• 한국응급구조학회지
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• 제19권3호
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• pp.69-85
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• 2015

Purpose: This study aimed to investigate the prevalence of musculoskeletal symptoms (MSSs) and their correlation with subjective health condition (SHC) among emergency medical technicians (EMTs). Methods: A self-reported questionnaire was disseminated to EMTs (N=257) at emergency medical institutions and fire stations. Results: The prevalence of MSSs was very high in the studied EMTs: 88.3% reported having MSSs. The most commonly affected site was the lower back (73.9%) followed by the neck (56.8%) and the shoulder (55.6%). MSSs were more common in women than in men, and its frequency increased with age. MSSs in the neck and shoulder were more increased in EMTs with < 1 year of service. MSSs in the hand / wrist / finger or leg / foot were significantly increased in EMTs of emergency medical institutions than those of fire stations. Job satisfaction was significantly lower in those with MSSs of the lower back. The subjective heath condition was decreased with age, marriage, or smoking. There was significant corelation between MSSs and SHC. Conclusion: This study suggests that MSSs are a reasonably common problem for EMTs, and that solutions need to be imposed such as some actual tasks or items related to work postures, work control, and work organization.

• 의학교육논단
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• 제23권3호
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• pp.154-159
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• 2021

The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted all aspects of undergraduate, postgraduate, and continuing medical education. Only the focus of medical education-care for patients and communities-has remained an integral part of all of the above sectors. Several challenges have been experienced by learners and educators as the education and training of future doctors has continued in the midst of this crisis, including the cancellation of face-to-face classes and training, reduced patient encounter opportunities, fairness issues in online assessments, disruption of patient interview-based exams, reflections on the role of doctors in society, and mental health-related problems linked to isolation and concerns about infection. In response to these disruptions, educators and institutions have rapidly deployed educational innovations. Schools have adopted educational strategies to overcome these challenges by implementing novel education delivery methods in an online format, providing clinical experiences through simulation or telehealth methods, introducing online assessment tools with formative purposes, encouraging learners' involvement in nonclinical activities such as community service, and making available resources and programs to sustain learners' mental health and wellness. During the COVID-19 pandemic, educators and institutions have faced drastic changes in medical education worldwide. At the same time, the quantitative expansion of online education has caused other problems, such as the lack of human collaboration. The long-term effects of the COVID-19 pandemic on medical education need to be studied further.

• 보건의료산업학회지
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• 제13권3호
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• pp.13-26
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• 2019

Objectives: To investigate whether medical institutions can prevent accidents by analyzing the root cause of a medical accident and identifying the tendencies. Methods: A total of 345 medical cases were used for the RCA(Root Cause Analysis). The root causes were classified using the SHELL model. The suitability of the model was confirmed by SPSS's MDPREF and Euclidean distance. An SPSS20.0 hierarchical regression analysis was used as an influencing factor on the degree of injury resulting from medical accidents. Results: The SHELL model was suitable for classification. The rates of accident causes were LS49%, L34%, LL10.2%, LE3.7%, LH2.3%. The order in which the degree of a patient's injury was affected were: Risk Threshold (${\beta}=.180$), Time (${\beta}=.175$), Surgical stage (${\beta}=-.166$), Do not use procedure (${\beta}=.147$). Conclusions: Health care institutions should remove priorities through system improvement and training. For patients' safety, the five factors of the SHELL model should be managed in harmony.

• Anatomy and Cell Biology
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• 제57권2호
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• pp.238-245
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• 2024

Body donation is the act of giving one's body to science for study, practice, and research. This selfless act contributed to the education and training of professionals in the field of medicine. Body donation programs allow medical students to learn about the different aspects of human anatomy, perfect their dissection skills, and develop a better understanding of the relationship between structure and function in the human body. The purpose of article is to improve body donation programs which meet ethical standards and best practices. This article emphasizes the significance of body donation to teaching medical institutions by discussing various aspects of body donation to medical colleges in India and the procedural steps followed, sample proformas and the obstacles faced during the whole process. The process of body donation varies among different countries pertaining to their legal frameworks and the challenges faced. A description of the problems faced in the process of body donation has been discussed with suggestions for potential solutions in this section. The sample formats of the forms filled by donors and the certificates issued by concerned organizations are also provided to clearly understand the process of body donation. The information compiled will pave the way for medical teaching institutions that have yet to start a body donation program.

• 한국산학기술학회논문지
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• 제17권7호
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• pp.357-366
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• 2016

이 연구는 일부 지역 의료기관의 외래원무관리 표준화를 위해 대한병원협회에 등록된 일부 지역 종합병원 이상 의료기관에 근무하는 원무팀 직원을 대상으로 설문조사 하였다. 이 연구의 결과를 요약하면 다음과 같다. 접수업무 프로세스는 설립주체, 병상규모, 원무팀 직원 수, 일평균 외래환자 수에 따라 큰 차이는 없었다. 그러나 진찰료 선납 여부는 병상 규모가 클수록 진찰료 선납을 받았다. 병상 예약업무 프로세스는 설립주체, 병상규모, 원무팀 직원 수, 일평균 외래환자 수에 따라 큰 차이는 없었으나, 예약 후 내원 시 진찰료 선납은 500병상 미만 의료기관이 11.8%, 500병상 이상 의료기관이 50.0%로 나타났다. 이 연구 결과 의료기관에 따라 외래원무관리 프로세스에 큰 차이는 없었으나 전산시스템, 시설관련 부분에 차이를 보였다. 이러한 업무프로세스의 차이를 극복하기 위해서는 의료기관의 경제적 부분이 지원되어야 한다. 환자에게 양질의 의료서비스를 제공하기 위해 의료기관평가인증원 조사항목과 설문을 통해 얻은 다빈도 응답을 토대로 도출한 표준화를 실제 의료기관에 적용하여 그 효과를 분석하는 것이 필요할 것으로 사료된다.

• 한국병원경영학회지
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• 제7권4호
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• pp.1-23
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• 2002

This study examined the influence of the separation of prescribing and dispensing roles(SPD) policy implemented in Korea in July 2000, especially on the change in the net profit of medical institutions. Using the data set from the Korea's National Health Insurance and the previous research, this study elicited the following main results. First, tertiary care institutions was estimated to lose about 631 billion won after the SPD policy. Second, general hospitals and hospitals gained about 557 billion and 564 billion won, respectively. Third, it is shown that clinics also gained 389-659 billion won. Finally, however, the change in net profit of medical institutions after the SPD policy largely depends on different estimation models. Moreover, it also varies from the assumptions on the price differential of a reimbursable drug which worked as cross-subsidy to insufficient physician's fee before the SPD policy. Despite such limitations as lack of data outside of the National Health Insurance's coverage, this study differs from others. This is the first research to explore the effect of the SPD policy on different types of medical institutions and to attempt to purely focus on the SPD policy. In this study, we can draw the policy implication that preparing for a policy change, the government should set up the policy evaluation system to collect the concerned data and develop the methodologies in advance to the policy implementation.

• 의료법학
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• 제20권3호
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• pp.143-174
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• 2019

우리 헌법은, 국가로 하여금 국민의 건강을 보호할 의무를 지우고 있고, 이에 따라 구체화된 규범인 의료법은 의료기관 개설 등에 관한 사항을 상세히 규정하고 있는데, 그 내용 중 하나가 의료인의 의료기관 복수개설·운영 금지제도이다. 이에 대하여, 종래의 판례는 '다른 의사 명의로 추가 개설하는 의료기관에서 직접 의료행위 등을 하지 않는다면 여러 개의 의료기관을 개설·운영할 수 있다'라고 해석함으로써, 사실상 복수의 의료기관을 개설·운영할 수 있었다. 하지만 일부 의료인들이 다른 의료인의 면허로 의료기관을 여러 장소에 개설하고 이익을 극대화하기 위하여, 환자유인행위를 하거나 과잉진료 및 위임치료를 하는 등의 불법의료행위를 조장할 뿐만 아니라 국민의 건강권 등을 침해하는 현실적 문제가 발생하게 되었다. 이에 입법자는 의료법의 개정을 통해 의료인은 어떠한 명목으로도 둘 이상의 의료기관을 개설하거나 운영할 수 없도록 의료기관 개설제도를 정비하게 되었다. 이와 같은 개정 의료법 제33조 제8항이 위헌인지 여부에 대하여, 헌법소원과 위헌법률심판 제청이 되어 헌법재판소에서 오랜 기간 심층심리 끝에 최근 합헌결정이 선고되었다. 헌법재판소는, 보건의료는 상거래의 대상이 되어서는 아니 되고, 공공의료기관의 비중, 영리목적 환자유인, 과잉진료 등을 방지하기 위한 점을 감안하여 '목적의 정당성'을 인정하였다. 또한 의료인이 외부 자본에 종속될 우려가 있는 점, 의료기관 개설 명의인과 실제 운영자가 분리되는 것은 우려스러운 점, 인간의 신체와 생명이 수단이 되어서는 아니 된다는 점, 현재의 의료체계상 과잉진료 확인이 불가한 점 등을 고려해 볼 때 '침해의 최소성'도 인정하였다. 나아가 '법익 균형성' 등 기본권 제한의 원칙인 과잉금지원칙을 준수하여 합헌이라고 판단하였다. 이와 같이 헌법재판소가 우려하고 있는 영리추구, 과잉진료를 현실적으로 방지하기 위해서는 입법적 보완이 필요하다. 이와 관련하여 소비자단체는 입법의 필요성에 적극 찬성하고 있고, 보건의료 공급자 단체 또한 입법의 필요성에 공감하고 있다. 따라서 입법자는 헌법재판소의 이번 결정을 존중하고, 국민들의 입장을 반영하여 빠른 시일 내에 보완입법을 마련하길 기대한다.

• 보건행정학회지
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• 제21권4호
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• pp.599-616
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• 2011

This research was performed to investigate the determination factors of medical service to cover the fee for selecting a doctor which is one of the most important causes of debilitating national health insurance in Korea. Data was from Korea Health Panel and analyzed by Dutton(1986)'s medical service model which was an extended Anderson Model and was widely used in the researches on determination factors of medical service. The results were as follows; In the determinants of selecting a doctor in specialized medical institutions and general hospitals, patients with serious diseases selected doctors more often than other patients. By industrial accident compensation insurance law and enforcement ordinances, insurance covers the fee of selecting a doctor in the hospitals appointed by Labor Welfare Corporation for the patients in critical conditions under industrial accident compensation insurance, while health insurance patients pay the fee themselves for selecting a doctor in all cases. It is suggested that patients with serious diseases proved by medical opinion be provided with health care insurance in selecting a doctor and that the health insurance benefit coverage be enhanced by staged lowering of patient's cost-sharing.

• 한국응급구조학회지
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• 제25권1호
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• pp.125-134
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• 2021

Purpose: The purposes of this study were to determine the changes in the pattern of patients who were transferred to the emergency room through inter-hospital private institutions and to determine how long transport takes following the COVID-19 outbreak. Methods: This retrospective observational study analyzed the emergency medical services reports of private institutions following the COVID-19 outbreak in South Korea. The study was conducted in Busan between January 19, 2019 and January 18, 2020, and between January 19, 2020 and January 18, 2021. Results: Upon comparing the patient transport times during the "Pre-COVID-19 period" and "COVID-19 period," a significant delay was noticed in the preparation for transfer of patients during the "COVID-19 period" (p<.05). There were significantly more patients with respiratory infections and patients who complained of general symptoms during the "COVID-19 period." Moreover, there was a higher frequency of patients who were transferred to a 'Level I' emergency room during the "COVID-19 period" compared to during the "Pre-COVID-19 period" (p<.05). Conclusion: Following the COVID-19 outbreak, there is a delay in patient transport to the emergency room through private institution inter-hospital transport and an increase in the number of patients complaining of respiratory infection symptoms. Thus, emergency medical services need additional administrative and economic support to transport infected patients.

• 대한임상검사과학회지
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• 제54권1호
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• pp.49-60
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• 2022

본 연구는 COVID-19 시대에서 빠르고 정확한 진단검사를 위해 임상병리사의 역할을 파악하고, 효율적으로 대응할 수 있는 체계적인 시스템 마련을 위한 기초자료를 제공하고자 하였다. 연구 방법은 15개 의료기관을 대상으로 설문조사 및 초점 집단 면담을 통한 분석을 하였다. 검체 채취 기관(11개)을 분석한 결과, 선별검사소 운영 기관은 7개, 임상병리사 10.4명, 채취 소요시간 2.1분, 검사소요시간 5.4시간, 검사건수 9,670건, 검사인력 6.2명으로 조사되었다. 초점 집단 면담 분석결과, COVID-19검사와 관련하여 검체 채취자 및 검사자를 보호하기 위한 근무시간, 근무장소, 근무환경이 포함된 표준화된 지침은 없었다. 그리고 감염사고 발생 시 법적인 보호 조치가 미흡하며, COVID-19와 관련한 인력에 관한 규정이 마련되어 있지 않았다. 또한, 신뢰도 있는 COVID-19 검사를 위해 검체 채취자 및 분자진단 검사자의 전문적인 교육이 요구되었다. 결론적으로 COVID-19와 같은 긴급상황 감염병 발생 시 대처할 수 있는 특수검사 단기수련기관 등을 통한 전문교육의 시행과 안정적인 인력공급 할 수 있는 법적인 체계마련이 필요할 것으로 사료된다.