• 한국병원경영학회지
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• 제23권1호
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• pp.28-40
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• 2018

Purpose: The purpose is to understand the perception of medical providers at tertiary hospitals in Seoul on the importance-performance of the reform on a doctor-designation system, and to provide the policy suggestion of the perception on such a system. Methodology: To achieve the purpose, this study utilized structured survey tools to conduct a questionnaire survey of nursing, administrative and medical technology professionals at six tertiary hospitals in Seoul. An importance-performance analysis was utilized for an analysis that showed the perception of the reform on a doctor-designation system. Findings: First, it was identified that those medical providers had the highest perception of the importance about the performance of the reform on a doctor-designation system. Second, according to the result of action grid of an importance-performance analysis (IPA), it can be identified that in the 2nd stage of 'Concentrate here' included are the items as to design and effect of medical care quality and subsidies & patient infection and safety and control fees, effect of income security of the method for compensating for loss established by the government and offering sufficient information on general medical services and doctor-designation medical services. In the 1st stage of 'Keep up the Good Work', and the 2nd stage of 'Concentrate here' included is the item as to the performance of patients of the reform on a doctor designation system. Practical Implications: There could be identified the effect of the reform bill on the perception of medical providers. It is expected that a better environment would be provided for patients to use a hospital and for medical providers to offer medical services, if the goverment makes efforts to improve methods for compensating for loss and continuous monitoring of the performance of patients.

• 한국병원경영학회지
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• 제19권2호
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• pp.73-88
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• 2014

Objective: This research investigates how to increase the quality of medical service and supply high quality of medical service to patients. By using Kano Model theory we examines what medical service attributes the hospital would be conducted preferentially for patient's satisfaction and provides informations of management strategies for hospitals. Method: To study patients' perception of medical service quality, first we performed pilot test to derive 30 medical service attributes. With 30 medical service attributes, we conducted survey of 300 subjects who have experienced medical services in 6 months. To examine patients' conception of medical services, a modified Kano's questionnaire using 5 scale is applied. Finally we calculated SI(Satisfaction index) and DI(Dissatisfaction index) and PCSI(Potential Customer Satisfaction Improvement) index with Kano's Model analysis results. Key Findings: We found that the quality of medical service categorized in 15 one-dimensional elements, 9 must-be elements and 6 indifferent elements. Moreover the attribute of gives prompt services and have patient's best interest at heart scored the highest SI, whereas the attributes of accurate and precise medical service, exact records, enough explanation and polite attitudes are the highest score of DI. And also good explanation of the bill scored the highest PCSI. In this study findings indicate that while medical service providers try to increase patients' satisfaction by improving hospital's environments, patients' perception of trust and good interpersonal relationships with medical service providers have strong and positive impact on patients' satisfaction.

• 한국간호교육학회지
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• 제14권1호
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• pp.98-107
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• 2008

Purpose: The purpose of this study was to provide basic data which is necessary for educating nursing and medical students for establishing a desirable sense of ethics values Method: In this descriptive research, a total of 140 nursing students and 124 medical students were selected. The tools used for data analysis were descriptive statistics, t-test, one-way ANOVA, and Scheffe test by using SPSS/WIN 12.0 version. Result: When the differences in the consciousness of biomedical ethics of nursing and medical students were compared, statistically significant differences were found in the category of brain death (t=-3.26, p=.001). Statistically significant differences were found in the general characteristics of religion (F=3.05, p=.018), and participation in religious activity (F=3.34, p=.006). Statistically significant differences were found in the characteristics related to the subjects' ethical values such as satisfaction level of a nurse/doctor (F=7.39, p=.000) occupation, the experience of A Patient's Bill of Rights (F=2.97, p=.020), the intention to attend biomedical ethics (F=5.61, p=.000), and the possibility of increasing ethical problems according to the development in the field of medical science (F=7.92, p=.000). Conclusion: An effort should be made to overcome the differences in the perception of biomedical ethics between nursing students and medical students. Moreover, when investigating the course of an integrated education for the establishment of a desirable sense of biomedical ethics, an alternative plan that could promote ethical values must be considered so that the significant variables can promote bioethical perception.

• Journal of Preventive Medicine and Public Health
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• 제22권3호
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• pp.398-405
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• 1989

A change in the consumer's surplus was measured in order to evaluate the social benefit to be derived from expanding health insurance to the entire population. The most refined and correct way to measure a project's net benefit to society is to determine a change in the consumer's surplus. Benefits from introducing the health insurance program to the uninsured people can be classified into two elements. The first is the pricing-down effect(E1) which results from applying the insurance price system, which is lower than the actual price, to the uninsured patients. The second effect(E2) is a decrease in actual payment because an insured patient pays only a portion of the total medical bill(copayment). We collected medical price information from the data banks of 93 hospitals, and obtained information of medical utilization by referring to the results of other research and from data published by the Korean Medical Insurance Societies. The total net benefit was estimated as \214 billion, comprising the first effect(E1) of \57 billion and the second effect(E2) of \157 billion. The price elasticity of physician visits is less than that of hospital admissions: however, benefits from the increase in physician visits are greater than those from hospital admissions because there are considerably more of physician visits than hospital admissions. The sensitivity analysis also shows the conclusion that expansion of the health insurance program to the entire population would result in a positive net benefit. Therfore, we conclude that the National Health Insurance Program is socially desirable.

• 대한예방한의학회지
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• 제10권1호
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• pp.109-121
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• 2006

The purpose of this study was to determine factors influencing patient satisfaction with medical services in hospital, which is classified into environmental aspect, human services and procedural services. Based on the results of literature review, the study focused on effects of social-demographical factors on patient satisfaction. The environmental aspect of medical care services included medical equipment and facilities, hygiene, ventilation, heating and air-conditioning, waiting and resting space, ward space and parking facilities. Procedural service included registration process, bill payment, waiting time after registration, examination and prescription as well as appointment process. Human services consisted of physicians listening to stories of patients, examination duration, physicians' explanation and physicians' service. As for nurses, explanation about disease, examination procedure and results, kindness and nursing care were evaluated. Services provided by other staff members were also evaluated. Patient satisfaction, defined as individual attitude toward medical service as a whole, was measured using a questionnaire. A total of 700 in-or out-patients were surveyed in 6 hospitals with more than 300 beds in North Gyeongbuk Province. 1. The level of patient satisfaction varied with characteristics of patients. Male patients and those in their 30s had a low level of satisfaction. Dissatisfaction level was positively related to education level but negatively related to economic condition. 2. As for patient satisfaction with medical service providers and other employees in hospital, satisfaction level with physician's explanation about treatment was higher. But dissatisfaction levels with treatment duration and the lack of explanation about examination procedures were high, calling for improvement. Dissatisfaction level with nursing care was high, calling for training of nurses for better service. Given the low level of satisfaction with human services, hospital employees need to be trained to improve their service. 3. It Was found that administrative service was also a significant factor influencing patient satisfaction in addition to medical service. It is therefore important for hospitals to provide patients with prompt and convenient procedural service. 4. Environmental factors such as medical equipment and amenity facilities also affected patient satisfaction. Thus environmental condition, procedural service and human service are all important to improve medical service in hospital. In summary, procedural service was the most significant factor for patient satisfaction. The level of satisfaction in patients was also affected by human service and environmental condition. It is therefore necessary to take patient-oriented approach in providing medical service in an effort to improve patient satisfaction. The finding of a lower level of satisfaction with human service signifies the need for training of healthcare providers and other hospital employees for better services. The introduction of advanced management programs is also needed to improve procedures that patients go through in hospitals.

• 디지털융복합연구
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• 제12권9호
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• pp.255-263
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• 2014

선진국과 달리 한국에서는 낮은 처리비용 등을 이유로 원거리에 있는 폐기물 처리시설에 의료폐기물 처리를 위탁하는 것이 가능하다. 이 과정에서 위험성 때문에 의원입법으로 개정법률안이 국회에 제출되어 있다. 본 연구는 선진국과의 비교연구를 통하여 의료폐기물 관련 문제해결을 위한 효과적인 방안을 모색하는데 그 목적이 있다. 연구방법은 문헌고찰 및 법률의 비교연구를 통한 서술식 방법을 채택하였다. 외국에서는 감염성 폐기물에 대하여 발생지 인근에서 신속한 처리를 원칙으로 하면서 장거리 이동 가능성을 제한하고 다양한 기술사용을 권장하고 있는 것에서 한국과 차이를 보인다. 따라서 외국 사례와 비교하여 의료폐기물 최적의 처리방안으로 권역화 방안을 제시했다.

• 대한예방한의학회지
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• 제18권3호
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• pp.11-21
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• 2014

The rapid development and distribution of information communication industry facilitates the changes of hospital administration, introducing EMR(Electronic Medical Record) instead of paper-based medical record in the medical field. The developed countries such as U.S. have established EMR system after in the middle of 1970s because the primary advantages of EMR is to store and handle vast amounts of records efficiently and increase the quality of health care. Most of health organizations in Korea also apply medical record system to their administration. As the result, they have accomplished a scientific administration system through the use of medical record to handle a variety of patient's information including patient's confidentiality and privacy such as family history, social status, income level, and so on. However, access to and the misuse of EMR causes illegal infringement of patient's information and finally it becomes a very serious medical issue. Potential leakage and misuse of records may seriously infringe patient's privacy rights. In this respect, the related agencies in the public and private sector have been making efforts to prevent patient's records leakages. Especially, the revision bill of Medical Law in 2002 establishes the ways on the security and standards of electronic records. However, it does not provide the proper guidelines which is applied to the rapid changes of the medical environment. One of the most priorities in the hospital administration is the production and maintenance of an accurate medical records fulfilled by medical recorders. Therefore, it is very important for health care providers to hire ethical-based medical recorders. But, unfortunately most of hospitals overlook the importance of their roles. All parts including government, physician and patient must have more concerns on the problems related to EMR. Therefore, this study aims to propose the proper ways to resolve the problems coming from EMR.

• 대한방사선기술학회지:방사선기술과학
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• 제27권4호
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• pp.67-74
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• 2004

전국 16개 시도의 44개 종합병원에 근무하는 방사선사 890명을 대상으로 방사선사의 인력양성 및 보건정책에 대한 사항을 특별시, 광역시, 중소도시의 지역별과 근속연수별로 구분하여 분산분석을 실시, 향 후 방사선사의 인력양성 및 보건정책에 관한 기초 자료를 제공하는 목적이 있으며 결과는 다음과 같다. 1. 방사선사의 교육과정에 있어서 근속년수별 분산분석 결과 4년제 방사선학과 개설과 교육과정 개정의 필요성을 20년 이상의 경력자가 5년 이하보다 높게 나타나 근속년수가 오래될수록 4년제 방사선학과 개설의 필요성을 느끼는 것으로 나타났다. 2. 방사선사에 대한 국가 보건정책에 대한 사항에서는 의료기사법의 개정의 필요성과 법정인력 확보의 필요성이 높게 나타났고, 방사선사의 인력배출 수급과 의료보험 청구시 방사선사 면허번호 청구 제도의 필요성이 지역별로 유의수준으로 나타났다.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.178-187
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• 2012

Purpose: In Korea, the nation's medical expenses were 12 billion won in 2010. The medical costs for individuals can also be overwhelming. If a patient has sustained severe trauma, his/her insurance company responsible may pay only part of the medical bills. In Korean, there are diverse types of medical insurance, such as health insurance, automobile insurance, and industrial accident compensation insurance. And each insurance system has a different type of payment system. Our study will be essential for establishing the optimal medical expense payment system. Methods: From January to December 2011, we retrospectively reviewed the medical charts of 161 patients who were admitted to our hospital's emergency room after having undergone severe trauma. Of those 161 patients, 125 were retrospectively reviewed. Written permission was obtained from all of the patients. We analysed the demographic characteristics, clinical outcomes, data of the trauma, type of the patient's insurance, and the entire bill when the patient was discharged. Results: Seventy-one patients had health insurance, 48 automobile insurance, and six industrial accident compensation insurance. High-deductible insurance included health insurance and industrial accident compensation insurance, with the deductibles up to 20.6% and 19.1%, respectively. We attempted to analyze the cause of the high deductible rate. In patients with health insurance, medicines, primarily sedatives, pain killers, antibiotics, and fluids. comprised a large proportion. On the other hand, industrial accident compensation insurance deducted for a high-grade hospital room charge. Conclusion: We found that medical expenses were diverse according to the type of insurance. In particular, health insurance forced patients to pay too much of the medical expenses. Therefore, in Korea we should try to identify the insurance problems and improve the wage system.

• 한국응급구조학회지
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• 제11권3호
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• pp.17-30
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• 2007

Accidents occur frequently and that the date of the emergency situation and the people a good quality of life to actively respond to the emergency scene in the line of business activities and given their lives silently. 1st EMT's is currently the most jobs in the ability to work within a hospital that can be verified by expanding employment opportunities than the rate of youth unemployment and a sharp alleviate part of the current emergency medical institution performing the duties within the contents of this communication in a Emergency patients reflected in the rates for schools that can be revitalized as part of the emergency medical system(part of the emergency medical workers) for the completion of the law concerning emergency care, if you want the current laws and enforcement rules are to be improving. Under the current provisions in law concerning emergency care, and enforceable rules on enforcement issues and identify practical issues for consideration and improvements to enumerate the reasons for the demotion, the following conclusions can be sure until they improve. In addition, the National Assembly recently passed a bill AED use, and enforceable rules to enforce party that can teach AED necessarily a grade, including 1st EMT's to protect people's lives and to actively deal with the emergency situation so that it can be. Resolving these issues in the country where the emergency medical system can create a foundation for the advancement of emergency patients can get a good length of life, opens.