• 제목/요약/키워드: Human Fact

검색결과 889건 처리시간 0.043초

의료보험 관리체계에 대한 연구 - 관리비용을 중심으로 - (A Study on the Health Insurance Management System; With Emphasis on the Management Operating Cost)

  • 남광성
    • 보건교육건강증진학회지
    • /
    • 제6권2호
    • /
    • pp.23-39
    • /
    • 1989
  • There have been a lot of considerable. discussion and debate surrounding the management model in the health insurance management system and opinions regarding the management operating cost. It is a well known fact that there have always been dissenting opinions and debates surrounding the issue. The management operating cost varies according to the scale of the management organization and component members characteristics of the insurance carrier. Therefore, it is necessary to examine and compare the management operating cost to the simulated management models developed to cover those eligible for the health insurance scheme in this country. Since the management operating cost can vary according to the different models of management, four alternative management models have been established based on the critical evaluation of existing theories concerned, as well as on the basis of the survey results and simulation attempts. The first alternative model is the Unique Insurance Carrier Model(Ⅰ) ; desigened to cover all of the people with no classification of insurance qualifications and finances from the source of contribution of the insured, nationwide. The second is the Management Model of Large-scale District Insurance Carrier(Ⅱ) ; this means the Korean society would be divided into 21 large districts; each having its own insurance carrier that would cover the people in that particular district with no classification of insurance qualifications arid finances as in Model I. The third is the Management Model of Insurance Carrier Divided by Area and Classified with Occupation if Largescale (Ⅲ) ; to serve the self-employed in the 21 districts divided as in Model Ⅱ. It would serve the employees and their dependents by separate insurance carriers in large-scale similar to the area of the district-scale for the self-employed, so that the insurance qualifications and finances would be classified with each of the insurance carriers: The last is the Management Model of the Multi - insurance Carrier (Ⅳ) based on the Si. Gun. Gu area which will cover their own self- employed people in the area with more than 150 additional insurance carriers covering the employees and their dependents. The manpower necessary to provide services to all of the people according to the four models is calculated through simulation trials. It indicates that the Management Model of Large-scale District Insurance Carrier requires the most manpower among the four alternative models. The unit management operating costs per the insured individuals and covered persons are leveled with several intervals based on the insurance recipients. in their characteristics. The interval levels derived from the regression analysis reveal that the larger the scale of the insurance carriers is in the number of those insured and covered. the more the unit management operating cost decreases. significantly. Moreover. the result of the quadratic functional formula also shows the U-shape significantly. The management operating costs derived from the simulated calculation. on the basis of the average salary and related cost per staff- member of the Health Insurance Societies for Occupational Labours and Korean Medical Insurance Corporation for the Official Servants and Private School Teachers in 1987 fiscal year. show that the Model of Multi-insurance Carrier warrants the highest management operating cost. Meanwhile the least expensive management operating cost is the Management Model of Unique Insurance Carrier. Insurance Carrier Divided by Area and Classified with Occupation in Large-scale. and Large-scale District Insurance Carrier. in order. Therefore. it is feasible to select the Unique Insurance Carrier Model among the four alternatives from the viewpoint of the management operating cost and in the sense of the flexibility in promoting the productivity of manpower in the human services field. However. the choice of the management model for health insurance systems and its application should be examined further utilizing the operation research analysis for such areas as the administrative efficiency and factors related to computer cost etc.

  • PDF

1979년(年) 8월(月) 집중호우(集中豪雨)에 의한 진해지구(鎭海地区)의 산사태(山沙汰)에 관한 연구(研究) (An Analysis of Landslides at Jinhae District Dated 25th of August, 1979)

  • 강위평
    • 한국산림과학회지
    • /
    • 제52권1호
    • /
    • pp.72-78
    • /
    • 1981
  • 1979년(年) 8월(月) 25일(日) 태풍(颱風) Judy 호(号)의 영향으로 진해지구(鎭海地区)는 일강우량(日降雨量) 465mm의 집중호우(集中豪雨)로 많은 산사태(山沙汰)가 발생하여 38명(名)의 인명사망(人命死亡)과 가옥(家屋), 농경지(農耕地)에 막대한 재산피해(財産被害)를 냈다. 기왕(既往)의 조사(調査)에 의하면 일강우량(日降雨量) 300mm 이상(以上)일때 산사태발생(山沙汰発生)의 위험이 있다고 하였으나 진해지구(鎭海地区)는 과거 27년간(年間)에 일강우량(日降雨量) 300mm 이상(以上)이 5회(回) 있었음에도 불구하고 한번도 산사태(山沙汰)가 발생(発生)한 기록(記錄)이 없었다. 이것은 이 지구(地区)에 있어서 산사태발생(山沙汰発生)에 관계(関係)되는 각인자(各因子)(강우(降雨), 지질(地質), 지형(地形), 삼림(森林))의 과거(過去)와 현재(現在)의 질적변화(質的変化)에 기인(基因)한다고 생각됨으로 이들의 인자(因子)와 산사태발생(山沙汰発生)의 관계(関係)를 알기 위하여 조사(調査)한 결과(結果)는 다음과 같다. 1. 산사태개수(山沙汰個数)는 71개(個), 면적(面積)은 15.3ha 이다. 2. 지질(地質)에 있어서는 산사태개수중(山沙汰個数中) 안산암(安山岩) 및 화강암(花崗巖)에서 각각(各各) 89%, 11% 이며 면적(面積)은 안산암(安山岩) 및 화강암(花崗巖)에서 각각(各各) 45%, 55%가 발생하였다. 3. 경사(傾斜) $26^{\circ}{\sim}35^{\circ}$ 범위에서 산사태개수(山沙汰個数)는 44%, 면적(面積)은 55% 발생하여 가장 많고 9% 이하(以下) $41^{\circ}$ 이하(以下)에서는 발생하지 않았다. 사면형(斜面形)에서 보면 산사태개수(山沙汰個数)는 하강사면(下降斜面) 및 복합사면(複合斜面)에서 각각(各各) 52%, 46% 발생하여 타(他) 사면형(斜面形) 보다 많았다. 4. 임령(林令) 5~15년(年)에서 산사태개수(山沙汰個数)(2.19개(個)/100ha)및 면적(面積)(0.47ha/100ha)이 가장 많았고 임령(林令) 26년(年) 이상(以上)에서는 발생하지 않았다. 5. 산사태발생인자중(山沙汰発生因子中)(강우(降雨), 지질(地質), 지형(地形), 삼림(森林)) 인력(人力)으로서 그 형질(形質)을 변화(変化)시킬 수 있는 것은 삼림인자(森林因子)뿐이다. 5. 진해지구(鎭海地区)는 과거(過去) 많은 집중호우(集中豪雨)가 있었음에도 불구(不拘)하고 이번 처음 산사태(山沙汰)가 일어난 것은 과거와 현재의 삼림인자(森林因子)의 질적변화(質的変化)에 기인(起因)된다고 생각된다.

  • PDF

Relationships among CEO Image, Corporate Image and Employment Brand Value in Fashion Industry

  • Ko, Eun-Ju;Taylor, Charles R.;Wagner, Udo;Ji, Hyun-Ah
    • 마케팅과학연구
    • /
    • 제18권4호
    • /
    • pp.307-331
    • /
    • 2008
  • The CEO and the Corporate Image is considered very important in the aspect of marketing. The fact that CEO image itself influences the company or value of the product directly and indirectly has been verified through many cases. Recently, the differentiation of products and services between companies became difficult because the disparity in technique between companies retrenched. As a result, the rate of people who decide to purchase or invest their money based on the corporate image or reputation has been increased. Also in the knowledge society like today, the talented employees are the company's customer and the company's necessity for managing those brains of marketing perspective on how to satisfy and attract the customers is being embossed. The Fashion industry is one of the most value-added industry and in those value-added businesses, the most important factor is the human resources' knowledge power. However the study of the relationships among the CEO image, the corporate image and employment brand value in fashion industry has not been carried out yet. This research considers that dynamic relationship exists among the CEO image, corporate image and employment brand value that affects a company's main goal of pursuing benefits and intends to investigate the relationships of the three concepts. The specific purposes of this study were, 1) to analyze the impact of CEO image on a corporate image, 2) to analyze the impact of corporate image on employment brand value, 3) to analyze the impact of CEO image on employment brand value, 4) to analyze whether corporate image plays a mediating role in the relationship between CEO image and employment brand value or not. A survey design with a structured questionnaire was employed for this research. A convenience sample of 398 subjects was selected from two groups, which are university students majoring in fashion and practitioners working in fashion industry. For the data analysis, descriptive statistic (i.e., frequency, percentage), factor analysis, and multiple regression analysis were used by utilizing SPSS 12.0 for Windows program. The results for this research are as follows, first, the study of the impact of CEO image (i.e., Managerial Competence, Reliability/Leadership, Personal Attractiveness) on corporate image (i.e., Product Image, Corporate Social Responsibility Image, Corporate Cultural Image) brought conclusion that the CEO image generally affected the corporate image in fashion industry. Managerial Competence and Reliability/Leadership affected Product Image, Corporate Social Responsibility Image and Corporate Cultural Image. However, while CEO's Personal Attractiveness affected Product Image and Corporate Social Responsibility Image, it did not affect Corporate Cultural Image. Second, the study of the impact of corporate image on employment brand value brought conclusion that corporate image (i.e., Product Image, Corporate Social Responsibility Image, Corporate Cultural Image) affected employment brand value. Corporate Cultural Image affected employment brand value the most and then the Corporate Social Responsibility Image and Product Image. Third, the study of the impact of CEO image on employment brand value brought conclusion that CEO image (i.e., Managerial Competence, Reliability/Leadership, Personal Attractiveness) affected the employment brand value. CEO's Reliability/Leadership affected the employment brand value the most and then CEO's Personal Attractiveness and CEO's Managerial Competence. Forth, the study examined whether corporate image plays a mediating role in relationship of CEO image and employment brand value and concluded that it does. Corporate image played a full mediating role between CEO's Managerial Competence and employment brand value while it played a partial mediating role between CEO's Reliability/Leadership and CEO's Personal Attractiveness. This study is meaningful in a sense that it examines the relationship among the CEO image, corporate image and employment brand value which has not been carried out yet in fashion industry. It will ultimately contribute to the success of a fashion company by providing useful information of establishing strategies for managing proper the CEO and the corporate image to the fashion company and operating the talented employees.

  • PDF

도시녹지 유형에 따른 도시민의 이용 특성 연구 - 수원시를 대상으로 - (Analysis on the Use Characteristics of Citizen based on Urban Green Spaces Type - Focuses on Suwon-City -)

  • 김예성;김현;고진수
    • 한국조경학회지
    • /
    • 제42권5호
    • /
    • pp.31-40
    • /
    • 2014
  • 도시에서의 녹지의 중요성은 나날이 증가하고 있다. 법에서는 도시공원을 도시계획시설로 정의하고 1인당 공급면적을 규정하고 있지만, 공원조성 업무를 담당하고 있는 지방자치단체는 높은 지가와 재원부족으로 인해 도시공원의 조성 및 관리에 어려움을 겪고 있다. 그러나 도시민의 경우 이용의 개념으로 도시녹지를 인지하기 때문에 법정도시공원뿐 아니라 하천, 저수지, 학교 운동장 등 기타녹지도 이용하고 있다. 그러나 실제 공원녹지를 이용하는 도시민들은 이용 자체에 목적을 두고 있으므로 법정도시공원뿐 아니라 하천, 저수지, 학교 운동장 등 기타녹지도 공원과 유사하게 인지하는 경향을 보인다. 이에 본 연구에서는 도시녹지를 법정공원녹지인 도시공원과 기타 녹지로 유형을 구분하고 유형에 따른 공원 이용행태와 이용만족도에 대한 차이를 분석하였다. 분석 결과 두 유형 간에 주목할 만한 차이가 나타나지 않는다. 이 같은 사실에서 향후 1인당 공원면적 산정 시 현행 법정공원녹지 외에도 지역적 특성을 반영하여 하천, 저수지, 학교녹지, 아파트 녹지 등 기타녹지를 포함하는 것이 바람직하다. 이와 같은 방식의 도시녹지 면적 산정은 지방자치단체의 재정 부담을 줄이고 향후 도시공원정책의 유효성을 제고할 수 있으며, 재원 부족으로 인한 장기 미집행시설에 대한 해제에 대비하는 방안이 될 수 있다고 판단된다. 또한 도로 만족도, 접근 편리성, 동선 편리성 등 접근성에 대한 요인이 도시공원 이용 만족도에 영향을 미치고 있다는 사실은 도시공원에 대한 만족도를 향상시키기 위해서는 공원면적의 양적인 확대뿐만 아니라 도시공원에 대한 접근성을 개선하기 위한 노력이 필요함을 알 수 있다. 도시녹지로 이동하는 수단이 대부분 도보임을 감안할 때 도시녹지로 이용하는 경로 분석을 통해 베리어 프리, 도보 안정성 확보 등 도시녹지 접근 편의성에 후속연구가 필요하다.

형질전환 비만모델 수컷 hGHTg rats에서 경신해지환(輕身解脂丸)이 혈중 항비만지표에 미치는 영향 (The effects GeongshinhaeGihwan 1(GGT1) has on the hGHTg (human growth hormone transgenic) obese male rats' blood-antiobestic index)

  • 정양삼;총배금;최승배;김경철;신순식
    • 대한한의학방제학회지
    • /
    • 제13권2호
    • /
    • pp.1-16
    • /
    • 2005
  • Objectives: To find out the effects GGTl, an antiobestic drug widely used in clinics, has on the blood-antiobestic index and the toxicity index using the data from the hGHTg obese male rats. We looked closely into both of the two indices because GGTl antiobestic effect can happen not only by pharmacological action, but also by its toxicity. Also, we verified the difference in effect between GGTl and reductil (sibutramine), which has been approved by the FDA of the United States. Methods: After performing the experiments for 8 weeks on the hGHTg obese male rats divided into three groups: the control group, the GGTl group, and the reductil (RD) group, we anesthetized the rats with Diethyl ether and took a 3ml blood sample from the heart. Then, after coagulating the blood in room temperature by using the plasma separator, we centrifuged it for 25 minutes in 3,000rpm using the high-speed refrigerated centrifuge. We kept the separated plasma in a deep freezer at $-80^{\circ}C$, and repeatedly measured the antiobestic index and the toxicity index twice using the hematology biochemistry analyzer. Also, in order to judge the indirect toxicity index, we separated liver from kidney and observed them. Results: When we looked at the results of the analysis of covariance on the measuring elements related to the antiobestic index (TC, HDL, LDL, TG, and GLU), there was no significant difference among the groups in all measuring elements. Also, the results of the analysis of covariance on the two roups (RD group and GGTl group) showed that the p-values had no significant difference under the level of significance 0.05. When we looked at the result of the analysis of covariance on the measuring elements related to the toxicity index (GOT, GPT, GGT, CREA, UA, ALB, and TP), we could see that the p-values in GPT, ALB, and TP have a significant difference among the groups. Also, the results of the analysis of covariance about the measuring elements related to the toxicity index on both groups, RD group and GGTl group, showed no significant difference in the p-values of all of the measuring elements in the two groups, RD and GGTl group. Conclusions: In conclusion, through this experiment, the safety of GGTl has been approved, and although the verification on its medical effect has not been clearly approved, when we consider the fact that it belongs to the same group as reductil, an antiobestic drug approved by the FDA of the United States, we could indirectly verify that GGTl has an antiobestic effect. We believe that when doing a sample design for a future experiment, it needs to be performed on a greater sample size based on the power analysis that needs to be performed primarily in experiments, and a more accurate verification is needed through more systematic experiment plans.

  • PDF

光州 中心의 人口移動 特性에 관한 硏究 (The Characteristics of Population Flows in kwangju Metropolitan Area)

  • 조혜종
    • 대한지리학회지
    • /
    • 제28권1호
    • /
    • pp.40-57
    • /
    • 1993
  • 본 연구에서는 光州를 중심으로 발생하는 人口流動의 특성에 관하여 분석하였다. 이를 위하여 生殘準法에 의한 이동 및 주거지 이동의 永久的 移動과 고속버스여객의 이동 및 환자의 受診移動의 一時的 移動으로 구분하였다. 分析結果, 1986-1990년 광주시 전출입의 양상은 전남이 규모상 탁월하지만 移動空間이 전국적으로 확산되고 있음이 밝혀졌다. 그리고 1980-1985년 센서스의 생잔율법에 의한 純移動의 분석과 광주시 5개 洞의 표본조사 결과에서는 移動因子로서 敎育因子와 移住者의 距離認知가 중요한 因子로 작용한다는 사실이 판명되었다. 한편, 1日移動의 분석결과, 週末과 休日에는 방문이동이 많고 連休에는 일시적 귀환이동이 탁월하게 나타났다. 환자의 수진이동은 생활환경의 변화에 따라 큰 폭으로 증가하고 있으며, 이런 현상은 광양, 여천의 공업지역에서 현저하게 나타나고 있다.

  • PDF

홍삼사포닌 투여의 다낭성난소에 의한 불임 치료효과 및 기작연구 (Studies on the Therapeutic Effect and Mechanism of Korean Red Ginseng Total Saponin on Infertility Caused by Polycystic Ovaries)

  • 김세은;오동민;심경미;정문진;임성철;나승열;이윤렬;강성수;문창종;김종춘;김성호;배춘식
    • Applied Microscopy
    • /
    • 제39권1호
    • /
    • pp.1-7
    • /
    • 2009
  • 사람에서의 PCO와 몇몇 측면에서 유사한, 실험적으로 유발된 다낭성난소(polycystic ovary, PCO)는 장기간 작용하는 estradiol valerate (EV)에 의해 유발된다. 랫드에서 스테로이드로 유발한 PCO 모델에서 홍삼 총사포닌의 역할에 대한 우리의 이전연구는 전침이 난소의 nerve growth factor (NGF) 농도를 조절하는 것을 검증하였다. 실제로 PCO와 관련된 난소 기능부전의 병리기전에서 신경성 요소의 관련성은 난소로의 교감신경유출(sympathetic outflow)의 증가로 인해 높아진다. 따라서 본 연구에서는 치료제로서의 GTS 투여가 PCO를 유발한 랫드에서 교감신경 활성을 조절할 것이라는 가설을 시험해보고자 하였다. 본 연구에서는 스테로이드로 유발한 PCO에 내재하고 있는 병태생리학적 과정과 연관된 NGF 단백질과 NGF mRNA를 분석함으로써 이루어졌다. PCO가 유발된 랫드에서 EV 대조군은 oil 대조군과 비교하였을 때 유의적으로 높은 NGF mRNA의 발현을 나타내었으며, GTS 투여군은 EV 대조군에 비해 유의적으로 낮은 NGF mRNA의 발현을 나타내었다. 그러나 NGF 단백질은 oil 대조군에 비해 EV 대조군과 GTS 투여군에서도 유의적인 변화를 발견할 수 없었다. 이러한 결과는 EV가 설치류에서 낭종 형성과 무배란을 유발하는 병리학적 단계의 구성요소일 수 있는 난소의 신경향성 단계(neurotrophic state)를 조절한다고 생각할 수 있다.

시각적 연출에 의한 3D 입체 애니메이션 표현 연구: 〈드래곤 길들이기〉를 중심으로 (A Study on Expressing 3D Animation by Visual Direction : focused on 〈 How to train your dragon 〉)

  • 김정현
    • 만화애니메이션 연구
    • /
    • 통권26호
    • /
    • pp.1-30
    • /
    • 2012
  • 애니메이션의 목적은 움직임을 통해 재미있는 스토리를 관객에게 전달하는 것이라고 할 수 있다. 이러한 목적을 달성하기 위해 애니메이션은 탄생 이후 지금까지 100여년 이상의 시간동안 수많은 기술들을 도입하면서 다양한 내러티브 방법과 시각 표현 방법을 개발해 왔다. 또한 표현 기술력이 발달하면서 애니메이션을 구성하는 모든 요소들도 점점 체계화되어 왔고, 동시에 현실 그 이상의 세계를 표현할 수 있도록 해 주었다. 말 그대로 애니메이션을 제작하는 감독이 상상하는 모든 것들을 스크린을 통해 관객이 눈으로 볼 수 있는 시대가 된 것이다. 그리고 현재에는 애니메이션을 관람하는 관객이 마냥 프레임 안에서 움직이는 그림에 의해 즐거움을 느끼게 되는 시대를 넘어서도록 많은 노력이 이루어지고 있다. 즉, 수동적으로 바라보는 애니메이션을 넘어 관객이 직접 느끼며, 체감하는 애니메이션으로 목적성이 변화하고 있다는 것이다. 이런 과정에서 그 중심에 3D 입체라는 기술이 애니메이션의 새로운 즐거움을 표현할 수 있도록 해주고 있다. 얼마 전, 국내에서도 극장용 3D 입체 애니메이션이 제작되었으나, 해외의 3D 입체 애니메이션과 같은 완성도 높은 영상미를 기대했던 관객에게 새로운 즐거움을 주지 못해 흥행 면에서 이렇다 할 성적을 거두지 못하였다. 이것은 국내의 입체 애니메이션 제작 산업이 아직 초보적인 단계에 불과하여 3D 입체 애니메이션 제작에 대한 인력 및 기술, 경험이 절대적으로 부족한 상태에서 제작되었기 때문이다. 그리고 대부분의 입체에 대한 연구가 재현 기술적 문제에 집중되어 있어 관객들이 직접적으로 접하게 되는 영상 그 자체에 대한 연구 또한 부족하거나 미흡한 실정인 것도 커다란 문제라 할 수 있다. 이러한 국내 상황 속에서 2010년에 개봉되었고, 현재까지 최고의 3D 입체 애니메이션 흥행작으로 손꼽히고 있는 드림웍스 작품인 <드래곤 길들이기>의 입체영상 화면은 연구될 가치가 충분하다 할 수 있다. 따라서 본 논문은 양질의 국내 3D 입체 애니메이션 제작 및 전문 인력 양성 시기초자료로 활용되고자 풍부한 입체감을 전달하기 위해 화면을 담아내는 시각적 연출을 중심으로 이론적 고찰과 사례를 분석하여 연구하였다. 그 결과 3D 입체 애니메이션은 새로운 분야가 아닌 기존 영상미학의 원리를 기반으로 입체영상의 특성이 적용되어져 확장되고 변화된 영역인 것을 알 수 있었다. 이러한 연구를 통해 실재감 재현을 위한 3D 입체 애니메이션 콘텐츠 제작에 필요한 이론적 기초연구의 토대를 구축하는데 도움이 될 것으로 본다.

의료인의 호스피스가정간호에 대한 지식과 태도 조사연구

  • 김옥겸
    • 호스피스학술지
    • /
    • 제2권2호
    • /
    • pp.28-48
    • /
    • 2002
  • The advances of medical technologies have not only prolonged human life span, but also extended suffering period for the patients with incurable medical diseases. Hospice movement was developed to help these patients keep dignity and lives peaceful at the end of their life. Since many patients prefer to spend the last moment of life at home with their family, hospice home care has become very popular worldwide. The purpose of this study for a promotion and development of hospice home care in Korea, and features basic research on medical profession's knowledge and attitudes to hospice home care. This study which was used for the research questionnaires developed by the researcher that were answered by 100 physicians and 127 nurses in a general hospital. Data were collected from April 22, 2002 to May 10, 2002. The SPSS was used to make a comparative analysis of the frequency, percentile, ANOVA, and x2-test. The results of the study were as follows; 1.The medical profession showed high level of knowledge of the definition and philosophy of hospice. However, the physician group of the examinees showed insufficient knowledge of the fact that hospice care includes bereavement care, while the nurse group's response to the same question showed a significant difference(x2=10.752, p=.001). 2.For whom the hospice home care is provided, 95.6% of the respondents showed very high level of knowledge as answering that the incurable terminal illness patients and their families are the beneficiaries of hospice care. The respondents counted nurses, volunteers, pastors, physicians and social workers, consecutively, as hospice care providers. More nurse were positive toward pastors than physicians in regarding as a hospice care provider by a significant difference(x2=11.634, p=.001). 3.For when to referral hospice home care to the patients, only 34.2% answered that patients with less than 6 months of survival time are advised to receive hospice care, reflecting very low level of knowledge. 23.0% of the physicians and 48.0% of the nurses answered that hospice care should be provided when death is imminent, making a significant difference between the two groups(x2=6.413, p=.000). 4.To promote hospice activities, 87.2% pointed out that it is crucial to make general people, including those engaging in the medical field, more aware of hospice. 79.7% answered that a national hospice management should be developed, marking a significant difference between the physician group and nurse group(x2=10.485, p=.001). 5.Advantages of hospice home care are 87.2% responded that patients can have better rest at home receiving hospice home care. Economical merit was brought forward as one of the advantages also, where there was a significant difference between the physicians group and nurse group(x2=7.009, p=.008). 6.The medical professions' attitude to hospice home care are 92.8% of the physicians answered that they would advise incurable terminally ill patients to be discharged from hospital, with 44.3% of them advising the patients to receive hospice home care after leaving the hospital. From the nurses' point of view, 20.9% of the terminally ill patients are being referred to hospice home care after discharge, which makes a significant difference from the physicians' response(x2=19.121, p=.001). 7. 30.6% of physicians have referred terminally ill patients to hospice home care, 75.9% of whom were satisfied with their decision. Those physicians who have never referred their patients to hospice home care either did not know how to do it(66.7%) or were afraid of losing trust by giving the patients an impression of giving up(27.3%). 94.9% of the physicians responded that they would refer their last stage patients to a doctor who is involving palliative care. 8.Only 36.2% of nurses have suggested to physicians that refer the terminally ill patients discharged from the hospital to hospice home care. Once suggested, 95.8% of the physicians have accepted the suggestion. Nurses were reluctant to suggest hospice home care to the physicians, as 48.8% of the nurses said they did not want to. From the result of this study the following conclusion can be drawn, the medical profession's awareness of general hospice care has been increased greatly compared to the results of the previously performed studies. However, this study result also shows that their knowledge of hospice home care is not good enough yet. There is a need for high recommended that medical education institute and develop regular courses on various types of hospice care. Medical field training courses for physicians and nurses will be very helpful as well. It is also important to train hospice experts such as palliative physicians and develop a national hospice management urgently in order to improve the hospice care in Korea.

  • PDF

멀티도어코트하우스제도: 기원, 확장과 사례분석 (The Multi-door Courthouse: Origin, Extension, and Case Studies)

  • 정용균
    • 한국중재학회지:중재연구
    • /
    • 제28권2호
    • /
    • pp.3-43
    • /
    • 2018
  • The emergence of a multi-door courthouse is related with a couple of reasons as follows: First, a multi-door courthouse was originally initiated by the United States government that increasingly became impatient with the pace and cost of protracted litigation clogging the courts. Second, dockets of courts are overcrowded with legal suits, making it difficult for judges to handle those legal suits in time and causing delays in responding to citizens' complaints. Third, litigation is not suitable for the disputant that has an ongoing relationship with the other party. In this case, even if winning is achieved in the short run, it may not be all that was hoped for in the long run. Fourth, international organizations such as the World Bank, UNDP, and Asia Development Bank urge to provide an increased access to women, residents, and the poor in local communities. The generic model of a multi-door courthouse consists of three stages: The first stage includes a center offering intake services, along with an array of dispute resolution services under one roof. At the second stage, the screening unit at the center would diagnose citizen disputes, then refer the disputants to the appropriate door for handling the case. At the third stage, the multi-door courthouse provides diverse kinds of dispute resolution programs such as mediation, arbitration, mediation-arbitration (med-arb), litigation, and early neutral evaluation. This study suggests the extended model of multi-door courthouse comprised of five layers: intake process, diagnosis and door-selection process, neutral-selection process, implementation process of dispute resolution, and process of training and education. One of the major characteristics of extended multi-door courthouse model is the detailed specification of individual department corresponding to each process within a multi-door courthouse. The intake department takes care of the intake process. The screening department plays the role of screening disputes, diagnosing the nature of disputes, and determining a suitable door to handle disputes. The human resources department manages experts through the construction and management of the data base of mediators, arbitrators, and judges. The administration bureau manages the implementation of each process of dispute resolution. The education and training department builds long-term planning to procure neutrals and experts dealing with various kinds of disputes within a multi-door courthouse. For this purpose, it is necessary to establish networks among courts, law schools, and associations of scholars in order to facilitate the supply of manpower in ADR neutrals, as well as judges in the long run. This study also provides six case studies of multi-door courthouses across continents in order to grasp the worldwide picture and wide spread phenomena of multi-door courthouse. For this purpose, the United States and Latin American countries including Argentina and Brazil, Middle Eastern countries, and Southeast Asian countries (such as Malaysia and Myanmar), Australia, and Nigeria were chosen. It was found that three kinds of patterns are discernible during the evolution of a multi-door courthouse model. First, the federal courts of the United States, land and environment court in Australia, and Lagos multi-door courthouse in Nigeria may maintain the prototype of a multi-door courthouse model. Second, the judicial systems in Latin American countries tend to show heterogenous patterns in terms of the adaptation of a multi-door courthouse model to their own environments. Some court systems of Latin American countries including those of Argentina and Brazil resemble the generic model of a multi-door courthouse, while other countries show their distinctive pattern of judicial system and ADR systems. Third, it was found that legal pluralism is prevalent in Middle Eastern countries and Southeast Asian countries. For example, Middle Eastern countries such as Saudi Arabia have developed various kinds of dispute resolution methods, such as sulh (mediation), tahkim (arbitration), and med-arb for many centuries, since they have been situated at the state of tribe or clan instead of nation. Accordingly, they have no unified code within the territory. In case of Southeast Asian countries such as Myanmar and Malaysia, they have preserved a strong tradition of customary laws such as Dhammthat in Burma, and Shriah and the Islamic law in Malaysia for a long time. On the other hand, they incorporated a common law system into a secular judicial system in Myanmar and Malaysia during the colonial period. Finally, this article proposes a couple of factors to strengthen or weaken a multi-door courthouse model. The first factor to strengthen a multi-door courthouse model is the maintenance of flexibility and core value of alternative dispute resolution. We also find that fund raising is important to build and maintain the multi-door courthouse model, reflecting the fact that there has been a competition surrounding the allocation of funds within the judicial system.