• Journal of Hospice and Palliative Care
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• 제23권4호
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• pp.252-255
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• 2020

This article aims to discuss the barriers hindering cancer patients from receiving early palliative care, which has been demonstrated to be more effective in improving quality of life and controlling symptoms. Specifically, there are barriers in four aspects of delivering early palliative care. First, the difficulty of starting discussions about early palliative care and the lack of adequate appointment time can impede communication between oncologists and patients and their family members. Second, determining the timing of referral and deciding upon and applying a standard for referral can be barriers in the process of referral from oncology to palliative care. Third, palliative care patients and their family members can face difficulties regarding in what format and by whom the services will be delivered. Fourth, biases, misinformation, and inaccurate beliefs can be barriers in the process of patients and their family members accepting care. In order to facilitate early palliative care, research and policy regarding these barriers are necessary, along with efforts made by medical staff.

• Molecules and Cells
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• 제46권2호
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• pp.120-129
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• 2023

Recent technical advances have enabled unbiased transcriptomic and epigenetic analysis of each cell, known as "single-cell analysis". Single-cell analysis has a variety of technical approaches to investigate the state of each cell, including mRNA levels (transcriptome), the immune repertoire (immune repertoire analysis), cell surface proteins (surface proteome analysis), chromatin accessibility (epigenome), and accordance with genome variants (eQTLs; expression quantitative trait loci). As an effective tool for investigating robust immune responses in coronavirus disease 2019 (COVID-19), many researchers performed single-cell analysis to capture the diverse, unbiased immune cell activation and differentiation. Despite challenges elucidating the complicated immune microenvironments of chronic inflammatory diseases using existing experimental methods, it is now possible to capture the simultaneous immune features of different cell types across inflamed tissues using various single-cell tools. In this review, we introduce patient-based and experimental mouse model research utilizing single-cell analyses in the field of chronic inflammatory diseases, as well as multi-organ atlas targeting immune cells.

• Journal of Preventive Medicine and Public Health
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• 제49권6호
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• pp.386-393
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• 2016

Objectives: General practitioners (GPs) retention in rural and underserved areas highly effects on accessibility of healthcare facilities across the country. Education seems to be a critical factor that affects GPs retention. Thus, the present study aimed at inquiry into medical education challenges that limit their retention in rural and underserved areas. Methods: A qualitative approach was applied for the aim of this study. Data were gathered via 28 semi-structured interviews with experts at different levels of Iran's health system as well as GPs who retained and refused to retain working in rural settings. Interviews mainly were performed face-to-face and in some cases via telephone during 2015 and then coded and analyzed using content analysis approach. Results: Iran's medical education is faced with several challenges that were categorized in four main themes including student selection, medical students' perception about their field of study, education setting and approach, curriculum of medical education. According to experts this challenges could results in making GP graduates disinterested for practicing in rural and underserved areas. Conclusions: Challenges that were found could have negative effects on retention. Modification in student's perception about rural practice could be done via changing education setting and approach and curriculum. These modifications could improve GPs retention in rural and underserved areas.

• 한국병원경영학회지
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• 제22권2호
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• pp.44-57
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• 2017

The objective of this study is to investigate financial integrity strategies for sustainable development of local public medical centers, and particularly focus on seeking ways to enhance its financial efficiency and publicness. The data which was collected from 33 local public medical centers was analyzed by Data Envelopment Analysis to measure its financial efficiency. Then, Matrix Analysis was used to examine the association of financial efficiency and publicness of local public medical centers with related factors. In the aspects of facilities and location, according to the results, the local public medical centers which have larger number of available hospital beds or located in bigger cities were examined to have higher degree of publicness. In the aspect of human resources, greater number of doctors made both financial efficiency and the degree of publicness decreased, whereas higher participation rate of educational program for doctors affects increasing its financial efficiency and publicness. Lastly, in the aspect of costs, higher labor, material, and administrative cost diminished financial efficiency, but enhanced the degree of publicness. Based on these results, this study concluded that enhancing the publicness of local public medical centers should be pursued by increasing the accessibility with better facilities and location, and also concurrently organizing rational expenditure structure with appropriate cost investment to the resources of local public medical centers. Also, it is necessary to enhance both financial efficiency and publicness simultaneously by improving the quality of health care services through the educational programs for medical staffs.

• 한국의학물리학회지:의학물리
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• 제23권4호
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• pp.239-251
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• 2012

본 논문에서는 원격제어가 가능한 의료용 로봇 응용을 위한 웹기반-영상처리 시스템을 구현하였다. 개발된 소프트웨어 시스템은 다양한 영상처리 모듈과 원격 제어동작 모듈로 계층적으로 구성되어 있으며, 계층적 구성은 상위계층의 복잡한 응용을 위한 확장성과 웹에서의 접근성을 만족하였다. 또한, 응용환경의 변화에 따른 처리된 영상의 표시, 전송, 저장 및 공유를 위하여 다양한 DICOM, VRML, CAD (STL) 파일형식을 지원하였다. 메시지를 기반으로 한 데이터 교환과 객체-지향 모듈과 오픈소스 기반의 소프트웨어 구성은 다양한 원격 의료 응용에 따른 다양한 요구조건에 맞는 효율적인 동적 조합이 가능할 것이다.

• 보건행정학회지
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• 제32권2호
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• pp.205-215
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• 2022

Background: The purpose of this study is to identify the factors infecting the medical care utilization from a new perspective by newly classifying the categories of administrative districts using the urban decline index and medical vulnerability index as indicators. Methods: This study targeted 150,940 people who used medical services using the 2015 cohort database (DB), 2010-2015 urban regeneration analysis index DB, and 2014-2015 public health and medical statistics DB. The decline of the region was classified using the urban decline index typed using k-means clustering and the medical vulnerability index typed using the quantile score calculation. Regression analysis was performed 3 times with medical expenditure, length of stay, and the number of outpatient visits as dependent variables. Results: There were 37 stable region (47.4%), 29 health vulnerable region (37.2%), and 12 decline region (15.4%). The health vulnerable region had lower medical expenditure, fewer outpatient visits, and a higher length of stay than the stable region. The decline region was all higher than the stable region but had no significant effect. Conclusion: The factors that cause the health disparity between regions are not only factors related to individual health behavior but also environmental factors of the local community. Therefore, there is a need for a systematic alternative that properly considers the resources within the community and reflects the characteristics of the population.

• 의학교육논단
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• 제24권1호
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• pp.10-17
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• 2022

South Korea is not a wasteland of publicly funded health care-instead, it has a good medical social security system known as the national health insurance (NHI). The NHI of Korea has three unique features; (1) low premiums, low insurance fees, and low coverage; (2) obligatory designation of medical institutions; (3) and allowance of non-benefit services. These features have made hospitals and doctors interested in profit-seeking. However, the commercialization of medical institutions has taken place in both private- and public-established sectors. A basic problem of commercialization is the co-existence of the obligatory designation of medical institutions and non-benefit services. The problem became worse in the Kim Dae-Jung government because it officially permitted non-benefit services. Since 2000, the Korean government has consistently pursued benefit extension policies, but the coverage rates of the NHI have stagnated. In addition, premiums and current medical expenses have markedly increased because policy-makers have emphasized accessibility to the NHI, while ignoring important principles of medical social security such as a needs-based approach and patient-referral system. In order to resolve the commercialization problem, the obligatory designation of medical institutions to the NHI should be changed to a contract system, and non-benefit services should be prohibited at NHI institutions. We must re-establish the patient-referral system via a needs-based approach. We also need to build a primary healthcare system and public health policies. We should make a long-term plan for healthcare reform.

• Journal of Chest Surgery
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• 제49권sup1호
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• pp.28-36
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• 2016

Background: This study aimed to develop the models for regional cardiac surgery centers, which take regional characteristics into consideration, as a policy measure that could alleviate the concentration of cardiac surgery in the metropolitan area and enhance the accessibility for patients who reside in the regions. Methods: To develop the models and set standards for the necessary personnel and facilities for the initial management plan, we held workshops, debates, and conference meetings with various experts. Results: After partitioning the plan into two parts (the operational autonomy and the functional comprehensiveness), three models were developed: the 'independent regional cardiac surgery center' model, the 'satellite cardiac surgery center within hospitals' model, and the 'extended cardiac surgery department within hospitals' model. Proposals on personnel and facility management for each of the models were also presented. A regional cardiac surgery center model that could be applied to each treatment area was proposed, which was developed based on the anticipated demand for cardiac surgery. The independent model or the satellite model was proposed for Chungcheong, Jeolla, North Gyeongsang, and South Gyeongsang area, where more than 500 cardiac surgeries are performed annually. The extended model was proposed as most effective for the Gangwon and Jeju area, where more than 200 cardiac surgeries are performed annually. Conclusion: The operation of regional cardiac surgery centers with high caliber professionals and quality resources such as optimal equipment and facility size, should enhance regional healthcare accessibility and the quality of cardiac surgery in South Korea.

• 한국컴퓨터정보학회논문지
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• 제27권4호
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• pp.61-77
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• 2022

본 연구는 비대면 진료의 개념과 제도적 도입과정에 대해 살펴보고 비대면 진료를 긍정적으로 인지하는 기대 편익 변인과 부정적으로 인지하는 위험 변인들이 이용의도에 어떠한 영향을 미치는지를 PLS-SEM을 사용하여 각 잠재변수의 영향력을 실증적으로 검증하였고 연구 결과는 다음과 같이 요약될 수 있다. 첫째, 의료서비스의 질은 비대면 진료의 인지된 유용성과 인지된 용이성에 유의한 영향을 미치는 것으로 나타났다. 둘째, 접근성은 비대면 진료의 인지된 용이성과 비용 절감에 유의한 영향을 미치는 것으로 나타났다. 셋째, 비대면 진료의 기대 편익들은 이용의도에 유의한 영향을 미치는 것으로 나타났다. 넷째, 기능적 위험과 서비스 위험은 의료진 위험에 유의한 영향을 미치고 의료진 위험은 비대면 진료의 이용의도에 부(-)의 영향을 미치는 것으로 나타났다. 본 연구는 비대면 진료의 이용의도에 영향을 미치는 긍정적 요인과 부정적 요인을 고려하여 이용 의도에 미치는 영향을 도출하여 의료소비자들의 행태를 실증적으로 규명하였다는 점에서 그 의의를 찾을 수 있다.

• 농촌계획
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• 제22권2호
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• pp.121-129
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• 2016

A disaster can be defined in many ways based on perspectives, in addition, its types are able to classify differently by various standards. Considering the different perspectives, the disaster can be occurred by natural phenomenon that is like typhoon, earthquake, flood, and drought, and by the accident that is like collapse of facilities, traffic accidents, and environmental pollution, etc. Into the modern society, moreover, the disaster includes the damages by diffusion of epidemic and infectious disease in domestic animals. The disaster was defined by natural and man-made hazards in the past. As societies grew with changes of paradigm, social factors have been included in the concept of the disaster according to new types unexpected by new disease and scientific technology. Change the concept of social disasters, Ministry of Public Safety and Security (MPSS) has provided the regional safety index, which measures the safety level of a local government. However, this regional safety index has some limitation to use because this index provides the information for city unit which is a unit of administrative districts of urban. Since these administrative districts units are on a different level with urban and rural areas, the regional safety index provided by MPSS is not be able to direct apply to the rural areas. The purpose of this study is to determine the regional safety index targeting rural areas. To estimate the safety index, we was used for 3 indicators of the MPSS, a fire, a crime, and an infectious disease which are evaluable the regional safety index using an accessibility analysis. For determining the regional safety index using accessibility from community centers to public facilities, the safety index of fire, crime, and infectious disease used access time to fire station, police office, and medical facility, respectively. An integrated Cheongju, targeting areas in this study, is mixed region with urban and rural areas. The results of regional safety index about urban and rural areas, the safety index in rural area is relatively higher than in the urban. Neverthless the investment would be needed to improve the safety in the rural areas.