• 인터넷정보학회논문지
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• 제10권2호
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• pp.29-40
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• 2009

인터넷 등의 정보기술의 발전은 기존의 의료기술에 빠른 변화를 가져오면서 e-Healthcare가 사회적 이슈로 등장하고 있다. 의료정보화 패러다임의 새로운 전환점이라 할 수 있는 e-Healthcare는 국내에서 의료정책방안이나 기술개발을 하고 있지만, 아직 의료정보화의 기반이 되는 인프라는 부족한 수준이며 개방된 인터넷 환경 내 역공학적 측면으로 민감한 의료정보 유출 및 프라이버시 침해에 대한 문제가 대두되는 실정이다. 본 논문에서는 앞서 제시한 문제점의 해결방안으로 e-Healthcare환경 내 개인의 의료정보 보호를 위한 역할기반의 접근제어 시스템(HPIP - Health Privacy Information Protection)을 네 가지 주요 메커니즘(사용자 신분확인, 병원 권한확인, 진료기록 접근제어, 환자진단)으로 제안하였으며, 실 환경에서 효과적으로 활용될 수 있도록 프로토타이핑을 통해 그 가능성을 타진해 보았다.

• 보건의료기술평가
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• 제6권2호
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• pp.156-161
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• 2018

Objectives: To evaluate results and workloads of the horizon scanning of the emerging health technology since 2014 to 2016. Methods: In order to analyze the results of the emerging health technology, we identified the number of research procedure between 2014 and 2016. The sixteen findings were calculated annual workload by person, and categorized by medical phase, classification of disease, and healthcare technology. Results: An average of 5.67 personnel were involved over three years, assessment of each emerging healthcare technology was performed for each person of identifying 54 cases, filtering 2.4 cases, prioritizing 0.9 cases were performed. According to the mapping by healthcare technologies, nine medical devices (56.3%), six drugs (37.5%), and one material of the medical treatment (6.3%) were assessed. Among sixteen findings, fifteen cases were health technologies for treatment and only one case for diagnosis. Conclusion: Future plans of the horizon scanning of the emerging health technology is required appropriate manpower in charge each target number of assessment. And a legal basis should be provided for policy reflection rate. Furthermore, an evaluation criteria and procedures should be transparent to avoid a conflict of interest.

• 보건행정학회지
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• 제18권4호
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• pp.148-169
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• 2008

As the Korean Government began to perceive healthcare as one of foundational industries for national dynamics, there has been mounting advocacy for the introduction of for-profit hospitals with a view to bringing efficiency in healthcare services industries and improvement of their international competitiveness. The Government is now considering the issue from all angles in favor of permitting for-profit hospitals. However, There have been few precedent studies on this subject to provide helpful data for the discussion and in the health policy making. This study used private hospitals - for-profit and nonprofit - in Florida, USA as study subjects to accumulate basic data that may be utilized for those involved in debates and health policy making relating to the introduction of for-profit hospitals in Korea. Among all the private general hospitals in Florida, those surveyed by AHA(American Hospital Association) for four consecutive years from 2001 and 2004 and others reported about to MCR(Medicare Cost Report) included in the collected data for analysis. In total 139 private general hospitals consisting of 73 for-profit hospitals and 66 nonprofit hospitals were included in the collected analysis data. Results of analysis revealed no significant difference between for-profit hospitals and nonprofit hospitals in the usage aspects of healthcare services including the average length of stay and the ratio of Medicare vs Medicaid patients. However, financial performances indicated by such factors. as the pre-tax return on assets and the pre-tax operating margin showed to be significantly higher in for-profit hospitals compared with nonprofit hospitals. And the ratio of personnel expenses and the turn period of total assets showed to be significantly lower in for-profit hospitals. Based on the hypothesis that arguments about the introduction of for-profit hospitals have considerably different viewpoints depending on the size of hospital represented by the number of bed, these two hospital types were compared again using the number of beds as a controlled factor, but the results were similar. We, therefore, could conclude that the for-profit hospitals in Florida included in this study could, in their for-profit operation, improve their financial performance by pursuing cost reduction and effectively utilizing their assets without limiting the amount and the range of their services or avoiding less medically protected groups such as Medicare and Medicaid patients.

• 보건행정학회지
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• 제26권4호
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• pp.265-270
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• 2016

Public health system for more prevention-oriented health promotion rather than hospital-based curative service, focusing population rather than individual, and comprehensive health management in the local community strongly needs to be constructed to solve major issues on efficiencies and equity problems which Korean healthcare system is facing nowadays. Public health promotes and protects the health of people and the communities where they live, learn, work, and play. Medical care tries to cure those who have diseases, but public health tries not to become ill and not to be injured. Debates on how we build or rebuild public health system, which is contrasted with medical care system, are needed in Korea, focusing how needs for healthy community and right to health are fulfilled. Public health specialists for practising population health at local community level should be systematically recruited, the function of public health centers should be strengthened, and new government organization should be established for place-based health management.

• 보건행정학회지
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• 제29권3호
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• pp.245-247
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• 2019

Although 19 years have passed since the enforcement of the Framework Act on Health and Medical Services, the Plans for Development of Health and Medical Services has not been established. This Plan is a 5-year basic long-term plan that covers the whole of health and medical services. This Plan should point to the direction of 30 long-term plans of healthcare, and this Plan should serve as a combination and coordination of 30 long-term plans and 22 related laws. The United States, the United Kingdom, and Japan have established long-term healthcare plans (4-, 10-, and 20-year plans, respectively). The long-term health plan of the United States has been approached bottom-up, those of the United Kingdom and Japan have been approached top-down. The rapid environmental changes that Korea is and will be experiencing emphasize urgently the need for establishing the Plan for Development of Health and Medical Services.

• 한국병원경영학회지
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• 제14권2호
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• pp.75-98
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• 2009

As the organizational environments are changing, organizational innovation has become a critical success factor for the healthcare organizations. Although there are lots of successful innovation cases in other industries, healthcare organization's management innovation cases are rare in Korea. This case study is focused on successful change process of a Maeumsarang psychiatric hospital. Main findings are: (a) virtuous cycle of healthcare service innovation and organizational innovation, (b) intensive training and learning, (c) usage of external resources, (d) high commitment HRM system, (e) CEO leadership, and (f) synchronization of planning and execution. Based on these findings, managerial implications are derived and future research directions are proposed.

• 셀메드
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• 제6권3호
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• pp.15.1-15.4
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• 2016

Evidence based practice (EBP) is a system of applying the most current and valid high quality evidence to support clinical decision making in a healthcare setting. In the twenty five years since its inception, EBP has become the accepted benchmark for excellence in healthcare. Although the system emerged within the biomedical sciences, in the years since EBP has become normative across all healthcare modalities from dentistry, allied health to complementary and alternative medicine (CAM). Practicing evidence based medicine within any modality potentially offers the patient the best available care based on high quality evidence. Yet it is the nature of the evidence that provokes some questions about the suitability of EBP across all modalities of healthcare. The meta analysis of randomized controlled trial (RCT) stands at the pinnacle of the hierarchy of evidence in EBP. This forms a challenge to CAM due to the difficulty in reducing the elementals of a holistic naturopathic assessment of a patient into an answerable question to be tested within a RCT. On one level this makes EBP paradigmatically incompatible with CAM, yet on another level it presents the opportunity to redefine the parameters of what is considered high level evidence. EBP has become a tool, and at times a weapon wielded by governments and health insurance companies to direct healthcare funding and policy. The implications of the nature of accepted evidence are becoming far reaching. The pursuit of the best available healthcare for each individual is the focus of EBP. However, the injudicious use of this system to direct health policy is fraught with biomedical bias and dominance. This issue raises the challenge to CAM to present high level evidence according to the rules of evidence, or face the annihilation of centuries of empirical knowledge.

• 전자공학회논문지
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• 제51권6호
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• pp.50-59
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• 2014

모바일 헬스케어 서비스에서 환자의 응급 상태를 정확하게 응급 감지하고 신속히 알리는 것이 매우 중요하다. 기존의 헬스케어 서비스에서는 전달된 생체 정보를 의료진 또는 의료 서비스 공급자가 항시 모니터링을 하여 환자의 상태를 판단하게 된다. 하지만 의료진이 항시 모니터링을 해야 하기 때문에 다수 환자를 실시간으로 동시에 모니터링하기에는 어렵다. 더구나, 환자마다의 고유한 환자의 건강 상태의 특징 (나이, 성별, 병력 기록 등)들이 있기 때문에 통계적인 의료 지식으로 환자의 상태를 진단하는 것은 더욱 힘든 일이다. 이러한 기존의 문제점을 해결하기 위해서 본 논문에서는 사용자 맞춤형 응급관리를 위한 모바일 헬스케어 시스템을 제시한다. 제안된 모바일 헬스케어 시스템의 특징은 환자의 고유한 건강 상태의 특징을 정책으로 정의하고 이를 기반으로 환자로부터 측정된 생체 정보에 대해 응급 상태를 판단하는 것이다. 제안된 모바일 헬스케어 시스템의 개념을 입증하기 위해 프로토타입을 구현하였다.

• 보건행정학회지
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• 제19권4호
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• pp.53-65
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• 2009

Purpose: This study was conducted to identify the prenatal heath care utilization and expenditure among pregnant women. Method: This was a 5-month follow-up study using a stratified sampling and the data were drawn from the "nationwide claim database of Korean National Health Insurance Corporation". Result: This study found that pregnant women were first diagnosed with pregnancy when they were 7.1 weeks pregnant, received 12.7 times of prenatal examinations and 10.6 times of ultrasonogram. It was revealed that 67.5% of the subjects continued to receive prenatal care at the same medical institutions from the diagnosis of pregnancy to the delivery. The study also showed that the total expenditure of prenatal care per pregnant woman was 700,000 Korean Won (KRW) on average and the insurance coverage rate stood at only 20%. Pregnant women living in metropolitan area spent more on prenatal healthcare expenditure than those who living in medium-sized city or rural area. Conclusion: The results of this study implies that the government needs to provide pregnant women with continuous support by increasing health insurance coverage for prenatal care. Especially, it is considered to provide more support to the pregnant women residing in medically underserved areas.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제16권2호
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• pp.29-36
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• 2010

Recently, the system that can eliminate discrimination and barrier to disabled, ensure the substantial independence of disabled and help participation in community of disabled is required. Therefore, the purpose of this study is 'construction of the Barrier-free environment' which members of societies included the disabled can live safely in the daily living environment. To achieve this result, this study is shown establishment and complementary direction of the policy related convenient facilities by comparing between domestic and international policy of the convenient facilities. The results of this study are as follows; Firstly, among the conflicting part between related laws and design standards shold be constantly supplemented. Secondly, policy to promote convenient in residential part is needed. Thirdly, composition of the organization that can support professional housing reconstruction is required. Fourthly, from early stage of policy making, not only opinion reflection of users but also maintenance of convenient facilities, continuous maintenance plan and making a policy for verification system is needed. Finally, when the revision of the existing policies or new policies undergo, 'Barrier-free perspective' should be considered.