사 본인의 판단이 없이 타인의 요구에 따르는 등의 불필요한 억제대 적용이 증가하는 원인을 파악하여 중환자실의 특수성에 맞는 억제대 적용 및 제거 지침을 마련하고자한다. 의료기관: 인천광역시에 소재한 의과대학 소속병원의 집중치료실 질 향상 활동: 불필요한 억제대 적용에 영향을 미치는 요인을 선정하여 개선활동 수행. 개선효과: 억제대 적용에 대한 중환자실 간호사에게 미치는 영향을 보면 태도 정도 p=0.09(p<0.1), 올바른 수행 능력은 p=0.005(p<0.05)로 통계적으로 유의한 것으로 나타났다. 지식 정도 p=0.172(p<0.05) 통계적으로 유의 하지는 않지만 모든 항목이 개선 활동 전 에 비해 2,3차 개선 활동 후에 향상 한 것으로 나타났다. 개선 활동 전에 8.1%였던 간호 기록, 0.7%였던 간호 중재, 0%였던 의사 처방율이 3차 개선 활동 후 3가지 모두 100% 달성되었다. 이는 억제대 적용율 감소 및 부적절한 억제대 적용율은 유의하게 감소 하였다. 교훈: 중환자실 간호사의 억제대 적용에 대한 태도, 지식, 올바른 간호 수행 능력은 지속적으로 재평가 되어지고, 교육내용은 좀 더 나은 간호 제공을 위하여 개발되어져야 할 것이다. 억제대 적용 기준과 제거 기준을 Check List 하여 객관성의 유지를 위한 개선 활동은 계속적으로 Feedback 되어야 할 것이다.

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