• 한국콘텐츠학회논문지
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• 제17권4호
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• pp.585-595
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• 2017

본 연구는 의료급여와 건강보험환자의 의료이용량의 차이를 분석하여 의료급여환자의 도덕적 해이로 인한 진료비 증가문제를 평가하고 합리적 의료급여 정책결정의 근거를 제시하기 위한 것이다. 이를 위하여 서울시민대상 건강보험과 의료급여 급여자료를 성별 연령별 의료기관 종별로 비교 분석하였다. 분석결과는 다음과 같다. 첫째, 상급종합병원의 입원 외래이용 모두 의료급여환자가 건강보험환자에 비해서 적어서 도덕적 해이가 존재하지 않았다. 오히려 의료급여환자들이 고비용 의료서비스를 이용하고 못하고 있었다. 둘째, 종합병원의 입원이용은 건강보험환자가 많은 반면 외래이용은 의료급여환자가 많아서 의료급여환자들이 본인부담이 적은 외래서비스 이용을 많이 이용하고 있었다. 셋째, 병원 의원은 의료급여환자의 이용이 입원과 외래이용 모두 건강보험환자에 비해서 많았다. 따라서 의료급여환자들은 병원 의원의 입원과 외래이용, 종합병원의 외래이용시 적은 본인부담으로 인해 불필요한 의료이용을 할 가능성이 있는 반면에 상급 종합병원 입원과 외래이용, 종합병원의 입원이용시 비급여 의료비 등 과도한 의료비 부담으로 인해 필요한 의료서비스 이용을 하지 못할 가능성도 있었다. 따라서 중증질환을 가진 의료급여환자들의 의료비 부담을 경감시키기 위한 정책은 지속하고, 의원 병원을 이용하는 의료급여환자들이 불필요한 의료서비스를 이용하지 않도록 관리해야 할 것이다.

• 한국의료질향상학회지
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• 제2권2호
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• pp.112-129
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• 1996

Background : A small number of high cost patients usually spend a larger proportion of scarce health resources. Aged, long-term care and readmitted patients usually belong to these high cost patient group. Among others, long length of stay and readmission can be reduced by checking its cause, and these are the areas needed most of quality improvement activity. Characteristics of high cost medical users between health insurance program and medical assistance program were reviewed. Methods : The inpatient claims of health insurance and medical assistance program were analyzed. Patients were divided by 6 groups; long-term, mid-term, short-term, readmitted, cancer and aged. We defined high cost patients as those who had spent one and half million won and over per 6 months. Characteristics of high cost patients for each group were reviewed. Results : medical assistance patients used much more resources than the insured members in the average hospital cost per case but less in daily hospital cost. The former had a longer length of stay and had much heavier diseases. Major diseases of both group were cancer, diseases of circulatory system and chronic degenerative diseases. Gallstone and schizophrenia were more in the insured program. However, pulmonary tuberculosis, asthma were more common among the medical assistance patients. Early readmission before 2 weeks were 28-30% of the total readmission. Readmission rate in the malignat neoplasm and renal failure were 80% and more. Q.A program should be installed to prevent unnecessary readmissions. Conclusion : Almost 30% of early readmissions and admissions due to complications and long length of stay should be reviewed carefully to keep cost down and to enhance the quality of hospital care.

• Journal of Preventive Medicine and Public Health
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• 제36권1호
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• pp.33-38
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• 2003

Objectives : To assess the difference in the volume of psychiatric treatments provided to health insurance inpatients, compared with those on medical assistance(the medical aid program) Korean psychiatric hospitals, and to determine factors which affect the volume of the services. Methods : 21 psychiatrists, from 3 Korean psychiatric hospitals recorded the frequencies psychiatric treatments provided to inpatients in one week (February 18-24, 2002). The records of 329 patients were analyzed through t-tests, and random effectmixed model analyses to define the difference between the two groups, and to find other factors affecting the volume of service. Results : A significant difference in the volume of psychiatric treatments provided was observed between the health insurance and medical assistance groups. The variation in the volume of service between hospitals was prominent, and other factors (gender, agegroup, length of stay and mental disorder)were also found to be significant. The patients on medical assistance received only 70% of the psychiatric treatments of those on health insurance. Conclusions : More effort is required to improve the methods of payment to increase the level of fee scheduling for medical assistance. Further studies on the mechanisms causing these differences in the volume of service are required.

• 치위생과학회지
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• 제21권1호
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• pp.70-78
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• 2021

Background: The aim of this study was to analyze the public demand for information about the job of dental hygienists by mining text data collected from the online Q & A section on an Internet portal site. Methods: Text data were collected from inquiries that were posted on the Naver Q & A section from January 2003 to July 2020 using "dental hygienist job recognition," "role recognition," "medical assistance," and "scaling" as search keywords. Text mining techniques were used to identify significant Korean words and their frequency of occurrence. In addition, the association between words was analyzed. Results: A total of 10,753 Korean words related to the job of dental hygienists were extracted from the text data. "Chi-lyo (treatment)," "chigwa (dental clinic)," "ske-illing (scaling)," "itmom (gum)," and "chia (tooth)" were the five most frequently used words. The words were classified into the following areas of job of the dental hygienist: periodontal disease treatment and prevention, medical assistance, patient care and consultation, and others. Among these areas, the number of words related to medical assistance was the largest, with sixty-six association rules found between the words, and "chi-lyo," "chigwa," and "ske-illing" as core words. Conclusion: The public demand for information about the job of dental hygienists was mainly related to "chi-lyo," "chigwa," and "ske-illing" as core words, demonstrating that scaling is recognized by the public as the job of a dental hygienist. However, the high demand for information related to treatment and medical assistance in the context of dental hygienists indicates that the job of dental hygienists is recognized by the public as being more focused on medical assistance than preventive dental care that are provided with job autonomy.

• Safety and Health at Work
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• 제8권1호
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• pp.89-93
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• 2017

Background: Rates of overweight and obese Australians are high and continue to rise, putting a large proportion of the population at risk of chronic illness. Examining characteristics associated with preference for a work-based weight-loss program will enable employers to better target programs to increase enrolment and benefit employees' health and fitness for work. Methods: A cross-sectional survey was undertaken at two Australian mining sites. The survey collected information on employee demographics, health characteristics, work characteristics, stages of behavior change, and preference for workplace assistance with reaching a healthy weight. Results: A total of 897 employees participated; 73.7% were male, and 68% had a body mass index in the overweight or obese range. Employees at risk of developing obesity-related chronic illnesses (based on high body mass index) were more likely to report preference for weight management assistance than lower risk employees. This indicates that, even in the absence of workplace promotion for weight management, some at risk employees want workplace assistance. Employees who were not aware of a need to change their current nutrition or physical activity behaviors were less likely to seek assistance. This indicates that practitioners need to communicate the negative effects of excess weight and promote the benefits of a healthy lifestyle to increase the likelihood of weight management. Conclusion: Weight management programs should provide information, motivation. and trouble-shooting assistance to meet the needs of at-risk mining employees, including those who are attempting to change and maintain behaviors to achieve a healthy weight and be suitably fit for work.

• 대한영양사협회학술지
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• 제27권4호
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• pp.232-247
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• 2021

This study attempted to examine the nutrition knowledge of caregivers for the elderly and the diet-related medical treatment and dietary assistance given by them. Thus, this research is a descriptive study focusing on the current nutritional knowledge of caregivers and the dietary assistance given by them. The survey included a questionnaire (nutritional knowledge level of digestive system diseases, diabetes, cardiovascular risk, brain disease, bone disease, and meal assistance performance status) for caregivers working in nursing homes for the elderly. Self-administered questionnaires were completed by 235 caregivers between February and March 2020. The results were analyzed using the SPSS 25.0, and the significance test of each question was verified by the Friedman test and the Chi-square independence test. The number of elderly people who needed meal assistance from caregivers was 4.4 more than the average. The most common types of meal assistance were partial assistance (59.20%) and the task of when to stop eating for the elderly (58.71%). Besides, the higher nutritional knowledge level of the caregivers, the more the time spent on services related to meal assistance (P<0.001), and the higher the meal assistance level. The disease state of the elderly was considered the most relevant (P<0.001). Caregivers with high levels of knowledge and offering significant meal assistance were found to have received nutrition education (P<0.001). Up to 80% of the respondents needed nutrition education, and most of them answered that they needed education on appropriate management methods for the specific disease state of the elderly (P<0.01). Accordingly, providing nutrition education for caregivers for the elderly should be a means to improve their ability to offer meal assistance.

• 지역사회간호학회지
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• 제8권1호
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• pp.116-132
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• 1997

The purpose of the study is to find out how laws related to the nursing profession can be improved by analyzing the rules and regulations concerning nursing. Furthermore, to help settle legal matters in the process of doing nursing work. The data used for the study are the Health and Medical Act, the Maternal and Child Health Act, the School Health Act, the Special Act for Health and Medical Service in Rural Areas, the Industrial Health & Safety Act and the Notice on Nursing Professional Courses analyzed by age and content. The results of the study are as follows : First, basic nursing practice includes 'nursing care for recuperation and assistance in medical treatment and in special areas including the pre-vention of disease, maintenance of health, control of environment, and other therapeutic activities. It is suggested that the phrase 'assistance in medical treatment' should be eliminated as it limits the basic nursing practice to the assistance of the medical treatment. Second, Article 56 of the Health & Medical Act prescribes a special nurse but it does not prescribe a specific job. Accordingly, the new provison concerning the specific jobs of a special nurse should be added or a job guide should be inseated. Third, it is prescribed that those who have completed the training course after obtaining a license are qualified to be a midwife, a special nurse and a nurse practitioner working in special areas. However, school nurses, occupational health nurses and maternal and health workers are required to obtain a nurse license, but not to take an additional training course. Nurses working in special areas should be legally recognized as nurse specialists. The regulations to control various qualification standards consistently should be established. Fourth, the qualifications and types of nurses by area prescribed by Article 54 of the Health and Medical Act are not consistent with those of special nurses as recognized by affiliated organizations of the Korean Nurse Association and some hospitals. Accordingly, the qualifications and types of special nurses should be adjusted in consideration of special nurses. Fifth, as Article 16, Paragraph 2 of the Health and Medical Act does not prescribe the type and scope of first - aid treatment that nurses can provide, the first-aid treatment of nurses might be considered as an unlicensed practice. The specific regulations regarding these matters should be established. Sixth, the contents of the nursing record, which are prescribed by Article 21 of the Health and Medical Act as a duty, include 1) matters concerning body temperature, pulse, breath and blood pressure 2) matters concerning drug prescription 3) matters concerning input and output 4) matters concerning the treatment and nursing care (Article 17 of the Enforcement Regulations, Health and Medical Act). However, these matters are limited to basic nursing care and assistance in medical treatment. The new recording methods on nursing process are suggested to be adopted legally. Seventh, the prescription right entrusted to nurses which are prescribed by the School Health Act, the Special Act on Health and Medical Service for Rural Areas, and the Industrial Health and Safety Act are not consistent with the rights of nurses as prescribed by the Health and Medical Act. New regulations prescribing the partial right for medical treatment entrusted to nurses in consideration of the restraint of time and place in emergency situations should be established.

• 한국산업정보학회논문지
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• 제27권4호
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• pp.115-126
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• 2022

코로나 19 팬데믹으로 인하여 보건의료분야 공적개발원조(ODA)의 중요성이 강조되고 있다. ODA 사업으로 지원된 의료기기의 운영관리, 유지보수에 대한 사후관리, 이를 실현하기 위한 직종별 차별화된 교육훈련 제공이 필요하다. 본 연구에서는 효과적인 의료기기 사후관리, 운영관리를 위해 직종(사용자와 유지보수자)간 교육훈련 성취도의 차이분석을 t-test 검증을 통해 분석하였다. 분석결과, 의료기기 사용자와 유지보수자 간 중점관리 대상 의료기기 6종류의 사용법과 관리방법(Q5), 각 의료기기의 사용 매뉴얼 이해(Q6)에서는 집단 간 차이가 있는 것으로 분석되었지만, 교육의 필요성, 목적, 강사에 대한 만족도 및 직종 간 커뮤니케이션의 필요성에서는 차이가 없는 것으로 분석되었다.

• 한국응급구조학회지
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• 제23권2호
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• pp.19-31
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• 2019

Purpose: This study aimed to investigate disaster preparedness competence and disaster response competence of paramedics working in emergency medical centers operating a disaster medical assistance teams. Methods: Data of 174 emergency medical technician(EMT)-paramedics were collected from July 15 to August 14, 2018 at regional and local emergency medical centers that operate disaster medical assistant team. Analysis of the data was carried out with IBM SPSS statistics 24.0 software (IBM, Armonk, NY, USA). Results: The mean disaster preparedness competence score was $3.57{\pm}0.63$ (out of five). Participants' disaster preparedness competence significantly differed according to type of emergency medical center (p<.000), disaster education experience (p<.000), and education frequency (p=.001). The mean disaster response competence score was $4.09{\pm}0.57$ (out of five). Participants' disaster response competence significantly differed according to disaster education experience (p<.000) and medical assistance experience (p=.045). Conclusion: Emergency medical technician-paramedics without disaster training should first be provided with this training. Further, it is important for EMT-paramedics to know their disaster preparedness and response capacities and strengthen their shortcomings. It is also important to develop education and training programs that properly equip EMT-paramedics with practical competencies.

• 의료법학
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• 제15권2호
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• pp.195-223
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• 2014

Nurses are medical care providers most closely associated with the national health. Their works are subdivided and specialized, and it is such a factor making nurse's role more important, and with the appearance of specialized nurses, they have secured a position as an independent medical care provider. As the domain of nurse's service becomes broader, there are more accidents and disputes related to nurses. However, there are not many studies conducted on such problems, and even when medical disputes take place related to nurses, the court does not make consistent judgments as a matter of fact. Besides, as the ambiguity of nurse's range of service and the lack of nursing workforce work as a factor causing nurse's medical malpractice, more legal discussions and studies are required to seek proper solutions to such problems. Thus, as a plan to clarify legal issues likely to occur due to nurse's medical practice, this study classified nurse's work into medical assistance practice and other jobs based on their own independent judgments, and proposed establishing concrete regulations on the range of their work, while reviewing common problems extracted from precedents related nurse's medical malpractice. Moreover, while examining Japanese precedents related to the Act of Medical Service Personnel, Nurses and Midwives, which is the sole act of nurses in Japan, this study reviewed the necessity of revising the present nurse-related regulations in Medical Service Act, or enacting a sole act of nurses.