• The Journal of the Korean life insurance medical association
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• v.33 no.2
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• pp.15-17
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• 2014

All Korean people are eligible for National Health Insurance(NHI). But large non-coverage of NHI is a big problem. The origin of this problem is from medical fee schedules. NHI calculate all hospital income including insurance medical practice, non-insurance medical practice and non-medical income(i.e. a funeral hall, a parking lot, stores in hospital).

• Quality Improvement in Health Care
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• v.7 no.1
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• pp.46-58
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• 2000

Background : Despite favorable effects of guidelines on patient care, guidelines often fail to achieve their objectives. Poorly implemented medical practice guidelines can produce only weak effects on the process of health care delivery. Therefore, we performed this study to investigate barriers related development of clinical practice guidelines. Methods : Cardiopulmonary resuscitation was selected as a target problem. Self questionnaires about management of cardiopulmonary resuscitation were developed by a researcher with advisory 8 experts. The questionnaires were designed as a unstructured methods. The data were collected from March 1 to May 31, 1999. A total 50 death case admitted inpatient to Inha University Hospital were subjected to evaluate the development and application of clinical practice guidelines for cardiopulmonary resuscitation. The data were examined by frequency, t-test with SPSS. Result : The article reviewed several common barriers that might limit successful implementation of guidelines in clinical practice, as illustrated by evaluating recommendations for cardiopulmonary resuscitation clinical practice guidelines. Some major problems with guidelines were characterized as follows (1) ethical problem : euthanasia, (2) occurrence on various emergency event and setting, (3) non-medical problems (4) unreliable of medical record etc. Conclusion : Careful analysis of guideline attributes, anticipated effect on medical care, and organizational factors revealed several barriers to successful guideline implementation that should be addressed in the design of future guideline-based interventions.

• The Korean Journal of Emergency Medical Services
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• v.20 no.2
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• pp.65-79
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• 2016

Purpose: This study was performed to evaluate the influence of field practice on subjective well-being and domains of life satisfaction in paramedic students. Methods: A self-reported questionnaire was completed by 143 paramedic students from March 5 to 31, 2016. The questionnaire consisted of subjective wellbeing, openness to experience, and domains of life satisfaction. The statistical analysis was done with SPSS/WIN 22.0. Results: The number of field practice had a lesser influence on degree of life satisfaction and positive emotions. Field practice did not influence negative emotions. Those who were open to experience tended to have higher degrees of personal satisfaction and competence irrespective of field practice. Conclusion: Openness to experience can enhance the life satisfaction and competence against the stressful conditions paramedic students experience in field practice.

• Health Policy and Management
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• v.21 no.2
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• pp.179-194
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• 2011

Although there have been studies regarding the separating policy of dispensary and medical practice, little study have provided a concrete empirical evidence to what extent the policy objectives are achieved. In this paper, we try to provide empirical evidence whether the policy separating dispensary from medical practice achieved the policy objectives, which representatively are reducing the mis-use or over-use of anti-biotic prescriptions and medicines, and decreasing the government spending for the cost of pharmaceutical support. By comparing the average of the rate of change of the number of medicines prescribed, the rate of anti-biotics prescribed, and the government spending for the cost of pharmaceutical support between the areas where the separation policy was implemented and the exceptional areas, we concluded that it is difficult to conclude that the policy separating dispensary and medical practice achieved its policy objects, as it first announced to achieve in the introduction of the policy in 2000. However, the limitation of this study is that the data, that can thoroughly analyze the effect of separating policy of dispensary from medical practice, cannot be collected as expected. Hence, we could not use a parsimonious empirical model to evaluate the effect of the policy introduced in 2000. Rather we used a simple statistical method to extract enough empirical evidence fro m the data available. In the near future, we would expect to see more research that analyze the exact effect of policy separating dispensary and medical practice with concrete empirical model using more sophisticated dataset.

• The Korean Journal of Emergency Medical Services
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• v.27 no.3
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• pp.59-70
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• 2023

Purpose: This study attempted to provide basic data to improve the maturation of career attitudes of emergency medical services students by identifying the effects of clinical practice satisfaction and career undecided level on the maturation of career attitudes of emergency medical services students who had experienced clinical practice. Methods: From May 1 to July 31, 2023, data were collected using a structured questionnaire from third and fourth year students who were enrolled in the department of paramedicine a university in City D and had experienced clinical practice. Results: The results showed that clinical practice satisfaction was significantly positively correlated with career attitude maturity (r=.382, p<.001) and negatively correlated with career indecision (r=.241, p=.002). The influencing factor of career attitude maturity was clinical practice satisfaction (β=.314, p<.001), with an explanatory power of 16%. Conclusion: It was confirmed that the influencing factor of career attitude maturity was clinical practice satisfaction, and the need to find ways to improve clinical practice satisfaction and develop customized education and practice programs for each institution to improve career attitude maturity of emergency rescue students was confirmed. Therefore, it is necessary to find specific ways to improve clinical practice satisfaction and develop customized educational practice programs for each institution.

• Korean Journal of Community Nutrition
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• v.16 no.1
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• pp.136-144
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• 2011

Assessment of quality of life (QOL) is a new method to investigate the effectiveness of dietary regimen. Particularly, diet-related QOL is the most appropriate method to estimate social and psychological problems originated from dietary regimen practice. The purpose of this study was to evaluate the diet-related QOL and the correlation between diet-related QOL and health-related QOL, and dietary regimen practice in online diabetes self-help patients who practice the dietary regimen. Sixty one subjects who intended to practice dietary regimen were recruited from online diabetes self-help community, and instructed to fill-up the self report questionnaires. Contents of questionnaire were comprised of general characteristics, clinical characteristics, dietary compliance, and dietary regimen practice. As a result, the mean score of the 'Dietary impact' among the diet-related QOL sub-scales was the lowest suggesting most of the subjects suffer from burden of dietary regimen practice. The "Dietary impact" was correlated with "Taste", "Convenience" and "Cost" (p < 0.05). "Self-care" and "Satisfaction" were positively associated with well-controlled blood glucose and dietary regimen compliance, but negatively associated with "Dietary impact". Diet-related QOL was significantly correlated with the Health-related QOL, particularly the mental and social component (p < 0.05). Diet-related QOL was negatively associated with BMI, and self monitoring blood glucose was negatively correlated with "Self-care" (p < 0.05). In conclusion, Diet-related QOL might be appropriate to evaluate the effects of dietary regimen or nutrition education. The need for dietary education of cognitive-behavioral strategies and problem-solving ability is required.

• Journal of Korean Clinical Nursing Research
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• v.22 no.3
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• pp.294-304
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• 2016

Purpose: This study was done to develop an evidence-based external ventricular drainage (EVD) nursing practice guideline in order to provide standardized nursing and prevent EVD related complications. Methods: We used the standardized methodology for nursing practice guideline adaptation developed by Korean Hospital Nurses Association for the guideline adaptation process in this study. Results: The newly developed EVD nursing practice guideline was adapted to the American Association of Neuroscience Nurses (AANN)'s clinical practice guideline which is 'Care of the patient undergoing intra-cranial pressure monitoring/external ventricular drainage of lumbar drainage.' There were 61 recommendations documented in the preliminary guideline all evaluated by 9 experts based on acceptability and applicability. The final practice guideline was composed of 3 domains with 57 recommendations. The three domains of nursing were the insertion, maintenance, and removal of the EVD. The number of recommendations in each domain was 8 in EVD insertions, 39 in EVD maintenance, and 10 in EVD removals. Of the 57 recommendations 3.5% were level 1, 31.5% were level 2, and 65% were level 3. Conclusion: The standardized practice guideline can improve nurses' performance and accuracy. It can also be used as the foundation for effective communication between all medical staff.

• The Korean Journal of Emergency Medical Services
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• v.17 no.3
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• pp.101-113
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• 2013

Purpose: The purpose of this study was to provide an appropriate direction for effective field practice program by analyzing the influencing factors on satisfaction of field instructor in ambulance ride practice of paramedic students in Korea. Methods: The questionnaires were filled out by 204 paramedic students from July 22 to September 13, 2013. The collected data were analyzed with SPSS WIN 19.0 program. Results: The stepwise multiple regression analysis revealed that the most powerful predictor of satisfaction of field instructor was sincerity of directions. A combination of sincerity of directions (38.2%), achievement(15.4%), improvement of knowledge(3.9%) 4-week field practice(3.0%), 2 week field practice(1.6%), 4 grade(1.8%) pre-expectation of field practice(1.8%) accounted for 65.6% of the variance in paramedic students. Conclusion: We proposed the effective field practice program as well as sincerity of directions of field instructors. It is necessary to discuss before ambulance ride practice within the faculty and the field instructors.

• The Journal of the Korean dental association
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• v.55 no.1
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• pp.53-62
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• 2017

As the citizens' life and body are the object of medical practice, it should ultimately protect the citizens' right of health. For this reason, medical practice possesses characteristics of non-profit and public and such special characteristics caused heavy regulations in the medical industry as exemplified by medical advertisements. For advancement of market economy, the government has been moving toward relaxing regulations in the medical industry and this trend can be shown in medical advertisements. Moreover, as a type of commercial advertisements, medical practitioners should be able to express their freedom of expression and freedom to occupation. From the perspective of patients who are medical consumers, they need access to information to locate appropriate medical practitioners and institutions for their symptoms. Therefore, medical advertisements can help realize the patients' right to know. This study will first analyze the general theories behind the necessity of medical advertisements and details of regulations, then analyze the issues from the cases of the supreme court and the constitutional court that are related to dental medical advertisements.

• The Korean Society of Law and Medicine
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• v.9 no.2
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• pp.181-207
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• 2008

With recent emphasis on evidence based medicine, clinical practice guidelines are seen as a potential mechanism by which unify various managerial and professional approaches to improving the quality of care. The development process of guidelines has been the subject of much research. and it is need translating the medical evidence of research into a clinical practice guidelines. the gathered evidence needs to be interpreted into a clinical, public health, policy, or payment context. The term 'clinical practice guidelines' can evoke a diverse range of responses from healthcare personnel. Clinical practice guidelines are increasingly used in patient management but some clinicians are not familiar with their origin or appropriate applications. Understanding the limitations as well as benefits of CPG could enable clinicians to have clearer view of the place of guidelines in every practice. In the context of increasing complaints and litigation in healthcare, the legal implications of clinical practice guidelines are of increasing importance. Clinical practice guidelines could, in theory, influence the manner in which the courts establish negligence by suggesting the doctor breached the duty of care by failing to provide the required standard of medical care. In several studies, the CPGs were relevent to and played a pivotal role in the proof of negligence. Much depends on the quality of guidelines and the tools developed and the authoritativeness of a guideline. Recently, there are several opinions the court also should review the validity and reliability of expert testimony including medical evidence. and widespread use of guidelines in malpractice lawsuit could lead the physicians to greater compliance with guidelines in the long term. In conclusion, Health care reformers, physicians as well as guidelines developers should understand that guidelines have both medical and legal aspects as a double-edges sword. so clinicians, legal representatives and decision-makers should not defer unduly to guidelines.