• 의료법학
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• 제20권2호
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• pp.231-260
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• 2019

지난 호에 이어 2018년도 주요 의료판결을 정리하였는데, 특히 설명의무와 관련된 법원의 설시는 그 한계가 어디까지인지 알 수 없을 정도로 다기(多岐)하여 가급적 많은 판결을 소개하기 위하여 노력하였고, 손해배상의 범위와 관련하여 개호비를 다액 인정한 판결과 각서의 효력이 증가된 치료비에도 미치는 것으로 본 판결도 관심을 가져볼 필요가 있다. 진료비상계 및 공제관련 판결은 서술내용에 비하여 가장 많은 토론이 이루어졌다. 의료기관 다중 운영 사례는 중간적 판결이지만, 워낙 의료계에 관심이 많은 사건이고, 임의비급여 관련 재량권 일탈 남용이 인정된 사건도 과거에 비하여 비중이 많이 줄었지만 여전히 의미가 있다고 보았다.

• 대한한의학회지
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• 제35권1호
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• pp.75-87
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• 2014

Objectives: This study aimed to analyze the utilization of Korean medical clinics by sex. Methods: Data was based on reports about usage and consumption of Korean medicine in 2011 by the Ministry of Health and Welfare and Korea Institute for Health and Social Affairs. 171 Korean medical hospitals and more than 300 Korean medical clinics were selected after 2 rounds of extraction, from the 12,250 Korean medical institutions throughout the country. The investigation was carried out between August 25 and September 30, 2011. The study group was composed of 290 men and 813 women; Korean medical institutions including clinics and hospitals were mainly used for their health care. Results: 1. For sociodemographic distribution, sex, marital status, education level, occupation status, and income level showed statistically significant differences. 2. Females had a lower subjective health status than did males. Muscle injury, hwa-byung, gastric disorder, lumbago, common cold, weight loss, and herbal tonics showed differences in prevalence rates between the sexes. 3. Arthritis, muscle injury, gastric disorder, ankle sprain, herbal tonics, and stroke showed differences in usage rates between the sexes. Likewise, major treatment methods had differences between the sexes. 4. There were no statistically significant differences between the sexes concerning acupuncture. Conclusions: Females were lower than males in several aspects of income and education level and occupation status. Males had a higher subjective health status than did females. Differences by sex of treatment methods and prevalence rates of several diseases existed.

• 한국병원경영학회지
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• 제26권2호
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• pp.27-42
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• 2021

This study investigated the differences in patient experience by arrangement type of medical tourism facilitators(MTF) from the pre-visit to visit stages. Specifically, patient experiences from each stage with different service providers (MTFs and medical institutions) were measured: provision of information and respect for patient preferences as pre-visit experiences with the facilitators, communication and concierge services as visit experiences with the facilitators, and medical services as medical institution experiences. The scale to measure foreign patients' experiences was modified from the 'Picker in-patient questionnaire(PPE)' and the 'Picker patient experience questionnaire(PPE-15)'. Quantitative data were collected by conducting a self-administered questionnaire on 173 patients from China, Russia, Mongolia, and Kazakhstan. Qualitative data were collected by conducting in-depth interviews with 9 patients and 9 service providers. The data were collected between January and October in 2019. Quantitative data was analyzed by SPSS 25 for Chi-squared test and ANOVA, and qualitative data were analyzed based on keywords. The main results are as follows. When foreign patients used only overseas MTFs, they had a relatively positive patient experience in respect of receiving pre-visit information(F=7.47, p<.01) and respect for patient preferences(F=3.11, p<.05). Looking at both domestic and overseas facilitators during the visit, the patient experience was relatively negative for communication(F=3.75, p<.05). Regarding medical institutions, patients had a relatively negative patient experience with regards to medical services when they used both domestic and overseas facilitators(F=6.49, p<.01). The implications of this study are as follows. Patients should have a seamless and high-quality experience regardless of the facilitator arrangement type. This can be prepared through service standardization for the service providers. It would be also necessary to consider each other's features and problems at the institutional level and to improve service coordination by having service providers periodically communicate with each other.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2001년도 제53차 추계 학술대회 연제집
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• pp.361-362
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• 2001

• 한국방사선학회논문지
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• 제15권6호
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• pp.841-847
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• 2021

방사선을 이용하는 관련 기관은 국내에 연구, 의료, 교육 등 다양하다. 최근에는 검진 및 의료기관의 방문 횟수가 증가하고 있다. 이로 인해 의료기관에서 방사선학적 검사 횟수가 증가하고 있다. 방사선작업종사자의 피폭뿐만 아니라 방사선 안전관리가 필요하다. 안전관리를 위해서 우선적으로 개인피폭선량계의 올바른 착용 및 착용 후 정확한 측정이 필요하다. 본 연구는 진단용 방사선발생장치의 방사선에 의한 PLD 소자의 계측 직선성을 평가하고 검증하려고 한다. 방사선 분할 조사 시간간격은 10, 30, 60 sec로 10회 조사와 거리에 따라 흡수선량 변화를 측정하기 위해서 조사거리를 30 ~ 100 cm까지 10 cm 간격으로 조사 후 측정하였다. 그 결과 시간 간격에 의한 흡수선량은 차이가 없었다. 이는 고흡수선량 연구에 진단용발생장치를 이용하여 다양한 연구에 도움이 될 것으로 여겨진다.

• 대한간호학회지
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• 제50권6호
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• pp.837-847
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• 2020

Purpose: The purpose of this study was to investigate the effects of hospital characteristics on employment rate, working period, and retirement of ward nurses in Korea through a retrospective cohort study based on HIRAS data. Methods: Data were obtained from a report on medical care institutions of Health Insurance Review & Assessment Service (HIRAS). Data from 259,941 nurses who were working for a day or more from January 1, 2012, to December 31, 2016, at 2,942 medical care institutions were analyzed. Life table method analysis, Kaplan-Meier analysis, and Cox proportional hazard regression analysis were conducted. Results: The employment rates of 5 yeas and 10 years for the total sample were 38% and 28%, respectively. The estimated mean value of the working period was 3,642.7 days (SE: 17.4 days). Cox proportional hazard regression analyses revealed that nurses who were working at the general hospital/hospital, clinic, and nursing hospital were more likely to leave the hospital compared to those who were working at the 3rd general hospital. Nurses who were working at the medical institutions which were located in cities and countries, established by the private foundation, rated lower levels of nursing, and owned an insufficient number of beds, nurses and doctors were more likely to leave their workplace compared to those of the counterparts. Conclusion: This study indicates that hospital characteristics may play a significant role in retirement and working period of ward nurses in Korea. The improvement of hospital conditions to reduce ward nurses' retirement are needed.

• 품질경영학회지
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• 제46권4호
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• pp.983-1000
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• 2018

Purpose: The purpose of this study is to provide academic and practical implications based on the analysis results of similarities and differentiation of Malcolm Baldrige National Quality Award (MBNQA) in healthcare institutes from 2007 to 2016. Methods: This study examined the characteristics and similarities, the changes made for the most importantly considered, a degree of improvement of patient satisfaction, and employee retention rate of the MBNQA awarded 8 healthcare institutes announced by NIST during the period of 2007-2016. Results: First, the MBNQA awarded 8 healthcare institutes that maintained and implemented effective plans for a long period of time to improve the quality of care services. Second, these organizations were selected among the top 10% of the institutional evaluations in the medical field in the United States. Third, they have tried to continuously improve patient and potential customer and employee satisfaction. Fourth, it is shown that the quality improvement efforts have made long-term and continuous improvement efforts on average 4-5 years. Lastly, the increased number of patients and the improved organizational performance are twice higher than those of other healthcare institutions. Conclusion: The results of this study suggest that common and differentiation strategies of healthcare institutions should be a good benchmarking model for other competitive healthcare institutions.

• 대한예방한의학회지
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• 제19권2호
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• pp.37-50
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• 2015

Objective : In order to understand the scale of medicinal expenditure in the Korean medicine, an analysis has been made of Korean National Health Account and statistic archives used to estimate the Korean National Health Account and also of such archives as are contributory to learn the scale of total health expenditures in the Korean medicine. Method : From the Korean National Health Account archives, an analysis has been made of National health insurance statistic annual reports, National health insurance non-payment items, Korean Economic Census (The Service Industy Survey), and Korea Health Panel data. Moreover, in order to know the sales of overall Korean medicine clinics, relevant data have been utilized and cited from investigations into National tax statistics, Korean medicine medical institutions and Korean medicines used, and current states of medicinal herbs and Korean medicine industry. Results : It is found that the average scale of each section of the medical expenditures archives in the Korean medicine in 2012 was KRW 3.5638 billion and that the average medical expenditures in the Korean medicine derived from Total Health Expenditure, The Service Industy Survey, National tax statistic, and Korean medicine industry are approximately KRW 3.3901, 3.4796, 3.7218 and 3.9634 billion. And the average expenditures derived from National health insurance patients and Korea Health Panel data are 2.5162 and 2.2292 billion won and those from the users and consumers of Korean medicines and herbs are 5.6,461 billion won. In order to verify the appropriateness of estimated medical expenditures in the Korean medicine included in the archives, an analysis has been made of uninsured costs which come from the aggregate sales amount surveyed minus health insurance treatment expenditures and it is found that the ratio of insured costs against total health expenditures in 2006 was 50.67% and 41.92% in 2012 and that the ratio based on National tax statistics and The Service Industy Survey was 52.19% and 49.28% in 2006 and 50.54% and 50.64% in 2012 and that the ratio of uninsured costs against Korean medicines and herbs and Korean medicine industry was 37.5% and 58.27% in 2013. Conclusion : It calls for the improvement of the accuracy of an investigation into Total Health Expenditure which comprise the actual conditions of health insurance and Korea Health Panel, the development of statistic schemes for understanding and classifying medical expenditures of all the Korean medicine medicinal institutions like medicinal clinics, and enhanced methods for independent panels to comprehensively collect and analyze the number of sampled Korean medicine medical institutions.

• 한국치위생학회지
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• 제11권4호
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• pp.489-497
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• 2011

Objectives : Based on data collected from patients who suffered from dental caries during the period between 1990 and 2008, the number of patients and their trends were analyzed as a source of evidence to conduct the oral health plan. Methods : A population of sample design for patient survey data was derived from computerized data saved at medical institutions accredited by National Health Insurance Corporation. Large institutions such as dental hospitals were included for the complete enumeration test, while the rest of medical institutions, for example, dental clinic, relatively small institutions, were used for the sample survey. Most of patients with dental caries were outpatients and their disease was treated at the dental hospital or dental clinic in general, therefore, main analysis was carried out at those institutions. Results : The rate of patients who suffered the dental caries has decreased to 56.8% in 2008 from 78.5% in 1990. The rate of patients who visited the dental hospital for treatment has increased to 4.8% in 2008 from 0.5% in 1990, whereas the percentage of those who visited the dental clinic has fallen to 97.9% from 99.5% during the same period. The ratio by age, in the meantime, it showed that patients aged 40s has increased to 13.5% in 2008 from 7.2% in 1990, and the number also has risen in 50s from 5.6% in 1990 to 9.9% in 2008. However, the number of children aged 0 to 9 who visited hospital for treatment of dental caries has fallen to 17.0% in 2008 from 33.9% in 1990. Conclusions : By figuring out the trends of patients with the dental caries during the period between 1990 and 2008, fundamental data for the oral health policy have been collected. As a result, the necessity of a new medical treatment system for managing the dental caries in terms of patient ages as well as the oral health policy and campaign was taken into consideration.

• 한국산업보건학회지
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• 제31권4호
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• pp.440-450
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• 2021

Objectives: This study aims to investigate whether working environment measurement institutions(WEMIs) are conducting safety and health education, risk assessment, and oversight of special management materials, and whether working environment measurement and special medical examinations are being conducted as prescribed in the Occupational Safety and Health Act(OSHA). Methods: In of February 2021, a questionnaire was prepared and distributed to 33 WMEIs registered with the Ministry of Employment and Labor(MoEL) in Busan and Gyeongsangnam-do Province. The responses were collected and then analyzed. Results: The findings show that 5 WEMIs(15%) complied fully with OSHA. Risk assessment was conducted by 13 WMEIs(39%) and safety education by 11 WMEIs(33%). Eighteen WMEIs(55%) conducted working environment measurement, and 29 WMEIs(88%) conducted special medical examinations. The implementation rate of the risk assessment in the health industry(85%) was higher than the one in the special technology industry(11%)(p<0.05). The implementation rate of the special medical examination in the examiners(54%) was not as high as the one in the analysts(91%)(p<0.05). Conclusions: The MoEL needs to check whether basic OSHA requirements are being observed during regular inspections by WEMIs. These findings indicate that it is necessary to prepare a plan to improve the rate of compliance with OSHA regulations.