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Legal regulations on telemedicine and their problems (원격의료에 대한 법적 규제와 그 문제점)

  • Hyun, Doo-youn
    • The Korean Society of Law and Medicine
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    • v.23 no.1
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    • pp.3-33
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    • 2022
  • In relation to telemedicine in Korea's medical law, there are Articles 17, 17-2, and 34 of the Medical Act. Since 'direct examination' in Articles 17 and 17-2 of the Medical Act can be interpreted as 'self-examination' rather than 'face-to-face examination', it is difficult to see the above regulation as a regulation prohibiting telemedicine. Prohibiting telemedicine only with the concept of medical examination or the 'principle of face-to-face treatment' is against the principle of "nulla poena sine lege"(the principle of legality). However, in order to qualify as 'examination', it must be faithful enough to replace face-to-face examination, so issuing a medical certificate or prescription after a poor examination over the phone is considered a violation of the Medical Act. In that respect, the above regulation can be said to be a regulation that indirectly limits telemedicine. On the other hand, most lawyers interpret that telemedicine between medical personnel and patients is completely prohibited based on Article 34, and the Supreme Court recently ruled that such telemedicine is not permitted even if there is a patient's request. However, this interpretation is not only far from the legislative intention at the time when telemedicine regulations were introduced into the Medical Act of 2002, but also does not match the needs of reality or the legislative trend of foreign countries. The reason is that telemedicine regulations are erroneously legislated. The premise of the legislation is wrong, and there are considerable problems in the form and content of the legislation. As a result, contrary to the original legislative intent, telemedicine was completely banned. In foreign countries, it is difficult to find cases where telemedicine is completely banned and criminal punishment is imposed for it. In order to fundamentally solve the problem of telemedicine, Article 34 of the Medical Act needs to be deleted.

The Rearch Of Method in the Appropriate number of Demand and Supply of OMD (한의사인력(韓醫師人力) 공급(供給)의 적정화방안(適定化方案) 연구(硏究))

  • Lee, Jong-Soo
    • The Journal of Korean Medicine
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    • v.19 no.1
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    • pp.299-326
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    • 1998
  • 1. Comparison of demand and supply A. Assumption of estimation of demand and supply we will briefly assumptions used for presumption once more before comparing the result of estimation of demand and supply examined previously 1) supply - The average applying rate for state. examination of graduate: ${\alpha}$=1.03109 - The ratio of successful applicants of state examinations: ${\beta}$=0.97091 - Mortality classified by age : presumed data of the Bureau of statistics - Emigrating rate: 0 % - Time of retire: unconsidered - An army doctor number: unconsidered and regard number of employed oriental medicine doctor. - Standard of 1995 : The number of survival oriental medicine doctor is 8195. the number of employed oriental medicine doctor is 7419. 2) demand - derivated demand method Daily the average amount of medical treatment: according to medical insurance federation data. there is 16 or 6 non allowance patient, we consider amount of medical treatment as 22 persons in practical because 21.94 persons (founded practical examination) are converted to allowance in comming demand. Daily the proper amount of medical treatment: 7 hours form -35 persons 5 hours 30 minutes form -28 persons. Yearly medical treatment days: 229 days. 255 days. 269 days . Increasing rate of visiting hospital days: -1996 year. 1997 year. 1998 year- . Rate of applying insurance: yearly average 71.51% (among the investigated patient) B. Comparison of total sum result 1) supply (provision) Table Ⅳ-1 below shows the estimation of the oriental medicine doctor in the future.

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  • A Study on The Periodic Medical Examination, and Health Care Management Programs of Industries -Busan City Province- (산업장의 건강검진과 보건관리실태에 관한연구 -부산 지역을 중심으로-)

    • Huang, Bo-Sun;Shin, Yu-Sun;Yun, Suk-Ok;Lee, Ji-Hyun;Kim, Jung-Soon;Kim, Lee-Soon;Kim, Bok-Yong;Kang, Young-Mee
      • Research in Community and Public Health Nursing
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      • v.4 no.1
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      • pp.14-24
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      • 1993
    • The Purpose of this study was to explore the condition of periodic medical examination and the health care services of industries in order to offer some basic data on developing industrial nursing care. To achieve this goal a self - administered questionnaire (developed by the academic affairs of community health nursing) was provieded to the nurses in 56 industries from Dec. 10, 1992 to Jan. 20, 1993. The statistical computer package, SPSS, was used to manipulate the data along with T-test and ANOVA. The results were as follows : 1. General characteristics: The greater part of the industries were manufacturing company, and below 300 employees of industry were 55.4%. The shift system was mostly one shift(66.1%) and three shift(23.2%), and 50.0% them organized the Industrial Safety and Health Commitee. Average a number of employees was 631 person. 2. Periodic Medical Examination: Most of the workers were receiving periodic medical examination from the designated hospital (95.71%). From the about 12.89% were gone through a colse medical examination. In colse medical examination 58.41% were decided 'C' and 36.73% were decided 'D'. About 6.23% off those who had any clinical findings were work-time shortening(7.84%), work-transition(8.12%), recoverating at home. The majority of the workers receive the result of the periodic medical examination individually (78.5%). 3. Special medical examination: The rate of those who are receiving special medical examination were 76.82% and about 8.24% were decided 'C' and 1.23% were decided 'D' Those who had any health problems were receiving follow-up checking (9.10%) and medical treatment while working (15.04%). The health managers in the company can consult (85.7%) those who had any suspicious sign and symptoms of occupational disease. 4. Health care services: The average score of health care services were 17.57 point out of 28 point, and the score was lower in health assessment and environmental hygiene than medical diagnosis and health education. There were significant differences in environmental hygine (F=3.72, P=0.017), health care services(F=3.94, P=0.013) according to the size of the size of the industries The other's significancy is not shown by any type of industrial nurse. The level of health care services were higher in the wokers who had better health and showed no singificant differences(T=-0.73, P=0.470).

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    A Study on the Periodic Medical Examination, and Health Care Management Programs in Industries -Kwang-Ju city and Chonnam Province- (산업장의 특성별 건강검진과 보건관리 -광주.전남지역-)

    • Kang, Heoi-Young;Park, In-Hee;Choi, Young-Ae;Oh, Mi-Sung;Choi, Hee-Jung;You, Su-Ok
      • Research in Community and Public Health Nursing
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      • v.4 no.1
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      • pp.58-66
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      • 1993
    • The purpose of this study was to explore the condition of periodic medical examination, and health care services in industries. This will offer some basic data in developing industrial nursing care requirements. To achieve this goal a self-administered questionnaire (developed by the academic affairs of community health nursing) was provided to the nurses working in 40 industries from Dec 20, 1992 to Jan 20, 1993. The statistical computer package SAS, along with t-test, and ANOVA was used to manipulate the date. The results were as follows : 1. General Characteristics: The greater part of the industries studied were manufacturing company, with over 500 employees. The shift system was used with most companies using one or three shifts, and 75.0% of them were organized with Industrial Safety and Health Committees. 2. Periodic Medical Examination : Most of the workers were receiving periodic medical examination from a designated hospital (96.7%). Of those 15.8% had a close medical examination. In the medical examination 9.4% were evaluated at 'C' and 3.8 were evaluated at 'D'. About 55.0% of those workers received the result of the periodic medical examination individually(95.0%). 3. Special Medical Examination : The rate of those who were receiving special medical examination was 98.4% and about 11.7% were evaluated at 'C' and 3.9% were evaluated at 'D'. Those who had any health problems (54.2%) were receiving follow-up care, 52.4% of them had medical treatment while working. The health care managers in the company consulted 97.1% of them who had any suspicious signs and symptoms of occupational diseases. 4. Health Care Services : The average score of health care services was 13.8 out of a possible 28 point. The score of health education and health assessment, was lower than medical diagnosis and environmental hygiene. There were no significant differences in health care services according to the size of the industries(F=.95, P=.429). The score of health care services was higher in the worker who had better health and showed significant differences (F=4.50, p=.025).

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    Comparison of Customer Satisfaction Before and After One-stop Service (당일 검사에 대한 원스톱 서비스 전과 후의 고객만족도 비교)

    • Kang, Kun-Woo;Lee, Eui-Jeong;Lee, Hyun-Kyung;Lee, Eun-Son;Lim, Yang-Hee;Han, Hyung-Tae
      • Quality Improvement in Health Care
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      • v.26 no.2
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      • pp.66-76
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      • 2020
    • Purpose:Hospitals provide top medical service using exceptional manpower, medical technology, and state-of-the-art equipment, thus raising the standard of customer satisfaction. In addition, their medical service is becoming higher than before. One-stop service is a good way to improve the quality of customer-centered service as a qualitative marketing strategy. This study thus aims to facilitate subsequent research and compare customer satisfaction before and after one-stop service. Methods: The study included 72 patients who received the reserved examination and one-stop service for 20 days from April 23 to May 12, 2014. The surveyed questionnaire data were analyzed using SPSS 18.00. Results: The comparison results of customer satisfaction showed that the satisfaction score was generally high in the areas of kindness of examination staff, the speedy/accuracy of work processing of examination staff, and the kindness of reservation staff. The group before one-stop service showed their dissatisfaction with repeated visits and difficulty of booking a desired day. The group after one-stop service showed dissatisfaction with the long waiting time for examination or same-day treatment. Conclusion: The one-stop service showed good results, but new uncomfortable issues for the customer were revealed as well, which may result in more work of employees. Considering the characteristics of various clinical departments, the author hopes to find an efficient operation plan through the development and improvement of an appropriate one-stop service method.

    Comparision of medical care utilization between newly detected hypertensive patients and known hypertensive patients (정기건강진단으로 밝혀진 고혈압환자의 의료이용에 관한 연구)

    • Cheon, Byung-Yool
      • Journal of Preventive Medicine and Public Health
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      • v.21 no.1 s.23
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      • pp.47-60
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      • 1988
    • The monthly ambulatory treatment days in newly detected hypertension group and known hypertension group were analyzed. The population was identified through the records of screening examination given by Korea Medical Insurance Corporation during the period from April to July, 1986. From the records of screening examination, 11,614 hypertensive patients were identified. By random sampling,959 patients were selected : among them, 544 fell under the category of known hypertension group and the other 415 fell under the newly detected hypertension group. The monthly ambulatory treatment days of these patients during the period from the April, 1985 to September, 1987 were analyzed in order to compare the exents of medical care utilization as well as to define and analyze the determinants responsible for the ambulatory treatment days between the two groups. The following results were obtained. 1) In the known hypertension group, no statistically significant changes in the ambulatory treatment days was observed after, in comparision to before, the screening examination. However, in the newly detected hypertension group the medical care utilization increased after the screening examination because of hypertension. 2) The ambulatory treatment days for hypertension of the known hypertension was statistically significant and higher than that of the newly detected hypertension group after screening examination. 3) There was no statistically significant change in the ambulatory treatment days in association with diseases other than hypertension in either group before and after the screening examination. 4) There was no statistically significant variable responsible for ambulatory treatment days in the known hypertension group. However, the income was a statistically significant variable in the newly detected hypertension group. 5) After the screening examination, the variables determining the ambulatory treatment days were the age of the patient and the diastolic blood pressure in the known hypertension group. These variables responsible for 2.02% of the total ambulatory treatment days. In the newly detected hypertension group, the income was a statistically significant variable which was responsible for 2.10% of total ambulatory treatment days. The above results satisfied the hypothesis that there would be no significant changes in the ambulatory treatment days before and after the screening examination in the known hypertension group. Also the hypothesis that there would be no significant change in the exents of medical care utilization for the diseases other than hypertension before and after the screening examination in either group was satisfied Also the medical care utilization was significantly higher in the known hypertension group than the newly detected hypertension group after the screening examination. This finding satisfied the hypothesis. This study was limited by the lack of considering fully the variables reponsible for the clinical symptoms of hypertension as well as for the individual characteristics. Thus, the result of this study are not fully adequate to define the determinants responsible for the exents of medical care utilization. In the future studies on medical rare utilization, additional variables should be considered.

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    Survey on the Incidence of Homeless Pulmonary Tuberculosis Infection Rate through Chest X-ray Examination (흉부 X-선 검사를 통한 노숙인 폐결핵 감염률 현황조사)

    • Kim, Mi-Young;Shin, Sung-Rae;Ryu, Young-Hwan;Lim, Hwan-Yeal
      • Journal of Radiation Industry
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      • v.10 no.4
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      • pp.249-255
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      • 2016
    • This study, Seoul City shelter, you are trying to seek medical cooperation and cure rate increase proposal Yu findings's current situation and tuberculosis of homeless tuberculosis. Inspector, and has a total 591 people is targeted to implement an interview after acquiring utilization agreement in studies conducted chest X-ray photography. Of the interview questions, three or more protons, it is determined that the TB symptomatic conducted sputum examination, chest X-ray examination confirms the physician radiology, when sputum examination primarily chromatic findings the double implemented and conducted by requesting the ship inspection also said inspection sputum acid-fast bacteria if it is true one, respectively. confirmed case result of checking whether there is a difference due to risk factors(Jb) at the chi square black, it was found that there is no statistically significant difference at 95% confidence level. (${\chi}^2=0.276$, p>0.05), suspected case (Ac, Ae) results of examining whether there is a difference due to risk factors in chi square black, that there is a statistically significant difference at 99% confidence level is I found (${\chi}^2=9.414$, p<0.01). The nature of the homeless tuberculosis screening and directed to the distance homeless specific location are likely to evaluate the actual incidence low and aggressive or management needs, the rationale is allowed insufficient reality is. Through this research, future, for tuberculosis high risk tuberculosis patient, such as homeless to expand the tuberculosis screening of infectious tuberculosis patients in private medical institutions, and one-stop service that chest X-ray examination and sputum examination is carried out at the same time introduced immediately to prevent the inspection and examination, cure, and should establish a foundation that can be up to post administration.

    Understanding of Neurological Examination for Clinical Therapist (임상치료사를 위한 신경학적 검사의 이해)

    • Kim, Byung-Jo
      • Journal of the Korean Society of Physical Medicine
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      • v.2 no.2
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      • pp.229-236
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      • 2007
    • Clinical therapist use neurological examination to acquire the necessary information from the patients who is neurological damaged. It is necessary to have enough neurological knowledge and clinical experience to collect useful data. Neurological disease of symptom is well correspond with anatomical location and function, therefore neurological examination is one of the powerful tool to diagnosis. These tools will be a great help to clinical therapist to evaluate the patients and helps to select most pertinent treatment approach to patients. Neurological examination can classified and evaluate with Mental Status Examination, Cranial Nerves Examination, Motor and Sensory System Examination, Reflexes, Gait and Station Evaluation, Special Maneuver. Generally, various neurological examination tools are used by therapist in clinical field. Understanding of method of Neurological examination tools and understanding of result of examination from patients's response is very important. Therefore, this research will help to understand clinical meaning by neurological examination.

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    A Study Of the Configuration requirements of the Crime of Issuance of Falsified Medical Certificates, etc. -Focusing on Supreme Court Decision 2004DO3360 Delivered on March 23, 2006 (허위진단서작성 죄의 구성요건 등에 대한 고찰 -대법원 2006.3.23. 선고 2004도3360호 판결을 중심으로-)

    • Kim, Young-Tae
      • The Korean Society of Law and Medicine
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      • v.10 no.2
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      • pp.115-150
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      • 2009
    • The Article 17 (1) of the Medical Service Act states that no one but medical doctor, dentist or herb doctor shall prepare medical certificate, post-mortem examination, certificate or prescription. Though medical certificate, post-mortem examination or certificate is a private document issued by doctor personally, it is accepted as reliable as public document. Therefore, for medical certificate, post-mortem examination or certificate, unlike other private document to guarantee authenticipy of the content, the Article 233 of the Criminal Act states the Crime of Issuance of Falsified Medical Certificates. In other words, the Criminal Act Article 233 states that If a medical or herb doctor, dentist or midwife prepares false medical certificate, post-mortem examination or certificate life or death, one shall be punished by imprisonment or imprisonment without prison labor for not more than three years, suspension of qualifications for not more than seven years, or a fine not exceeding thirtht million won. The subject of the Crime of Issuance of Falsified Medical Certificates is only a medical or herb doctor, dentist or midwife and the eligibility requirements are specified in the Medical Service Act. Medical certificate is the medical document to be issued by medical doctor to certify the health status and show the Jugdement about the result of the diagnosis, Post-mortem examination is the document to be listed by medical doctor to confirm medically about human body or dead body, and Certificate life or death is a kind of medical certificate to verify the fact of birth or death, the cause of death, such as Birth Certificate, Certificate of Stillbirth or Certificate of Dead Fetus. To constitute the crime of Issuance of Falsified Medical Certificates, it is necessary for the contents of the certificate to be substantially contrary to the truth, as well as it is needed the subjective perception that the contents of the certificate are false. The Supreme Court Decision 2004DO3360 Delivered on March 23, 2006 declared that although the Defendant did not MRI scan, etc. for precise observation about the disability status of Mr Park, it was difficult to believe that the contents of the Disability Certificate of this case were contrary to the objective truth or the defendant had perception that the contents of the certificate were false. I don't agree with the Supreme Court Decision, because the Supreme Court confirmed the decision by the court below despite the Supreme Court should have made the court below retry the reason why the Defendant did not MRI scan, etc. for precise observation about the disability status of Mr Park.

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    Survey on Medical doctors' awareness and perceptions of Bisphosphonate-related osteonecrosis of the jaw (비스포스포네이트 관련 악골괴사 (Bisphosphonate-Related Osteonecrosis of the Jaw)에 관한 의사의 인식도 조사)

    • Kim, Jin-Woo;Jeong, Su-Ra;Pang, Eun-Kyoung;Kim, Sun-Jong
      • The Journal of the Korean dental association
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      • v.53 no.10
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      • pp.732-742
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      • 2015
    • The objective of this study was to identify bisphosphonate-related osteonecrosis of the jaw (BRONJ) awareness and experience level of patients by medical doctors who prescribes bisphosphonate being used, analyze dental examination referral reality and to utilize its result as basic education data for early diagnosis of BRONJ and its prevention. The study was carried out through a self-administered questionnaire distributed among a sample 192 residents and specialists. They belonged to family medicine, internal medicine and orthopedics of 6 tertiary medical centers located in Seoul. The survey consisted of 22 questions; general characteristics, bisphosphonate therapy, awareness of BRONJ, implementation level of dental examination referral. Among 192 medical doctorss, 78.1% (n=150) showed awareness of BRONJ. Only 8.9% (n=17) had correct response in all 5 BRONJ knowledge questions. Dental examination referral by medical doctors was implemented in below 30% of the total patients. At the time of bisphosphonate administration, specialist of oncology most highly recognized necessity of dental examination referral and it was represented in the order of endocrinology, rheumatology, family medicine, orthopedics specialists. As recognition of medical doctors for BRONJ and implementation level of dental referral were represented to be low, it is considered that enhancement of BRONJ recognition for medical doctors and development of high accessible education program for increasing implementation rate of dental examination referral would be required.


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