• Korea Journal of Hospital Management
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• v.29 no.1
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• pp.56-63
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• 2024

Purposes: This study aims to analyze the correlation with the current status of the medical resident application rate, physician's income, and non-benefit rates of majors in each specialty subject and to suggest implications. Methodology: First, it analyzes the correlation between the medical resident application rate by specialty subject and the income of physicians. Second, it analyzes the correlation between the income of specialists and the non-benefit rate for each specialty subject at the clinic level. Findings: First, a significant positive correlation was found between the medical resident application rate and the average physician's income for each specialty subject (r=.718, p<.01). Second, a significant positive correlation was observed between physician income at the practitioner level by medical specialty and the non-benefit rate (r=.726, p<.01). Practical Implications: In this study, the correlation between medical resident application rate by specialty subject and physician's income, non-payment and physician's income was confirmed. Choosing a department that is less risky and can earn higher income is a natural phenomenon, but it is necessary to adjust the physicians crowding phenomenon to a specific specialty subject at the government level to maintain the medical system.

• Quality Improvement in Health Care
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• v.1 no.1
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• pp.110-118
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• 1994

As the first step to improve the medical recording for the hospitalized patients, we tried to identify problems of completion rate of the medical recording and made the completion rate of the medical recording within due date known to the public in the hospital and commended the best Department and resident officially. The results were as follows: 1. The average number of the medical recordings per a recorder by years of residency(average number to quorum) was 293.3(398.8) in 1st year, 82.5(68.1) in 2nd year, 21.2(8.3) in 3rd year, and 20.5(1.9) in 4th year-residents. There was only 2 residents who prepared the medical recordings more than the average of 125.6 recordings per a resident. 2. Among 13 Departments, the medical recording was wholly put in charge of the 1st year-resident in 6 Departments. The duty was shared with the 2nd year-resident in 5 Departments and the 3rd year-resident in 1 and the 4th year-resident in Only 1 Department. 3. The more the cases requiring the medical recording, the lower the completion rate(80% less than 100 recordings, 70% in 100-299, 60% in 300-399 and 33.3% in more than 400). 4. There was no difference in the completion rate of the medical recording before(1991) and after(1993) a public nitice(1992). However, 4 Departments showed improvement of 21-45% in the completion rate, and no case was found where billing for medical assurance was postponed due to delayed completion of the medical recording. 5. The completion rate was relatively low(72-78%) from January to March. The main reasons were shortage of men power due to preparation of board examination, attendance to military duty, and lack of training in the medical recording for the new 1st year-residents. 6. The official commendation of the best Department and resident by letters did not improve the completion rate of the medical recording. In conclusion, The main reason of the low completion rate of the medical recording was the fact that the 1st year-residents were almost exclusively responsible for the medical recording. Hence, it is mandotory that this practice gets staffs' attention to improve the completion rate. Public notice of the completion rate of the medical recording shows prompt improvement of the completion rate. Prize money rather than commendation by a letter for the best Department would also be more effective to improve the quality of medical recording.

• Korean Medical Education Review
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• v.19 no.2
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• pp.63-69
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• 2017

Resident training programs in South Korea lag far behind that of advanced countries. Given the problems the current system in South Korea has, it is time to consider a new resident training system, resident training for general competencies. Training for the general competencies was practiced in medical fields in advanced countries such as the USA, Canada, and the UK as early as 20 years ago. This system has rendered itself a key component of resident training. Although a few theoretical procedures on general competencies have been practiced in South Korea, the awareness of this concept is still very weak, and the application of the theory to actual training is a long way off from becoming effective. It is urgent for South Korea to adopt competency- and outcome-based training for general competencies. To this end, the knowledge of the concept of this type of training should be improved. Also, the system should be carefully designed to cover a doctor's whole career, and be applied immediately. The competency- and outcome-based training for general competencies is a system that assures high level qualifications. It reflects the needs of our society under the recognition that a professional organization should be committed and accountable in order to respond to social demands. As the benefits of the new training system reach the public and medical care consumers, training-related expenses should be borne by social costs.

• Korean Medical Education Review
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• v.23 no.1
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• pp.23-36
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• 2021

Residents serve as educators who teach patients, medical students, fellow residents, and other medical personnel while being trained as learners. The purpose of this study was to review the literature on the competencies, perceptions, and educational status of residents as teachers, and to suggest appropriate competencies and curricular components. A literature review was conducted and resident-related institutional homepages were searched. Many countries are developing the educational competencies of residents as teachers and implementing educational programs. Residents most often taught clinical knowledge and clinical skills to patients, medical students, fellow residents, and other medical professionals, and recognized the importance of education, the joy of teaching, and the role of teachers; however, the task of teaching was burdensome. Based on these findings, competencies and educational programs for the resident as teacher are proposed. The competencies consist of the five stages of ACCESS (active learner, clinical teacher, curriculum developer, educational scholar, social communicator, supervisor/leader), and specific teaching content, methods, and assessment methods are suggested to develop these competencies. Educating residents to develop their competencies as teachers is very important as a way to foster lifelong learning skills, help others, and assist in leadership roles.

• Korea Journal of Hospital Management
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• v.18 no.2
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• pp.15-32
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• 2013

Few public health researchers have paid research attention to the location of medical institutions in Korea. Previous studies were published in geography journals, and relied on limited data in terms of geographic regions and the type of medical institutions. This study utilized nationwide data covering 8 types of medical institutions. We obtained data from Health Insurance Review and Assessment Service and National Population and Housing Census. The correlation coefficients of resident, daytime, university-graduate population, and the population of different age groups (fewer than 15, 15~64, 65 or more) were compared to understand their relative association with the location of medical institutions. Medical clinic, dental clinic, oriental medical clinic, and pharmacy, all of which are almost completely operated by private sector, showed strong positive correlation with population. Hospital-level medical institutions, which are operated by both public and private sector, had moderate positive correlation. Daytime population and university-graduate population, rather than resident population, were more correlated with the location of medical clinics. The correlation coefficients of the population of 15~64 age group and the location of medical institutions were greater than that of other age groups. The results showed that daytime and university-graduate population are more important than resident population to explain the location of medicalrelated facilities. The results also suggests that the population of age groups (especially, 15~64) might be one of important influence factors in the location of medical institutions.

• Quality Improvement in Health Care
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• v.10 no.1
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• pp.20-27
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• 2003

Background : The doctors' strike was not only a manmade disaster but also a chance to apply a new pattern of emergency medical service for patients. We hope to propose a new pattern of emergency medical service by comparing the patterns of emergency medical service given by resident and staff during the doctors' strike. Methods : We reviewed the medical records of patients who received emergency medical service in the Emergency Department(ED) of Deagu Catholic University Hospital during 3 days a week prior to the residents' strike (July 21-23, 2000) with those of patients receiving emergency medical service during the first 3 days of the residents' strike (July 28-30, 2000). We evaluated the patient's severity, the cause of the ED visit, the performance on the laboratory study, ECG, and radiological study, the disposition, and the length of ED stay. Also, we compared the collected data by presenting doctor and by patient's severity. Results : The staff performed fewer tests admitted fewer emergent and non-emergent patients than the residents. Also, the length of ED stay was shorter in both the emergent (212.76 vs. 321.40 minutes) and the non-emergent groups (117.68 vs. 171.39 minutes) for patients presenting to staff. Conclusion : It is desirable that emergency medical service is given by staff, not by resident.

• Molecules and Cells
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• v.44 no.5
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• pp.281-291
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• 2021

Tissue-resident macrophages play an important role in maintaining tissue homeostasis and innate immune defense against invading microbial pathogens. Brain-resident macrophages can be classified into microglia in the brain parenchyma and non-parenchymal brain macrophages, also known as central nervous system-associated or border-associated macrophages, in the brain-circulation interface. Microglia and non-parenchymal brain macrophages, including meningeal, perivascular, and choroid plexus macrophages, are mostly produced during embryonic development, and maintained their population by self-renewal. Microglia have gained much attention for their dual roles in the maintenance of brain homeostasis and the induction of neuroinflammation. In particular, diverse phenotypes of microglia have been increasingly identified under pathological conditions. Single-cell phenotypic analysis revealed that microglia are highly heterogenous and plastic, thus it is difficult to define the status of microglia as M1/M2 or resting/activated state due to complex nature of microglia. Meanwhile, physiological function of non-parenchymal brain macrophages remain to be fully demonstrated. In this review, we have summarized the origin and signatures of brain-resident macrophages and discussed the unique features of microglia, particularly, their phenotypic polarization, diversity of subtypes, and inflammasome responses related to neurodegenerative diseases.

• Annals of Surgical Treatment and Research
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• v.95 no.5
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• pp.233-239
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• 2018

Purpose: In Korea, the working-hour limitation regulation has been implemented in December 2017. We aimed to define the difference in operative experience of surgical residents before and after implementing this policy in 2 hospitals among 8 affiliated hospitals of the Catholic Medical Center where implemented the 80 working-hour limitation policy since March 2015. Methods: All the operation records were reviewed, and the number of resident-participated surgeries between March and August in 2002 and 2017 were compared. Operations performed or participated in by residents as first assistants were defined as resident participated surgery. Results: After 2 years from the initiation of the resident work-hour limitations, the number of resident participated surgery has slightly decreased in both hospitals (Yeouido St. Mary's Hospital [YSM]: 317 to 302, St. Paul Hospital [SPH]: 635 to 461). For each resident, changes were like followings: $0{\rightarrow}21$ cases for R1, $65{\rightarrow}72$ cases for R2, $83{\rightarrow}192$ cases for R3, and $169{\rightarrow}17$ cases for R4 in YSM. In SPH, number of resident participating surgery was changed like followings: $4{\rightarrow}32$ cases for R1, $222{\rightarrow}100$ cases for R2, $317{\rightarrow}300$ cases for R3, and $92{\rightarrow}29$ cases for R4. In both hospital, while, total number of resident participating oncologic surgery has been decreased, number of resident participating appendectomy has been far increased. Activity of each grade resident is different according to hospital. Conclusion: Although total number of resident participating surgery decreased, variable changes were observed in each grade of resident according to each type of surgery and different hospitals. It is believed that comparisons of experiences from more hospitals in the future would be helpful in establishing the guidelines for surgical experience requirement of residents in Korea.

• Safety and Health at Work
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• v.9 no.4
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• pp.408-415
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• 2018

Background: Nursing home resident care is an ongoing topic of public discussion, and there is great interest in improving the quality of resident care. This study investigated the association between nursing home employees' job satisfaction and residents' satisfaction with care and medical outcomes. Methods: Employee and resident satisfaction were measured by questionnaire in 175 skilled nursing facilities in the eastern United States from 2005 to 2009. Facility-level data on residents' pressure ulcers, medically unexplained weight loss, and falls were obtained from the Centers for Medicare and Medicaid Services Long-Term Care Minimum Data Set. The association between employee satisfaction and resident satisfaction was examined with multiple and multilevel linear regression. Associations between employee satisfaction and the rates of pressure ulcers, weight loss, and falls were examined with simple and multilevel Poisson regression. Results: A 1-point increase in overall employee satisfaction was associated with an increase of 17.4 points (scale 0-100) in the satisfaction of residents and family members (p < 0.0001) and a 19% decrease in the incidence of resident falls, weight loss, and pressure ulcers combined (p < 0.0001), after adjusting for staffing ratio and percentage of resident-days paid by Medicaid. Conclusion: Job satisfaction of nursing home employees is associated with lower rates of resident injuries and higher resident satisfaction with care. A supportive work environment may help increase quality of care in the nation's nursing homes.

• BMB Reports
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• v.52 no.9
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• pp.554-559
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• 2019

Despite reports suggesting that tissue-resident natural killer (trNK) cells cause ischemic kidney injury, their contribution to the development of tubulointerstitial fibrosis has not been determined. This study hypothesized that the depletion of trNK cells may ameliorate renal fibrosis by affecting transglutaminase 2/syndecan-4 interactions. Aristolochic acid nephropathy (AAN) was induced in C57BL/6 mice as an experimental model of kidney fibrosis. The mice were treated with anti-asialo GM1 (ASGM1) or anti-NK1.1 antibodies to deplete NK cells. Although both ASGM1 and NK1.1 antibodies suppressed renal $NKp46^+DX5^+$ NK cells, renal $NKp46^+DX5^-$ cells were resistant to suppression by ASGM1 or NK1.1 antibodies during the development of tubulointerstitial fibrosis in the AAN-induced mouse model. Western blot analysis showed that both antibodies increased the expression of fibronectin, transglutaminase 2, and syndecan-4. These findings indicate that trNK cells played an exacerbating role in tubulointerstitial fibrosis by activating transglutaminase 2 and syndecan-4 in the AAN-induced mouse model.