• Title/Summary/Keyword: 2차 의료기관

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A Study on the Repeat Tests for Diagnosis at a Tertiary Hospital in Taegu City (3차진료기관(3次診療機關)과 환자의뢰기관간(患者依賴機關間)의 중복검사(重複檢査))

  • Park, Jae-Yong;Kim, Gui-Young
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.3 s.43
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    • pp.457-468
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    • 1993
  • This study was conducted to investigate the repeat test rate for diagnosis at a tertiary hospital for the outpatients who were referred themselves to the hospital by the clinics and other medical facilities. The study population consisted of 498 patients who visited outpatient department of internal medicine, general surgery, orthopedic surgery and neurosurgery in the hospital between March 16 and April 11, 1992. This study was surveyed by the questionnaire about the tests for diagnosis at first level medical facilities, and then, was investigated by the medical record about the tests for diagnosis at a tertiary hospital. The proportion of test among the patients who utilized the first level medical facilities was 20.9% for the X-ray test, 10.6% for the urinalysis, 9.0% for the electrocardiogram, 3.4% for the computer tomogram and 6.4% for the ultrasonogram. At the tertiary hospital, the X-ray test was 45.2%, the liver function test was 24.1%, the urinalysis was 19.1%, and the electrocardiogram was 15.7%. The proportion of patients who possessed results of test for diagnosis at the first level medical facilities was 76.5% for the computer tomogram, and 31.3% for the ultrasonogram. As the repeat test rate between the first level medical facilities and the tertiary hospital, the thyroid function test was the first rank as 71.4%, the second rank was the routine CBC as 67.9%, and the third rank was the X-ray test as 64.4%. But among the patients that brought the result for tests at the first level medical facilities, the repeat test rate was as follow : the routine CBC was 75.0%, the liver function test was 72.1%, and the computer tomogram was 15.4%.

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Medical Care Utilization Pattern of Medical Aid Program Beneficiaries (의료보호대상자(醫療保護對象者)의 의료이용(醫療利用) 양상(樣相))

  • Kim, Ju-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.17 no.1
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    • pp.37-45
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    • 1984
  • This study was conducted to identify the problems in the medical aid program by reviewing the medical care utilization pattern of the beneficiaries. The data were abstracted from the monthly bills and vouchers for medical care of the whole benefi챠aries(17,527) in Gyeongsan Gun submitted by the physicians to county government for the period of 1 calendar year from October 1981 to September 1982. The number of medical aid beneficiary accounted for 12.7% of the total county population, a higher proportion than the national average-9.5%. Monthly primary care utilization rate per 100 beneficiaries was 9.3 persons with 14.0 visits and 42.9 medication days. for the 2nd and 3rd care, there were 1.7 admissions and 9.3 OPD visits per 100 beneficiaries per year. The beneficiaries of the first class medical aid program had a higher utilization rate of both the primary and secondary/tertiary care facilities. Females utilized more the primary care facilities than males while males utilized more the secondary/tertiary care facilities than females. A significantly lower utilization rate was observed in January than in the other months and this was seemed due to the renewal process of the medical aid certificate. Among 1,931 patients utilized the 2nd/3rd care facilities 84.4% was out-patients and the lowest ratios were in the minor specialties including ENT, ophthalmology, dermatology and urology. The average hospital days per in-patient were 21.2 days and OPD days per out patient were 4.7 days. The average hospital days for a psychiatry in-patient was 74.4 days which was the longest average hospital days among all the specialties. Average medical care cost per beneficiary in a year was W9,821:W24,240 for the 1st class and W7,464 for the 2nd class. The medical care cost for the primary care per patient was W3.901 and W840 per day compared with W49,875 per patient and W5,822 per day for the secondary/tertiary care. From the findings of this study following recommendations were made to improve the medical care program: 1) The renewal process of the medical care certificate should be expedited. 2) Minor specialty clinics should be designated as the primary medical care facility for the medical aid program to reduce the expenses by absorbing more patients referred to the secondary/tertiary care facilities directly. 3) The medical care cost for the primary care facility should be escalated to reduce the differential between the primary and secondary/tertiary care facilities.

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Mongolia Medical Assistance 'M-LIMS' Design and Analysis (몽골 의료지원용 'M-LIMS' 의 설계 및 분석)

  • Yang, Kyung-Sik;Ahn, Woo-Young;Park, Sung-Sik;Koo, Kyung-Wan
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2014.07a
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    • pp.437-441
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    • 2014
  • 몽골은 현재 국민에 대한 의료 평등이 잘 되어있지 않다. 몽골의 의료 기관은 1,2,3차 기관 세 종류가 있는데 1차는 기본기관, 2,3차는 전문기관이다. 하지만 전문기관은 도시에만 존재하기 때문에 도시권 외 주민들은 전문기관의 의료 서비스를 받기가 매우 힘들다. 게다가 해외 의료 기관들도 모두 수도 울란바토르에 집중되어 있기 때문에 그 격차는 더욱 더 심해진다. 이러한 의료 불평등을 조금이라도 해소하기 위하여 제안하는 것이 'M-LIMS' 이다. 'M-LIMS'는 기본적으로 이동식 병원이다. 'M-LIMS'에서는 환자 진료를 위한 몇 가지 기능을 제공한다. 첫 번째로 환자 관리를 위한 환자용 차트 작성이다. 두 번째로는 환자들의 진료 상황을 볼 수 있는 리스트 검색 및 공유 기능이다. 세 번째로는 환자들의 데이터들을 이용하여 규격화 된 차트로 변환하는 차트 작성 기능이다. 그리고 네 번째로는 차량 내 의사뿐이 아닌 다른 의사도 진료에 참여 할 수 있는 원격 진료 기능이다. 이렇듯 'M-LIMS'의 기능을 이용한다면 몽골의 의료 평등에 한 걸음 더 기여를 할 수 있지 않을까 기대를 한다.

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Curriculum study of information security awareness for medical institution (의료기관 정보보호 인식교육을 위한 교육과정 연구)

  • Kim, Dong-Won;Han, Keun-Hee
    • Convergence Security Journal
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    • v.19 no.4
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    • pp.151-163
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    • 2019
  • As smart devices and communication technologies have developed rapidly, the healthcare industry in the globe is seeing remarkable issues on medical security. At the same time, personal medical records are being shared in the network, which would raise the risk of information security. This thesis aims to develop the curriculum to raise the awareness of information security among workers in medical institutions by referring to NCS(National Competency Standards) International standards, medical institutions' requirements and educational institutions' curriculums on information security based on proven results from medical devices and systems introduced in the public health centers, territorial branches, community health posts and primary, secondary, tertiary hospitals. Thus, this thesis offers the method to improve information security in healthcare institutions through validation testing conducted by medical practitioners and ICT experts.

Development of Vaccination Coverage Estimation Methods of National Immunization Program in Korea (도농복합 지역 영유아 예방접종수첩 기록의 정확도)

  • Lee, Moo-Sik;Kim, Kwang-Hwan;Kim, Jee-Hee
    • Proceedings of the KAIS Fall Conference
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    • 2010.11b
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    • pp.885-888
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    • 2010
  • 현재 우리나라는 보건소 중심의 예방접종등록사업을 진행 중에 있다. 2004년부터 시작된 이 사업은 현재는 전국민을 대상으로 실시하고 있다. 예방접종등록사업은 피접종자들은 대체적으로 예방접종에 대한 적절한 시기를 판단할 수 있는 정보가 부족하기 때문에 예방접종과 관련된 정보들을 국가나 사회에서 적시에 피접종자들에게 제공해 줄 수 있다. 따라서 이에 대한 확인이 등록에 앞서 그 정확성을 확인 필요가 있다. 예방접종등록사업의 가장 기본적인 사업으로 진행된 것은 예방접종 수첩의 제공과 그 관리를 통한 예방접종 사업으로 지속적으로 전개되어 왔으며, 일반 국민과 개원의사들에서도 대중적으로 보급되어 있다. 국가 예방접종률의 산출 그리고 취학 어린이 예방접종력 증명서 제출 제도를 위하여 예방접종 수첩을 활용하는 방법이 현실적으로 유용할 수 있다. 따라서 예방접종 수첩의 예방접종력 정확성을 확인할 필요가 있다. 지역조사에서 접종기관으로 확인된 민간 의료기관 365곳 가운데 의료기관 이전 및 폐업으로 반송된 경우가 4건(1.1%)이었으며, 응답한 경우는 129곳으로 응답률은 35.3%였다. 조사된 의료기관 전체를 대상으로 확인된 1,201건에 대한 BCG 접종여부의 정확도는 69.5%였다. B형 간염의 정확도는 1차가 41.3%로 낮았으며, 2차와 3차는 각각 76.6%, 79.7%였다. DTaP의 정확도는 약 80%였으며, 정확도가 제일 높은 것은 DTaP 3차로 82.5%였으나 다른 것과 가장 낮은 정확도와 2% 정도 밖에 차이가 나지 않았다. 폴리오의 정확도는 약 80%였다. MMR의 정확도는 83.2%였다. 일본뇌염의 경우 약 80.0%였으며, 수두의 정확도는 74.9%로 다른 질병과 비교하여 낮은 수치를 보였다. 조사된 의료기관을 전체로 한 기타예방접종별 예방접종수첩의 접종여부의 정확도는 인플루엔자는 정확도는 74.1%였으며, 뇌수막염은 72.7%의 정확도를 보였다. A형 간염 1차의 정확도79.5%였으며, 폐렴구균 1차의 경우 73.2%로 나타났다. 국가필수예방접종별 예방접종수첩의 접종일자에 대한 정확도는 BCG 80.1%로 확인되었고, B형 간염 1차 89.7% 2차는 82.1% 3차는 79%로 B형 간염 중 가장 낮은 정확도를 보였다. DTaP는 1차와 2차는 약 87% 3차는 85.1% 4차는 83.5%로 확인이 되었다. 폴리오는 1차가88.1%로 가장 높은 정확도를 보였고 그 다음으로 2차가 86.2%, 3차가 84.8%로 확인되었다. MMR의 정확도는 84%였으며, 일본뇌염 1차의 정확도는 83.1%로 나타났다. 수두의 접종일자 정확도는 83.7% 이고, 인플루엔자의 정확도는 55.3%로 상대적으로 낮은 수치를 보였다. 기타예방접종별 접종일자 정확도의 조사 결과 뇌수막염 1차과 폐렴구균 1차는 약 90%로 상대적으로 높은 정확도를 보였고, A형 간염 1차는 88.4%의 정확도를 보였다.

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Survey on Medical Technologist Desired Wage in Primary and Secondary Medical Institutions Nationwide in the Republic of Korea (한국의 1차·2차 의료기관 임상병리사의 희망임금 실태조사)

  • Junghyun KIM;Chang-Sub SONG;Byung-Ho CHOI;Sanghee LEE
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.4
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    • pp.314-323
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    • 2023
  • This study assessed the desired wage guidelines for medical technologists (MTs), mainly primary care providers and those in secondary medical institutions, in 16 cities and provinces in Korea. A survey of 1,327 MTs was conducted using a structured Google questionnaire from August 1, 2022, to September 30, 2022. The wage levels differed according to gender, age, education, career, region, and employment status. There were differences in wage levels according to gender and region with less than one year of career, and the wage gap was relatively larger for woman than man. An awareness of wage compensation appropriate for work performance, and technology value compensation were low at 2.01, 2.23, and 2.30, respectively. This study suggests that primary and secondary medical institutions should provide reasonable wages compensation for MTs' work in order to create an environment where MTs can receive stable jobs and work. Moreover, the Korean Association of Medical Technologists should establish a cooperative system so that the starting wage of MTs in primary and secondary medical institutions can receive the desired wage of 34 million won.

Problems of the Current Referral System of the Terminal Cancer Patients in Korea (말기 암 환자의 완화 의료 연계 시스템의 문제점과 개선 방안)

  • Yun, Cho-Hee;Lee, Ju-Young;Kim, Mi-Ra;Heo, Dae-Seok
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.94-100
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    • 2002
  • Purpose : The system to refer terminally ill patients to palliative or hospice care which ultimately give them emotional, psychological, and social support hasn't been fully developed and organized yet in Korea. The controversies concerning the current referral system are being analyzed to present the improvements. Methods : The questionnaires were asked to be filled out by family members of the 76 patients by phone interview, who were referred from the Seoul National University Hospital between April, 2001 to March, 2002. They were referred to the 35 palliative and hospice care-giving institutes and hospitals which were given questionnaires by mail. Results : Of the 76 patient's family members, 47 family members accepted to answer the questionnaire. The first thing that influence to family to determine the referral of patient was solicitation of doctors or nurses (44%). And they were influenced by allowance for the other things such as convenience of patients (32%), convenience of caring family members (24%). In the course of determining of referred institutes, responders had considered at first their dwelling area, and then fame of institutes, the place which patent had wanted to spend last hours or which is suitable for patient's funeral service, and their financial condition. Thirty-eight the 47 responders answered that they had experienced difficulties in referral procedure. The worst among difficulties was unwanted discharge, and followings were lack of information about the referred institutes, concern about patient's suffering, resistance of patient and opposition of other family members, etc. Although they expressed dissatisfaction in referral procedure, most of them answered they had been satisfied with hospice care at referred institute after referral. Merits of referral which responders counted were patient's peace, caring family's comfort and reduced cost in order. Of the 35 referred institutes, 24 institutes' staffs responded mail questionnaires and sent to us in return. Except one responder, the rest approved the referral system and thought that referred patients had been satisfied with their hospice care. And they claimed that systemic support of the government is definitely necessary. The most difficult thing which responders experienced in care of referred patients was lack of information about patients. Besides, there were patient's financial problems, lack of understanding about their institutes of patients or family, and inconvenience of terminal cancer patient's pain control. Conclusion : The development and support of the organized referral system is needed to alleviate the troubles which patients, family members, and palliative or hospice institutes and hospitals have to face through the procedure of the referral.

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A Study on the Improvement of Information Security Model for Precision Medicine Hospital Information System(P-HIS) (정밀의료 병원정보시스템(P-HIS) 정보보호모델 개선 방안에 관한 연구)

  • Dong-Won Kim
    • Convergence Security Journal
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    • v.23 no.1
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    • pp.79-87
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    • 2023
  • Precision Medicine, which utilizes personal health information, genetic information, clinical information, etc., is growing as the next-generation medical industry. In Korea, medical institutions and information communication companies have coll aborated to provide cloud-based Precision Medicine Hospital Information Systems (P-HIS) to about 90 primary medical ins titutions over the past five years, and plan to continue promoting and expanding it to primary and secondary medical insti tutions for the next four years. Precision medicine is directly related to human health and life, making information protecti on and healthcare information protection very important. Therefore, this paper analyzes the preliminary research on inform ation protection models that can be utilized in cloud-based Precision Medicine Hospital Information Systems and ultimately proposes research on ways to improve information protection in P-HIS.

A Study on Health Care Utilization Rates by Gender and Age: Focusing on Data from the 17th Wave of Korea Welfare Panel (2023) (성별 및 연령대별 보건의료 이용율에 관한 연구 : 한국복지패널 17차 웨이브(2023) 자료를 중심으로)

  • Ok-Yul Yang
    • Journal of the Health Care and Life Science
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    • v.11 no.1
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    • pp.105-114
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    • 2023
  • This study aims to analyze the secondary data of disease distribution and medical service behavior according to gender and income by using the 17th wave data of the Korea Welfare Panel, which is being distributed in April 2023. Data for 7,865 people of raw data generated using the R language were collected, and among them, missing values (NA, - 2,012) were analyzed for 5,853 people. For analysis, average income by health status and gender, relationship with chronic diseases, outpatient visits to medical institutions by gender/age group, type of medical institution used by age group, and annual health checkup usage rate by gender/age group were examined. Through this, the medical utilization rate was higher in men than in women, and the utilization rate of hospitals and clinics was high.

Comparision of Medical Care Utilization Patterns between Beneficiaries of Medical Aid and Medical Insurance (의료보호대상자의 의료이용양상)

  • Kim, Bok-Youn;Kim, Seok-Beom;Kim, Chang-Yoon;Kang, Pock-Soo;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.185-201
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    • 1991
  • A household survey was conducted to compare the patterns of morbidity and medical care utilization between medical aid beneficiaries and medical insurance beneficiaries. The study population included 285 medical aid beneficiaries that were completely surveyed and 386 medical insurance benficiaries selected by simple random sampling from a Dong(Township) in Taegu. Well-trained surveyers mainly interviewed housewives with a structured questionnaire. The morbidity rates of acute illness during the 15-day period, were 63 per 1,000 medical aid beneficiaries and 62 per 1,000 medical insurance beneficiaries. The rates for chronic illness were 123 per 1,000 medical aid beneficiaries and 73 per 1,000 medical insurance beneficiaries. The most common type of acute illness in medical aid and medical insurance beneficiaries was respiratory disease. In medical aid beneficiaries, musculoskeletal disease was most common, but in medical insurance beneficiaries, gastrointestinal disease was most common. The mean duration of acute illness of medical aid beneficiaries was 3.8 days and that of medical insurance beneficiaries was 6.8 days. During the one year period, mean duration of medical aid beneficiaries chronic illnesses was 11.5 months which was almost twice as long compared to medical insurance beneficiaries. Pharmacy was most preferrable facility among the acute illness patient in medical aid beneficiaries, but acute cases of medical insurance beneficiaries visited the clinic most commonly. Chronic cases of both groups visited the clinic most frequently. There were some findings suggesting that much unmet need existed among the medical aid beneficiaries. In acute cases, the average number of days of medical aid users utilized medical facilities was less than medical insurance users. On the other hand, the length of medical care utilization of chronic cases was reversed. Geographical accessibility was the most important factors in utilization of medical facilities. Almost half of the study population answered the questions about source of funds on medical security correctly. Most respondents considered that the objective of medical security was afford ability. The chief complaint on hospital utilization was the complicated administrative procedures. These findings suggest that there were some problems in the medical aid system, especially in the referral system.

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