• Title/Summary/Keyword: Healthcare institutions

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The National Status of Tuberculosis Using Nationwide Medical Records Survey of Patients with Tuberculosis in Korea

  • Park, Yoon-Sung;Hong, Sung-Jin;Boo, Yoo-Kyung;Hwang, Eun-Suk;Kim, Hyun Jung;Cho, Seung-Hee;Na, Kyung-In;Cho, En-Hi;Shin, Sang-Sook
    • Tuberculosis and Respiratory Diseases
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    • v.73 no.1
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    • pp.48-55
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    • 2012
  • Background: The epidemiology of tuberculosis (TB) has been assessed based on the data of the analysis of TB patients notified to the surveillance system in Korea. However, the national status of TB is not validated through this surveillance system. The objective is to determine the epidemiology of TB and to understand the accurate status of TB patients treated in private institutions. Methods: Medical records of 53,579 patients who had been diagnosed with TB in 2008 were analyzed. Results: Among 53,579 patients, the number of sputum smear positive cases was 15,639(29.2%) and the number of new cases was 39,191 (73.1%). The drug resistance rate of new cases was 5.3%, while the rate stood at 13.3% for TB patients with treatment history. The number of multi-drug resistant TB (MDR-TB) patients was 2,472 (4.6%), which consists of 2.9% of new cases and 9.3% of TB patients with prior treatment history. The number of extensively drug-resistant TB patients was 749 (1.4%), consisting of 1.1% of new cases and 2.2% of TB patients with prior treatment history. In terms of treatment outcomes, 66.4% of all TB patients, 70.5% of new cases, 64.4% of relapse cases, and 46.8% of MDR-TB cases were cured or completed. It was inferred that in 2008, the total number of TB patients reached 70,767, 145.6 per 100,000 people (95% confidence interval, 145.5~145.7). Conclusion: We conclude that the medical records review of the Health Insurance Review and Assessment Service (HIRA) data can be very effective in promoting the understanding of the current status of TB in private institutions.

An Analysis of Factors Affecting Financial and Operating Efficiency at Regional Public Hospital (지방의료원의 재정 및 운영효율성에 영향을 미치는 요인)

  • Jin Won Noh;Hui Won Jeon;Jung Hoe Kim;Jeong Ha Kim;Hyo Jung Bang;Hae Jong Lee
    • Health Policy and Management
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    • v.33 no.3
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    • pp.355-362
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    • 2023
  • Background: Financial efficiency in monetary units and operational efficiency in non-monetary units are separately classified and evaluated. This is done to prevent the duplication of monetary units and non-monetary units in inputs and outputs. In addition, analyses are conducted to determine the factors that affect each aspect of efficiency. To prevent duplication of monetary and non-monetary units in inputs and outputs, financial efficiency, consisting of monetary units, and operational efficiency, comprising non-monetary units, are separately classified and evaluated. Furthermore, an analysis is conducted to identify the factors that affect each aspect of efficiency. Methods: This study conducted a panel analysis of 34 regional public hospitals and influencing factors on efficiency for 5 years from 2015 to 2019. Financial efficiency and operational efficiency were calculated through data envelopment analysis. Moreover, multiple regression analysis was conducted to identify the factors that influence both financial efficiency and operational efficiency. Results: The factors that affect financial efficiency include the number of medical institutions within the treatment area and the ratio of patients receiving medical care. Additionally, operational efficiency is influenced by the type of medical institution, the number of medical institutions within the treatment area, and the number of nursing positions per 100 beds. Conclusion: In order for regional public hospitals to faithfully fulfill their functions and roles as regional base public hospitals, several measures are necessary. Firstly, continuous monitoring and reasonable support are required to ensure efficient operation and performance. Secondly, a financial support plan tailored to the characteristics of local medical centers is needed. Additionally, local medical centers should strive to enhance their own efficiency.

The Factors of Related towards Intention to Organ Donation by the Citizens of Busan (부산시민의 장기기증의사에 관련된 요인)

  • Hwang, Byung-Deog;Im, Bock-Hee;Jung, Woong-Jae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.1
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    • pp.341-350
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    • 2011
  • This study aims at providing basic data on organ donation by analyzing factors of influencing toward intention to organ donation and further at improving people's consciousness on organ donation, subject to citizens of Busan City. The data was collected for 47 days from 14 July to 31 August, 2009. Among a total of 2200 cases of the questionaries, only 2042 cases were used. For data analysis, SPSS 17.0 was used, and for the specific analysis method frequency analysis to understand general characteristics of the participants. In addition, examination on T-test and ANOVA analysis were conducted after analyzing the factors for participants' consciousness on organ donation, and logistic regression analysis for understanding of relations between participants' will to donate organs and general characteristics. The results of this study are summarized as follows; First, among the participants, those who have heard about organ donations were 71.6%. Second, the factors that general characteristics influence on the attitudes towards organ donation include gender, chronic diseases or incurable diseases in the respondents or their family, religion, acceptive attitude factor, exclusive attitude factor and positive attitude factor towards organ donation. Based on the results, in order to raise people's consciousness on organ donation and form social sympathy, more than anything else, public mass media like broadcasting is important. In addition, as organ donation centers and related institutions prepare nationwide events, we should endeavor to prepare the opportunities in various ways to converse people's consciousness on organ donation and further put organ donation into practice.

An Analysis on Patients Trend and Income of Primary Care Clinic (일차 진료의원의 진료수입의 형평성 분석연구)

  • Lim, Sun Mi;Im, Geum Ja;Park, Kwan Jun;Park, Yoon Hyung
    • Health Policy and Management
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    • v.24 no.1
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    • pp.92-99
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    • 2014
  • Background: Korea's primary care clinics are seeking increase in consultation fees by expanding supply within the frame of the health insurance system, but inequality of physician income between regions and individuals is exacerbating. The purpose of this study lies in analyzing the distribution of patients of primary care clinics, their specialized field, and the degree of inequality between medical fee income according to region. Data was acquired from the Health Insurance Review and Assessment Service on charged bills made by clinic-size medical institutions from 2008 to 2011. Methods: By comparing the outpatient number per clinic according to the clinic's specialized field, results showed that ophthalmology, otolaryngology, dermatology, orthopedics, and internal medicine showed high numbers whereas plastic surgery, neuropsychiatry, cardiothoracic surgery had fewer outpatients. The number of outpatients for clinic according to region showed Chuncheonnam-do, Jeju-do, Gangwon-do, Chungcheongbuk-do, Ulsan to have higher numbers of outpatients. For those four years, clinics in the Seoul area had a rather lower number. Results: As a result of comparing the decile hierarchy distribution ratio between specialized fields according to primary care clinics income from National Health Insurance, the inequality degree showed that obstetrics and gynecology and general medicine were each 0.130, 0.280 for the decile distribution ratio, which was the highest degree of inequality within the specialized field. Their Gini coefficient were also relatively high at 0.691, 0.528 respectively. On the other hand, the decile distribution ratio for otolaryngology and orthopedics were 0.510, 0.468, respectively, while their Gini coefficient each at 0.318, 0.314 makes their inequality degree relatively lower than other fields. Conclusion: This study is limited in that the data used was the health insurance charges submitted by clinics, which does not provide total information of the doctors' income. However, because most clinics are largely dependant on their income to come from health insurance reimbursements. Therefore, the results of this study can be used effectively. In the future, research that includes data on non-covered service income should be conducted to closely examine policy plans with a new medical fee policy which can resolve the medical fee income inequality issue between clinics as well as revitalize primary medical care.

A Study on the Medical Ethics Education at Colleges of Korean Medicine (한의대 교과목으로서 의료윤리에 관한 고찰)

  • Lee, Jeong-Won;Lee, Hai-Woong
    • Journal of Society of Preventive Korean Medicine
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    • v.22 no.2
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    • pp.13-24
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    • 2018
  • Objectives : According to the data from the 2016 Yearbook of Traditional Korean Medicine, 10 out of 12 medical schools of Korean medicine are offering medical ethics. Medical ethics has become essential in Korean medicine education, but there has been no agreement on the content of education yet, so initial discussions are necessary with respect to the content and methods of education. Methods : In this study, basic data were collected by searching papers, reports, books, and media articles on medical ethics related to Korean medicine education, and by studying the website of medical schools of Korean medicine nationwide. Based on the collected data, the status of medical ethics lectures were determined and compared with the current state of medical ethics lectures by western medical schools. The contents suitable for medical ethics education at medical schools of Korean medicine were discussed. Results : The topics of the medical ethics include: the basic concepts of medical ethics, the ethics of birth, the ethics associated with genetics, the ethics associated with death, and the ethics regarding doctor-patient interaction, the ethics of medical research, medical rationing ethics, ethics between medical staffs, medical law and ethics, philosophical base of medical ethics, ethics of doctor as professional, and moral personality formation of doctor. The contents of medical ethics in traditional Korean medicine reflected views on the human body and life based on "Huangdi's Internal Classic"and medical ethics from the viewpoints of Buddhism and Confucianism. Conclusions : Medical schools of Korean medicine are medical training institutions, and medical ethics education is essential to become a Korean medicine doctor as professional worker, medical practitioner, and biomedical researcher. There is no fundamental difference in the basic principles of medical ethics in both western and Korean medicine, and there are differences in contents depending on the clinical practice. The contents of medical ethics on clinical practice should be modified for Korean medicine doctors, and traditional Korean medicine ethics would be set up upon that. In the national licensing examination, medical ethics needs to be added as one part so that all the ethical problems related to the clinical situation can be solved.

Design and Development of Personal Healthcare System Based on IEEE 11073/HL7 Standards Using Smartphone (스마트폰을 이용한 IEEE 11073/HL7 기반의 개인 건강관리 시스템 설계 및 구현)

  • Nam, Jae-Choong;Seo, Won-Kyeong;Bae, Jae-Seung;Cho, You-Ze
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.36 no.12B
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    • pp.1556-1564
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    • 2011
  • The increased life expectancy of human due to the advance of medical techniques has led to many social problems such as rapidly aging populations, increased medical expenses and a lack of medical specialists. Thus, studies on improving the quality of life with the least amount of expense have been going on by incorporating advanced technologies, especially for Personal Health Devices (PHDs), into the medical service market. However, compatibility and extensibility among manufacturers of PHDs have not been taken into account in most of the researches done on the development of PHDs because most of them have been supported by individual medical organizations. The interoperability among medical organizations can not be guaranteed because each medical organization uses different format of the messages. Therefore, in this paper, an expansion module that can enable commercially-available non-standard PHDs to support the IEEE 11073, and a smart-phone-based manager that can support easy and comprehensive management on receiving and transmitting the collected data from each PHD using IEEE 11073 standard were developed. In addition, a u-health system that can transmit the data collected in the manager using the standard data format HL 7 to medical center for real-time medical service from every medical institutions that support this standard was designed and developed.

Development of the Performance Measurement Model of Electronic Medical Record System - Focused on Balanced Score Card - (균형성과표를 활용한 전자의무기록시스템의 성과측정 모형개발)

  • Lee, Kyung Hee;Kim, Young Hoon;Boo, Yoo Kyung
    • Korea Journal of Hospital Management
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    • v.21 no.4
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    • pp.1-12
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    • 2016
  • The purpose of this study are suggest to performance measurement model of Electronic Medical Record(EMR) and Key Performance Index(KPI). For data collection, 665 questionnaires were distributed to medical record administrators and insurance reviewers at 31 hospitals, and 580 questionnaires were collected(collection rate: 87.2%). Regarding methodology, Critical Success Factor(CSF) and index of the information system were derived based on previous studies, and these were set as performance measurement factors of EMR system. The performance measurement factors were constructed by perspective using BSC, and analysis on causal relationship between factors was conducted. A model of causal relationship was established, and performance measurement model of EMR system was proposed through model validation. Analysis on causal relationship between performance management factors revealed that utility cognition of the learning & growth perspective factor had causal relationship with job efficiency(${\beta}=0.20$) and decision support(${\beta}=0.66$) of the internal process perspective factors, and security had causal relationship with system satisfaction(${\beta}=0.31$) of the customer perspective factor. System quality had causal relationship with job efficiency(${\beta}=0.66$) and decision support(${\beta}=0.76$) of the internal process perspective factors, all of which were statistically significant(P<0.01). Job efficiency of the internal process perspective had causal relationship with system satisfaction(${\beta}=0.43$), and decision support had causal relationship with decision support satisfaction(${\beta}=0.91$) and job satisfaction (${\beta}=0.74$), all of which were statistically significant(P<0.01). System satisfaction of the customer perspective had causal relationship with job satisfaction(${\beta}=0.12$), job satisfaction had causal relationship with cost reduction(${\beta}=0.53$) of the financial perspective, and decision support satisfaction had causal relationship with productivity improvement(${\beta}=0.40$)of the financial perspective(P<0.01). Also, cost reduction of the financial perspective had causal relationship with productivity improvement(${\beta}=0.37$), all which were statistically significant(P<0.05). Suitability index verification of the performance measurement model whose causal relationship was found to be statistically significant revealed that $X^2/df=2.875$, RMR=0.036, GFI=0.831, AGFI=0.810, CFI=0.887, NFI=0.838, IFI=0.888, RMSEA=0.057, PNFI=0.781, and PCFI=0.827, all of which were in suitable levels. In conclusion, the performance measurement indices of EMR system include utility cognition, security, and system quality of the learning & growth perspective, decision support and job efficiency of the internal process perspective, system satisfaction, decision support satisfaction, and job satisfaction of the customer perspective, and productivity improvement and cost reduction of the financial perspective. In this study, it is expected that the performance measurement indices and model of EMR system which are suggested by the author, will be a measurement tool available for system performance measurement of EMR system in medical institutions.

A Risk Prediction Model for Operative Mortality after Heart Valve Surgery in a Korean Cohort

  • Kim, Ho Jin;Kim, Joon Bum;Kim, Seon-Ok;Yun, Sung-Cheol;Lee, Sak;Lim, Cheong;Choi, Jae Woong;Hwang, Ho Young;Kim, Kyung Hwan;Lee, Seung Hyun;Yoo, Jae Suk;Sung, Kiick;Je, Hyung Gon;Hong, Soon Chang;Kim, Yun Jung;Kim, Sung-Hyun;Chang, Byung-Chul
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.88-98
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    • 2021
  • Background: This study aimed to develop a new risk prediction model for operative mortality in a Korean cohort undergoing heart valve surgery using the Korea Heart Valve Surgery Registry (KHVSR) database. Methods: We analyzed data from 4,742 patients registered in the KHVSR who underwent heart valve surgery at 9 institutions between 2017 and 2018. A risk prediction model was developed for operative mortality, defined as death within 30 days after surgery or during the same hospitalization. A statistical model was generated with a scoring system by multiple logistic regression analyses. The performance of the model was evaluated by its discrimination and calibration abilities. Results: Operative mortality occurred in 142 patients. The final regression models identified 13 risk variables. The risk prediction model showed good discrimination, with a c-statistic of 0.805 and calibration with Hosmer-Lemeshow goodness-of-fit p-value of 0.630. The risk scores ranged from -1 to 15, and were associated with an increase in predicted mortality. The predicted mortality across the risk scores ranged from 0.3% to 80.6%. Conclusion: This risk prediction model using a scoring system specific to heart valve surgery was developed from the KHVSR database. The risk prediction model showed that operative mortality could be predicted well in a Korean cohort.

Characteristics and components of the third place for daily support of the elderly in Korea (한국 노인의 일상 지원을 위한 제3의 장소의 특성 및 구성요소)

  • Choi, Yeonhee;Seo, Hyunbo
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.27 no.1
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    • pp.45-51
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    • 2021
  • Purpose: Problems related to the elderly's daily life, such as social isolation and absence of a place to go, are already widely recognized, but there are few domestic studies or support policies for this, and the elderly leisure welfare facilities provided by the state do not fully support the elderly's daily life. There are studies related to the elderly's neighborhood environment and facilities, which can be seen as the third place for the elderly in Korea, but these are mostly quantitative studies. In order to talk about the third place for daily support for the elderly in Korea, a detailed study of the use cases of the third place in Korea is needed. This study analyzes the third place of the elderly in Korea and discovers the characteristics and components. Based on the detailed analysis of the third place of the elderly, the characteristics of the third place of the elderly in Korea and the elements constituting it are found to be able to represent the specific necessary environment of the third place of the elderly. Methods: The research targets include 'A Mill' (located in Jungnang-gu, Seoul), and 'Roadside in front of Villa B'(located in Dongdaemun-gu, Seoul), 'C-dong roadside park'(located in Dobong-gu, Seoul) within the range of repeated observations and meetings among the places used as a third place for the elderly was selected. The site survey consisted of in-depth interviews, observational surveys, and participatory observations. In-depth interviews were held for a total of 5 months, from October to December 2019 and from April to May 2020. Results: As a result, a total of 11 characteristics (adjacent to the residence, an open place, an independent space, a comfortable place to stay, a pleasant space, safety is guaranteed, a place that has been operated for a long time, a place that can be used autonomously, a place where social exchange occurs, No financial burden, fun activities) was discovered. Implications: This study is significant in that unlike the existing studies focusing on the use behavior of established institutions or facilities, the elderly identified the necessary environment through their own created places.

Future Tasks of the Law Forcing CCTV Installation in Operating Rooms (수술실 내 CCTV 설치 의무화 법안의 향후 과제)

  • Lim, Ji Yeun;Kim, Kye Hyun
    • The Korean Society of Law and Medicine
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    • v.22 no.4
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    • pp.185-210
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    • 2021
  • On September 24, 2021, the new provisions(Article 38-2 of the Medical Service Act) mandatory CCTV installation in operating rooms where the unconscious patient is operating such as general anesthesia. The revised medical law aims to effectively prevent illegal activities that may occur in the operating rooms and to promote appropriate resolution to medical dispute. According to the law, medical institutions operating unconscious patients, such as general anesthesia, must install CCTVs in the operating rooms by September 25, 2023, and film surgical scenes only at the request of patients and their guardians, regardless of the consent of the medical personnel. The bill delegated the legislative device to minimize infringement of fundamental rights to subordinate statutes without stipulating it in the law.(Article 38-2(10)) The most realistic policy plan to minimize the infringement of the fundamental rights of patients is to prepare specific regulations. Therefore, this study examines the legislative background and main contents of the amended CCTV installation bill, and suggests issues to be reviewed when preparing subordinate statutes by analyzing major issues. It was reviewed based on compliance with the principle of minimizing infringement of fundamental rights of information subjects in the operating rooms. The information subjects of CCTV are health professionals and patients. Suggesting issues should be considered when preparing subordinate statutes so that the purpose of the CCTV installation law can be achieved while minimizing infringement of right of self-determination of personal information, personality rights, and human rights. It is hoped that this paper will be referred when discussing subordinate statutes and regulations to contribute minimizing infringement of fundamental rights.