• 대한의사협회지
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• 제61권11호
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• pp.687-698
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• 2018

Inappropriate antibiotic use significantly contributes to antibiotic resistance, resulting in reduced antibiotic efficacy and an increased burden of disease. The objective of this study was to investigate the characteristics of prescribers whose antibiotics use was high and to explore factors affecting the use of antibiotics by medical institutions. This study analyzed the National Health Insurance claims data from 2015. Antibiotic prescription data were analyzed in terms of the number of defined daily doses per 1,000 patients per day, according to the World Health Organization anatomical-therapeutic-chemical classification and methodologies for measuring the defined daily dose. We investigated the characteristics of prescribers and medical institutions with high antibiotic use. Multivariate regression analyses were performed on the basis of characteristics of the medical institution (number of patients, type of medical institution [hospital or clinic], age of the physician, etc.). The number of patients and number of beds were found to be significant factors affecting antibiotic use in hospitals, and the number of patients, region, and medical department were significant factors affecting antibiotic use at the level of medical institutions. These findings are expected to help policy-makers to better target future interventions to promote prudent antibiotic prescription.

• 한국병원경영학회지
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• 제12권4호
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• pp.1-21
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• 2007

The relaxation of the regulation in selection of medical institution allows patients to use their own judgement in choosing proper institution for their diseases. Since the change of the regulation, there should have been many changes in medical institution selection behavior. The analysis of the change in disease specific selection pattern is critical because there be an optimal selection criteria that ensure the efficient and effective utilization of medical resources. This study analysis the institution selection factors by comparing the choice among the cases of acute diseases, the cases of chronic diseases, inpatient services, outpatient services, and emergency medical service. The comparisons performed in terms of size, class and other characteristics of medical institutions. For the study the nationally surveyed database was used and the data were analyzed using logistic regression procedure. The results indicates that the primary care facilities were not properly utilized. This study speculates that the reason for the undesirable pattern of utilization is that the roles of primary care facilities in the healthcare delivery system was not clearly defined. Based on the results, the medical policy implications are discussed.

• 한국산업정보학회논문지
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• 제25권6호
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• pp.69-84
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• 2020

본 연구는 ISO18091:2019 을 기반으로 행정안전부에서 개발한 공공서비스 품질관리 프레임워크를 의료기관의 COVID-19 대응 시스템에 적용하고 이를 통하여 관련 의료서비스 품질 개선을 위한 방안을 마련하기 위하여 수행되었다. 2020년에 초에 발생한 COVID-19 사태는 전 세계를 강타하고 있으며 2020년 11월 현시점까지 해결되고 있지 않은 중대한 사건이라고 할 수 있다. 한편, 우리나라의 의료기관들은 신속한 확진자 검사 및 철저한 격리를 통하여 COVID-19 바이러스의 전파를 막는 데 좋은 성과를 내고 있다. 그 결과로 소위 K-방역은 전 세계로부터 긍정적 명성을 얻고 있다. 본 연구에서는 공공서비스 품질관리 프레임워크를 기반으로 작성된 품질관리 체크리스트를 적용하여 국내 의료기관의 COVID-19 대응 관련 현황을 점검 및 평가하였다. 3개의 의료기관과의 인터뷰를 수행하였으며, 이를 바탕으로 7가지의 범주에 대한 현황을 분석할 수 있었다. 또한, COVID-19사태의 장기화에 대비한 관련 의료서비스 품질을 위한 개선점도 제안하였다.

• 보건의료산업학회지
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• 제2권1호
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• pp.105-124
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• 2008

The purpose of this research is to provide the data base for the activation of Quality Improvement operation through investigating the status of Quality Improvement operation, and finding out factors influencing on the goal-orientation of QI performers in the medical centers of more than one hundred beds where are practicing Quality Improvement operation. In order to reach the purpose, document study was carried out grounded on the proceeding researches and formulated statistical data in relation with the status of Quality Improvement performers, and proof study was carried out through questionnaire survey. The subjects of the survey were the Quality Improvement performers working in seventy three medical centers in Pusan-Gyeongnam, Daegu-Gyeongbuk, and Ulsan. Among eighty three Quality Improvement performers, fifty, five were questionnaire surveyed, on the result of which Reliability Analysis, Factor Analysis, and Multiple Regression Analysis were made, using statistical program. The the results of the proof analysis on this research are as follows. First, in the factors influencing the devoting to goal pursuit of QI performers, organization-goal contribution(0.44) had significant positive effects, while organization conflict(-0.25) had significant negative effects. In other words, the higher the organization-goal contribution was, the higher the devoting to goal pursuit was, while the less the organization conflict was, the higher the devoting to goal pursuit was, which was statistically significant.(p<0.05). Second, in the aspect of goal performance types of QI performers, the process-centered type showed high level of the devoting to goal pursuit, which was statistically significant.(p<0.05). Third, in the aspect of QI performance degree, the higher the devoting to goal pursuit was, the higher the QI performance degree was, which was statistically significant.(p<0.05). In addition, the performers who perceived their workplaces organic structure showed much higher QI performance degree, which statistically significant.(p<0.05). Generalizing the results of this research, it is possible to offer a few suggestions as follows. First, as the competition among the medical centers is more severe recently owing to medical center evaluation system, medical centers are practicing various Quality Improvement operation in all of medical services such as clinical performance and management performance, to reach the purpose of both cost-cutting and medical quality improvement. Thus in order to practice Quality Improvement operation more efficiently in medical centers, it is essential to nuke use of problem-solving methods and statistical members. This as the willingness of chief executives and positive attitude and recognition of organization members. This requires the installation of divisions in charge and disposition of persons in charge, not to speak of persistent training of Quality Improvement. Second, the divisions in charge of QI carry out Quality Improvement operation at the medical center level, and take the role of generalizing and adjusting QI performances of various departments. Owing to this role, the division in charge of QI is considered indispensable organization in the QI operation of medical centers along with medical QI committee, while it contributes to the government's goal of reducing quality level gaps among medical centers. Therefore it is necessary for government and QI organizations to give institutional support and resources for the sake of QI operation of medical centers, besides to supply systematic trainning and informations to the divisions and persons in charge of QI. Third, it is certain that disposition of persons in charge should be determined in view of the scale and the scope of QI operation in medical centers.

• 한국비블리아학회지
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• 제21권3호
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• pp.45-56
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• 2010

본 연구는 한국의학도서관협의회 소속의 대학 및 병원도서관을 대상으로 웹사이트 구축현황을 살펴보고, 나아가 웹사이트를 운영하고 있는 국내 29개 의과대학도서관 웹사이트의 메뉴구성과 콘텐츠를 비교, 분석하였다. 본 연구의 결과는 다음과 같다. 첫째, 의학도서관 웹사이트의 메인메뉴는 소장자료검색, 전자정보원, 도서관서비스, My Library, 도서관안내, 게시판의 6개로 정리된다. 둘째, 의학도서관 웹사이트에서 제공하는 주요 정보서비스는 '자관 Pubmed, 원문복사/상호대차, 정보검색, 이용교육, 논문작성지원, SDI서비스, 모바일서비스, 학위논문제출, 참고정보원, 교외접속, 주제별서비스, 인용정보분석, 대출예약/연기, 희망도서신청, Q&A게시판'의 15가지이다. 셋째, 가장 많은 기관에서 제공하고 있는 정보서비스는 원문복사/상호대차이며, 다음은 '대출예약/연기, 희망도서신청, 교외접속, 이용교육, 참고정보원, Q&A게시판, 자관 Pubmed, 학위논문제출' 등의 순이다.

• 한국응급구조학회지
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• 제6권1호
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• pp.185-197
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• 2002

Today, the basic problem of functional safe management of Korean Disaster Control system was separately administrated 33 acts that are relating to safe management in 13 ministries. Because of the facts that the fire service is not provided practically, the control system and risk management for safe administration are not operated, the information can not be shared with each other, and the various laws have the lacks of linkage, the National Safe System was appeared unsteady. The roles and functions of fire service have started with restriction to operate structurally and institutionally, which operational structure of fire service is becoming weak. As a result, the federal and local fire organizations have not reached yet to the institutionalization and the local fire service agencies have bias with the task regarding the fire service because of the relation between organizational structure and the local fire agency. With the enforcement of the federal and local fire system, professionality and autonomy for making policy, and dealing with changes of fire service positively, the national fire service on the policy performance can be established. Promotion of research and development and education training to strengthen innovation in technology and competition in fire industry will contribute to the firmly establishment of control system to prevent from fire, flood, terror and national disaster. This article proposed that (a) the established law and administration, agency are required efforts to effectively operate fire service system; (b) the national fire service agency, national college of fire, national institute of science fire, and national fire service hospital should be early established to make firmly policy to operate effectively and practically. These kinds of innovational acts are known the best ways of operating solid policy of national fire service system.

• 보건교육건강증진학회지
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• 제1권1호
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• pp.83-97
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• 1983

The present study is to provide information for the improvement of school health services through research on the current condition of its organization and practice in universities, colleges and junior colleges. The scope of this study is consisted of four components including health organizations/units, school health services, environmental sanitation and health education for the 30 universities, the 20 colleges and the 32 junior colleges in Korea. The major findings are summarized as follows: (1) Among the sampled schools, around 73% of them have the health service organization/unit. When we break down health service organization/unit into the types by the level of school, around 73% of the universities have formal organization called "health center" and 20.0% of them have an informal organization called "health room". For the colleges level, 30.0% of them have the "health center" and 40.0% of them have the "health room". The figure of junior colleges is a quite different from universities and colleges, 56.3% of junior colleges have the "health room" only but the other have no service organization at all. (2) It was found that only 22.0% of 82 schools have the health committee for the school health services. It might be necessary to have a kind of expert committee to establish an annual health service program, budget and health policy in the school. (3) Approximately 29% of those schools having formal health organizations/units appointed directors as a medical persons. 13.4% of the sampled schools are appointed doctors (including the dentists) at health service organization/unit, 9.8% are appointed pharmacist and 65.9% are appointed nurses. Therefore, the data imply that the school health services are depending mainly on nurses. (4) The major activities of school health services are covering primary medical care (84.1%), health counseling (72.0%), physical examination (68.3%), vaccination (58.5%), tuberculosis control (54.9%), parasite control (29.3%) and dental health case(9.8%). Also 69.5% of the schools have the program on the environmental sanitation and the health education program. (5) In regard to health budget taking account of 34 schools, approximately 92% of them have less than 5,000 won per students and only 8.8% of them have more 10,000 won per students. At the average health budget per students is 4089.8 won in universities, 1617.1 won in colleges and 475.0 won in junior colleges. (6) The students enjoy the benifit of medical insurance at 11.0% of 82 schools surveyed. They are all universities. (7) The study found that 56 universities, colleges and junior colleges provide the annual physical examination. Only 21.4% of them have provided it for all students and school employees. (8) 64.3% of the 56 schools surveyed keep a record of the regular physical examinations. Records must be utilized as the basic data for the evaluation of the student's health condition and so the individual student is encouraged to take care of his own health. (9) At the 59 schools which practice health counseling, the main concerns of the counsellees are venereal disease, tuberculosis and psychoneurosis. This shows the need to practice health education in the area of preventive medicine. (10) 69.5% of the 82 universities, colleges and junior colleges surveyed are concerned with supervision of the environmental sanitation in their school, but non-professionals are in charge at 70.1% of them. This indicates negligence in environmental sanitation. (11) 53.7% of the 82 schools responded that they have no special instructive measure for the students' health and 54.9% are found to be negative in the use of a health education method. This reveals a problem. They are not positive to the recognition of their function as the initiative organization for the students' health. (12) The supplementary education for the faculty of the school health services is executed only at 8.5% of all the schools surveyed.

• 한국병원경영학회지
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• 제6권2호
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• pp.37-69
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• 2001

A new cost management system, called Activity Based Costing (ABC) system, has arisen to solve the limitation of a Traditional Cost Accounting (TCA) system until last two decades and ABC has been applied by many companies. TCA systems have limitation in tracing cost because they arbitrarily allocate overhead cost to the cost objects without standard for direct cost distribution. ABC is an accounting system that assigns costs to products or services based on the resources they consume. The costs of all activities are traced to the products for which they are performed. Therefore ABC is a cost management system that provides a matrix to accurately quantify consumed resources triggered by activities and activities triggered by products and services. There is little implementation of ABC in the health services field, one of service industries, due to complicated and many activities, and volatile cost object. However, the necessity for applying reasonable cost accounting system is largely issuing as strategy responding hostile environment, and financial pressure, and it is imperative to implement the Activity Based Costing (ABC) system. Therefore, this study presents the framework to develop ABC system for total health service organizations. Cost objects in this study base on medical service activities per health insurance claim from one general hospital located in Metropolitan Statistical Areas (MSAs). Medical service activities include all health insurance claims in the hospital. The purpose of the study is presenting useful tools and basic frame to develop Activity Based Costing system for health service organizations which want to use ABC system. The steps to develop ABC system for health service organizations are following: 1. Identifying of activity centers; 2. Definition of cost objects and activity by activity center; 3. Analysis of activity and tracing activity contribution; 4. Allocation of direct cost for specific activity; 5. Allocation of indirect cost for specific activity; 6. Allocation of depreciation for facilities, applicants, and consumption goods; 7. Allocation of administration cost; 8. Allocation of cost among activity centers; and 9. Tracing cost of cost objects by activity center. This study identified necessary information from existing reports which hospitals generally made by each step, and defined outcome which had to be produced in each step using this information. The steps of this study had limitation to apply all different size hospitals because the steps were structured ABC system by one hospital, however, this study used similar basic framework and methods with general cases. When a health service organization want to apply Activity Based Costing (ABC) system on all activities of it in future days, this study is very useful to design system structure in the health service organization.

• 한국정보통신학회논문지
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• 제4권2호
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• pp.337-346
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• 2000

본 연구는 노인복지를 향상시키기 위하여 필요한 정보서비스를 분석해보고 어떠한 방향으로 정책을 실행해야 하는지를 분석하기 위해 면담조사와 문헌적 조사방법을 이용하여 연구하였다. 사회적 변화요인을 분석해 보면 첫째, 조기퇴직 및 수입원 감소로 인한 경제적 문제 둘째, 노인들의 만성적 질병으로 인한 의료적 문제 셋째, 여가적 문제 넷째, 소외감과 고독감을 느끼게 만드는 문제 등으로 분석된다. 이러한 문제를 해결하기 위한 정보서비스를 분석해 보면, 첫째, 경제적 문제를 위한 재택근무서비스ㆍ노인전용홈뱅킹서비스 둘째, 의료적 문제를 위한 의료지원서비스ㆍ의료정보서비스ㆍ원격의료지원서비스 셋째, 여가적 문제를 위한 이벤트정보서비스ㆍ여가정보서비스ㆍ원격교육서비스 넷째, 소외적 문제를 위한 인터넷서비스ㆍ지식학습지원서비스 등의 정보서비스가 필요하다. 이러한 정보서비스를 개발하기 위한 정책방향은 첫째, 노인복지협의회의 구성 둘째, 노인복지전용망의 구축 셋째, 정보서비스 이용 활성화 넷째, 국가정책의 변화 다섯째, 노인복지정보서비스의 연구ㆍ개발이 이루어져야 한다.

• Journal of Nutrition and Health
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• 제34권4호
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• pp.458-471
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• 2001

To evaluate the infra structure supporting hospital nutrition services, we conducted a survey on the unit of organization, unit of dietitians work system, number of personnel engaged on nutrition services, productivity of food service, management of dietitians works, computerization of nutrition services etc. Total ninety-six hospitals were participated in the survey, and they were varied in terms of hospital classification, location, number of beds and type of food service management. All of the large hospitals with more than 400 beds conducted nutrition services under the department of nutrition, but some of the middle and small hospitals with less than 400 beds conducted nutrition services under the other department such as administration. In most of the tertiary hospitals, the work of dietitians were separated in which food services and medical nutrition services were conducted independently by different dietitians, whereas, in most of general hospitals and all the hospital, food services and medical nutrition services were conducted by the same dietitians in all time. The numbers of dietitians and cooks per 100 beds were fewer in the large hospitals with more than 400 beds than the hospitals with less than 400 beds, and the number of cooking and meal serving assistants were the just opposit. The average productivity of food service was 44.5 meals per hour for each dietitian, 84.8 meals per hour for a cook and 7.0 meals per hour for a cooking and meal serving assistant. The productivities for dietitians and cooks tend to be higher in large hospitals than middle and small hospitals, whereas the productivities for cooking and meal serving assistants were just opposite. The large hospitals seemed to solve the problem on the lack of working personnels by hiring part-time workers and by utilization of computer system for their works. The pattern of daily work management in food service area was not much different between dietitians duties, but the pattern of daily work management in medical nutrition service area was different in a way which the analysis of patients nutrient intakes was almost not conducted by dietitians handling both food services and medical nutrition services. Therefore, this study demonstrates that there are significant differences in the infra structures conducting nutrition services among hospitals, suggesting that the strategies to improve this improve this structure in relation to the improvement of service qualities need to be investigated in the future. (Korean J Nutrition 34(4) : 458∼471, 2001)