• CRM연구
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• v.3 no.2
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• pp.21-41
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• 2010

The current research was conducted to examine the factors that affect outsourcing performances, and further investigate whether a discrepancy in performance exists between the medical institutions and hotel service institutions. The study surveyed both medical and hotel administrators for approximately two months, who managed outsourcing tasks. Total of 325 responses out of 350 distributed were collected. However, due to inadequate responses, six responses were excluded, amounting to total of 319 (155 medical institutions, 164 hotels) valid responses included in the final analysis. First, the informal outsourcing relationships between representatives of outsourcing service seekers and providers did not appear to have significant effects in terms of the levels of trust in neither medical institutions nor hotel industries. However, the relationships affected outsourcing degrees exclusively in medical institutions, showing the disparity between the two service institutions. This was explained due to the continuing long term efforts required to establish an informal relationship in medical institutions. Second, communication was shown to have positive effects on levels of trust in both medical institutions and hotel industries. This indicates a prominent outsourcing trait that emphasizes the significance of mutual cordial communication that contributes to establishing positive relationships. Third, opportunistic behavior of the outsourcing service providers appeared to negatively affect the levels of trust as well as outsourcing degrees for both medical and hotel industries. Therefore, opportunistic behaviors were found to have more tendencies to causing tension and discomfort rather than creating a relationship based on mutual credibility or conviviality. Fourth, the effect of service infrastructures on the level of trust did not appear to be significant on medical institutions, while showing positive influence on hotel industries. Additionally, service infrastructures were found to positively influence the outsourcing performance levels for both sectors. Fifth, trust between outsourcing service seekers and providers did not appear to have noticeable impact on the outsourcing degrees for either institution. On the contrary, trust appeared to have positive impacts on performance for both institutions. This further indicates that, when engaging in outsourcing, strengthening relationships through mutual partnership with outsourcing entities rather than establishing contractual relationships leads to improving the reciprocal trust, which in turn improves work results. Lastly the outsourcing degree of service seekers appeared to have positive impact on the outsourcing performance for both medical institutions and hotel industries, indicating the causal relationship between the affectability of outsourcing degrees and the following performance results.

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.1
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• pp.17-23
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• 2017

Purpose: Activated charcoal (AC) has been widely used as a universal antidote. Currently, emergency medical centers in Korea cannot administer AC due to discontinuation of the supply of commercial ready-mixed AC suspension. This study was conducted to investigate the proportion of emergency medical centers that administer AC to poisoning patients and provide basic information for emergency physicians and toxicologists. Methods: A prospective telephone survey of all of the included emergency medical institutions was conducted. The type of emergency medical institution, average annual number of patients admitted to the emergency department, annual average number of patients who were poisoned and whether the hospital currently utilizes gastric lavage and administration of AC were determined. Results: AC was administered to poisoning patients in 40% of regional emergency medical centers, 59.3% of local emergency medical centers, and 45.9% of local emergency medical rooms. Overall, 37% of total emergency medical institutions did not administer AC due to discontinuation of the commercial ready-mixed AC suspension. Additionally, 77% of emergency physicians in institutions without AC knew AC is necessary for poisoning patients. The rate of vomiting experienced by the medical staff according to types of charcoal showed that the average rate of vomiting was 33% for commercial ready-mixed activated charcoal suspension and 51% for self-prepared charcoal powder (p=0.02). Conclusion: AC should be secured promptly in emergency medical institutions. Before the supply of commercial ready-mixed AC suspension becomes again it is essential to develop a standardized regimen for self-preparation of charcoal powder and to educate emergency physicians and toxicologists to its use.

• Health Policy and Management
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• v.32 no.1
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• pp.3-13
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• 2022

Health centers provided intensive health care services for local residents according to changes in the times and environment. Public health centers were given various roles such as medical treatment, administration, and service, and the demand for functional reorganization has emerged. We analyzed the literature on the functional restructuring of public health care institutions. In addition, the current status of medical services, which is the main function of institutions, will be analyzed through health insurance statistical data, and detailed contents will be analyzed according to regional types and income levels. As a result of the analysis of medical services at institutions, the total number of patients was 2,238,000, and the number of visits was 11,806 times. Total medical expenses were 169.6 billion won, of which 132 billion won was found to be benefit. When analyzing the number of patients per institution, public health centers had the largest number of 4,326, and the share of benefit was also the highest at public health centers. It should focus on the function of providing local health and medical services related to health promotion and disease prevention in the community. This functional reorganization of public health centers can contribute to forming cooperative relationships with private medical institutions in the local community. For this, first, to establish the role, essential functions for public health centers for preventive health management are established. Secondly, regular manpower expansion and flexible manpower management are required in the human resources sector. Finally, in the organizational sector, it is necessary to establish a step-by-step organizational system according to environmental changes.

• Korea Journal of Hospital Management
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• v.13 no.3
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• pp.1-16
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• 2008

According to Myers (1984) and Myers and Majluf(1984), there exists a financial hierarchy from internal to external financing, from long-tenn debt to equity, due to information costs. The purpose of this study is to assess the profit-making corporation of healthcare institutions. Data was collected from 130 hospital presidents and financial managers. We analysed the frequency and one way ANOVA by SPSS Windows 14.0K. The major findings of the study were as follows: We found that the priorities which a healthcare institutions financing were internal financial, other allowance, a credit loan, a security loan, and a lease through this study. The priorities which a healthcare institutions raised the capital differed as to the number of beds and revenues. The priorities were no difference from ownership, location and an annual business.

• Health Policy and Management
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• v.29 no.3
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• pp.248-261
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• 2019

Establishing a healthcare delivery system is key to building a cost-effective healthcare system that can prevent the waste of healthcare resources and increase efficiency. Recently, the rapid increase in the national medical expenditures due to the aging of the population and the increase in chronic diseases has raised the question about the sustainability of the healthcare system including the health insurance system. This is why we need to reform the medical delivery system, including the function setting of medical institutions. Accordingly, gradual and practical efforts based on the recognition of reality are needed for solving the problems and improving the medical delivery system. The first effort is to secure policy measures to establish functions and roles of medical institutions which are the basis of the healthcare delivery system, and a systematic medical use system for appropriate medical use. This approach can be achieved through a reasonable health insurance schemes. Without reasonable reform efforts, it will be difficult for Korea's health care system to develop into a system that can provide cost-effective and high-quality medical services that the people want.

• Korea Journal of Hospital Management
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• v.25 no.3
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• pp.38-52
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• 2020

Purpose: The purpose of the study is to suggest the main functions and implications of public hospitals to effectively respond to the future epidemic crisis based on analyzing the accessibility to designated Coronavirus Disease 2019 (COVID-19) medical institutions of Seoul and examining the main features of the quarantine of Seoul municipal hospitals. Method: To analyze the response and function of Seoul municipal hospitals, we reviewed the Infectious Disease Control and Prevention ACT, 258 articles of Seoul Metropolitan Government press releases from January to the end of April, 48 articles of Seoul Metropolitan Government's daily newsletters, 2019 Health Bureau Budget report. We also referred to internal data of Seoul Children's Hospital, Seoul Seobuk Hospital, and Seoul Eunpyeong Hospital during the same period. Besides, the accessibility to medical institutions was analyzed by using the COVID-19 data which was announced daily basis. Results: The accessibility of COVID-19 patients living in the Southeastern part of Seoul to a medical institutions was 16.2km on a distance basis, and it was the lowest accessibility among four regions of Seoul since it took about 40 minutes by car. On the other hand, patients living in the Northeast part had the highest accessibility, as the access to medical institutions was 10.7km and 27 minutes by car. Also, the main functions of the municipal hospital of Seoul against COVID-19 were to shift the public hospital function to COVID-19 patients only hospitals, to perform the epidemiological investigation by medical doctors, and to support the operation of self-isolation facilities, community treatment centers and triage rooms of community health centers. Conclusion: Through the experience of COVID-19, we suggested that the functions of public hospitals will be reorganized as the reinforcement of infectious disease treatment and mental health for quarantined patients, cooperation with private hospitals, supporting for strengthening community health capacity and preparation for another epidemic.

• Journal of Korean Clinical Nursing Research
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• v.21 no.3
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• pp.355-365
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• 2015

Purpose: The purpose of this study was to evaluate nursing protocols for superficial cryotherapy in different medical institutions. Methods: The study was conducted with a cross-sectional descriptive design. The medical institutions including general hospitals, hospitals, and geriatric hospitals were randomly selected. A total of 435 nurses from 126 institutions completed a questionnaire. Data were collected from December 2014 to June 2015. Results: Forty-two institutions (39.5%) had nursing protocol for cryotherapy. The nurses reported that durations of cold application were 2 minutes to 5 hours. Frequently used cold therapy devices in order of frequency were frozen gel packs, ice packs, and frozen IV fluid bags. There were variances in the duration of cold application according to the types of institution ($x^2=7.78$, p=.020) and nursing units ($x^2=26.42$, p<.001). In addition, intervals of cold application were different according to the nursing units (x=12.23, p=.032). There were differences in cold application instruments by regional groups (x=70.38, p<.001). Most of the nurses (95.6%) responded that national nursing protocol for superficial cryotherapy were needed. Conclusion: There were difficulties in providing consistent nursing interventions because of the practical differences and absence of evidence-based guidelines for cryotherapy. The researchers recommend that basic studies with various instruments be conducted and proper nursing protocols be developed for cryotherapy.

• Nuclear Engineering and Technology
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• v.54 no.2
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• pp.449-455
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• 2022

The rapid rise in the application of novel treatment techniques, such as intensity-modulated radiotherapy (IMRT), motivated us to survey the status of Korea's radiation safety management and the shielding designs of facilities employing medical linear accelerators (LINACs). To this end, a questionnaire was used to collect information on LINAC facilities and treatments, workload, shielding design, shielding management, and path of obtaining shielding information. Out of 100 domestic institutions, 52 responded to the survey. Approximately 70% of the institutions utilized IMRT for more than 60% of their cases, and an IMRT factor of 5 was adopted by 75% of these institutions. Over 80% of the institutions accounted for the applied time-averaged dose rate per week and instantaneous dose equivalent rates in their shielding designs. Approximately 45% of the institutions obtained important shielding information via a radiation shielding design company and the NCRP-151 report. Overall, most facilities were shown to follow the standards recommended by the relevant international agencies. However, the requirement to establish standardized shielding design information and clarify ambiguous paths for information acquisition was also highlighted. Therefore, the study's results can be used as a foundation for establishing a safety control system and for creating adequate shielding designs.

• Quality Improvement in Health Care
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• v.12 no.2
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• pp.113-123
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• 2006

Objective : This research is focused on understanding the current status of the Health Smart Card already in use in other advanced countries. This research will analyze the current status of the medical institutions Health Smart Card system adoption process and its effects, and provide a basis for future policy decisions for the effective adoption and diffusion of a Health Smart Card system, in the medical field, through the completed research and analysis. Method : This research surveys the domestic, and foreign, status of Health Smart Card usage. The research also presents up-to-date methodology for the evaluation of the effects of medical and health care technology. The research also conducts a survey of the domestic medical institutions that have implemented a Health Smart Card system, and then analyzes the results of the survey. Additionally, the research carried out a survey and analysis of medical institutions with no Health Smart Card system implemented, and considered the factors affecting the diffusion of Health Smart Card systems in considering an effective policy for the introduction and diffusion of such a system. Research Results : Through the study of the methodology of medical and health care information technology in advanced countries, the methodology for assessing Health Smart Card technology has been established, and focuses on 6 aspects. The study on the status of foreign implementation has shown a model for the Health Smart Card system. A survey was conducted on the current status of medical institutions with an implemented Health Smart Card system, and the survey results have been analyzed. Also, factors influencing the adoption of Health Smart Card systems have been analyzed through the survey on those medical institutions that have not implemented a Health Smart Card system. Conclusion : The government must provide institutional measures for sharing medical records by constructing an IT infrastructure at the national level to enable the adoption and diffusion of a Health Smart Card system. Such a network will make connections between medical institutions possible, thus making the diffusion of the Health Smart Card system nationwide. For the successful adoption and diffusion of a Health Smart Card system, a model system development, under a medical record sharing system, should be conducted. Additionally, a regional unit based model should be developed for the model project, as is done in advanced countries, along with the application of such results.

• Progress in Medical Physics
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• v.31 no.2
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• pp.20-28
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• 2020

Purpose: The objective of this study is to perform Postal dosimetry audits for medical linear accelerators in radiation therapy institutions using glass dosimeters and Gafchromic film reading systems and postal dosimetry audit procedures, and to evaluate radiation therapy doses and mechanical accuracy in medical institutions. Methods: Photon output measured and analyzed using a standard phantom for measuring photon output dose using a glass dosimeter for medical linear accelerators. Mechanical accuracy was measured and analyzed using software for film measurement. Results: Measurement and analysis of photon beam output dose using a standard phantom glass dosimeter for photon beam output dose measurement was completed. All tolerance doses were within 5%. Mechanical accuracy measurement and analysis using a standard phantom for verifying the mechanical accuracy of linear accelerator (LINAC) using a Gafchromic film were completed, and all results were shown within tolerances (2 mm or less). Conclusions: In this study, Postal dosimetry audits were performed on the output dose and mechanical accuracy of photon beams (207 beams) for 106 LINACs from 48 institutions. As a result of corrective action and re-execution, it was confirmed that all engines met the acceptable standard within 2 mm in the linear accelerator.