• Journal of Society of Preventive Korean Medicine
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• v.23 no.2
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• pp.117-127
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• 2019

Objectives : Korean medicine practice is not specifically described in medical law, and then has always been a quarrel. So far The criteria for judgment in Korean Medicine Doctor's Medical Devices Using should clinically prove it only by Korean medicine theory and academic Traditionally descending from old ancestors. Comprehensively review of Korean Medicine Doctor's Medical Devices Using and Duty of Care, and then present a new understandings to determine future Korean Medicine Practice. Method : An existing court cases of Korean Medicine Doctor's Medical Devices Using and Duty of Care were reviewed. After reviewing various papers published for several years, various opinions were reviewed and suggested. Results : The range of Korean Medicine Doctor's Medical Devices Using has changed since the 1951 National Medical Law stipulated Korean medicine as medical professionals. The issue of the recent ruling that distinguishes medical practice from Korean medicine practice were condensed into what emphasis to interpret amongst 1) The basic principles of learning, 2) Curriculum and professionalism, 3) Risks. The Constitutional Court's ruling was important in order of 'Risk', 'curriculum and expertise', and 'basic principles of learning.' A duty of Care means an obligation to pay attention to something. A duty of Care does not mean a "highest level," but requires a "best care" and does "best under given conditions." Even in the duty of Care, Because Korean medicine has a purpose to protect and promote the health of the people, Some standards of western medicine have to be adapted to the current general medical technology. Korean Medicine doctors can recognize the duty of care in the "some basic range" of knowledge belonging to western medicine. Conclusions : The interpretation of Korean Medicine practice are currently in compatible the argument that should clearly divide Korean medicine from Western medicine, and that should be changed in light of the changing medical environment. Therefore If Korean medicine's standard is applied to the extent to which Korean Medicine doctors are educated, it is necessary to define a new definition to actively interpret Korean Medical practice. The academic basis of Korean medicine and the level of Korean medicine practice based on the books that are traditionally available, and then current textbooks of Korean Medicine College, Korean Medicine Clinical Care Guidelines, and classification of Korean standard medical practices should be standardized. Increasingly, Korean Medicine practice should be interpreted according to reality, focusing on protecting and promoting the health of the people rather than academic differences.

• Journal of Information Technology Applications and Management
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• v.28 no.1
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• pp.1-12
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• 2021

The purpose of this study is to analyze the medical ecosystem in the post-corona era. In addition, this study introduces a new medical CRM model that allows primary-level hospitals to overcome the economic difficulties and to occupy a competitive advantage in the post-corona era. The medical environment in the post-corona era is expected to be changed by non-face-to-face treatment, reinforcement of public medical care, the transformation of a medical system centered on the primary-level hospitals, and the use of AI and big data technologies. The medical CRM model presented in this study emphasizes the establishment of mutual customer relationships through close information exchange between patients, primary-level hospital, and the government. In the post-corona era, primary-level hospitals should not simply be approached as private hospital pursuing profitability. These should be reestablished as the hospitals that can provide public health care services while ensuring stable profitability.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.37-47
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• 2024

Purpose: This study aimed at developing a novel tube thoracostomy technique using the sternum, a fixed anatomical structure, as an indicator to reduce the possibility of incorrect chest tube positioning and complications in patients with chest trauma. Methods: This retrospective study analyzed the data of 184 patients with chest trauma who were aged ≥18 years, visited a single regional trauma center in Korea between April and June 2022, and underwent chest computed tomography (CT) with their arms down. The conventional gold standard, 5th intercostal space (ICS) method, was compared to the lower 1/2, 1/3, and 1/4 of the sternum method by analyzing CT images. Results: When virtual tube thoracostomy routes were drawn at the mid-axillary line at the 5th ICS level, 150 patients (81.5%) on the right side and 179 patients (97.3%) on the left did not pass the diaphragm. However, at the lower 1/2 of the sternum level, 171 patients (92.9%, P<0.001) on the right and 182 patients (98.9%, P= 0.250) on the left did not pass the diaphragm. At the 5th ICS level, 129 patients (70.1%) on the right and 156 patients (84.8%) on the left were located in the safety zone and did not pass the diaphragm. Alternatively, at the lower 1/2, 1/3, and 1/4 of the sternum level, 139 (75.5%, P=0.185), 49 (26.6%, P<0.001), and 10 (5.4%, P<0.001), respectively, on the right, and 146 (79.3%, P=0.041), 69 (37.5%, P<0.001), and 16 (8.7%, P<0.001) on the left were located in the safety zone and did not pass the diaphragm. Compared to the conventional 5th ICS method, the sternum 1/2 method had a safety zone prediction sensitivity of 90.0% to 90.7%, and 97.3% to 100% sensitivity for not passing the diaphragm. Conclusions: Using the sternum length as a tube thoracostomy indicator might be feasible.

• Health Policy and Management
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• v.11 no.4
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• pp.1-20
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• 2001

Korean government had introduced copayment system as cost sharing to office-based medical care in order to reduce the demand for care in 1986. This review focuses on trends and characteristics of copayment on office-based medical care from 1991 to the end of Jan. 2001. Objectives of this study is ${\circled}1$ to analyse historical trends of copayment on office-based medical care during the last decade, ${\circled}2$ to analyse the effect of copayment introduced to office-based medical care on NHI finance, ${\circled}3$ to analyse the changing trends of the size of copayment in utilizing office-based medical care for the past 10 years, ${\circled}4$ to evaluate the meaning of copayment alteration implemented after the introduction of new prescription system and finally ${\circled}5$ to draw a some policy implications from the results of this review. We found that the main purpose of copayment introduction had been reduction in the expenditure of NHI finance. But, the reduction effect of insurer's expenditure has turned out to be negative and NHI finance has been in crisis after the introduction of new prescription system. Also, the copayment level of the insured has increased actually on a large scale. It seems that the introduction of new prescription system has changed the meanings and its policy implications of copayment system.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.3
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• pp.582-588
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• 2011

The objective of this study is to examine the difference about manner of utilization and satisfaction on western and oriental medical care. The data came from the National Health and Nutrition Examination Survey in 2001 and 2005. The Andersen model of health behavior was employed to make this analysis. The major statistical methods used in this analysis are chi-square test and logistic regression. The major findings are as follows; Medical care is totally increased in 2005 in comparison with 2001, but medical care in the oriental side is decreased. There is no significant variables in predisposing factors such as sex, age, education level and spouse. Of health behavior factors, the average persons in health state are more favorable in oriental care rather than western care. Oriental care is favorably taken in health insurance subscribers and residents in a large city of enabling factors. The patients with musculoskeletal disease are more dependent in oriental care than western medical care. In conclusion, the findings show that it is largely related to patients' health state, medical insurance, living area and disease types to take oriental medical care. These characteristics should be considered in establishing policies of the oriental medical care in the future.

• The Korean Journal of Emergency Medical Services
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• v.18 no.3
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• pp.19-35
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• 2014

Purpose: This study aimed to improve the quality of prehospital emergency care for elderly patients by determining current prehospital care status based on run sheets and level of knowledge, and prehospital care confidence toward the elderly through questionnaires answered by 119 emergency medical technicians (EMTs). Methods: This study was conducted with 4,946 elderly patients who were transferred to the hospital by 119 ambulances in D city from March 1, 2013 to February 28, 2014. This study was a descriptive study of 119 run sheets. The questionnaire was completed by 160 EMTs working in D city. All data were analyzed by using SPSS 21.0. Results: 74.2% was due to disease among the 4,946 elderly patients who were transferred by 119 ambulances, and a rest was due to injury. The mean knowledge score of the 119 EMTs regarding elderly patients was low. Their confidence on prehospital care of the elderly patients statistically significantly differed according to career at hospital and education. Conclusion: Theoretical knowledge, education on prehospital care of the elderly, and repeated technical prehospital care education and training accompanied by feedback assessment by 119 EMTs are needed.

• Journal of Digital Convergence
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• v.12 no.7
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• pp.327-336
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• 2014

This study aims to identify factors to affect regular utilization status of medical care in cardio-cerebrovascular patients. The research selected 770 cardio-cerebrovascular patients among surveyees from the Korea Health Panel 2010. We analyzed states of medical care utilization using descriptive statistics. Logistic regression analysis was used to examine the main factors associated with regular utilization status of medical care in cardio-cerebrovascular patients. In result, the significant factors associated with regular utilization status of medical care in cardio-cerebrovascular patients were age, education level, household income level. CCI, presence or absence of high risk drinking, and presence or absence of obesity. There's a high probability that patients aged between 60 and 69, equal to and higher than those of high school graduate in education level, upper middle class in household income, the higher CCI, absence of high risk drinking, presence of obesity utilize medical care services more regularly. Therefore, it is necessary to develop effective program and individualized approach for patients using lesser periodical medical care and patients with high risk drinking problem. In the future, these findings can be used an important data for healthcare policy and assessment.

• Health Policy and Management
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• v.26 no.2
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• pp.115-124
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• 2016

Background: This study aims at making a survey on health care service providers' cultural competence and making an appraisal of Chinese medical tourists on service quality, health care service providers' cultural competence, perceived value, and satisfaction. Methods: The data was collected from August until November, 2014 and 150 health care service providers and 65 Chinese medical tourists from 12 medical institutions in Daegu were enrolled in analysis. Results: The results showed that health care service provider's knowledge on Chinese culture was very low with 33.5% of correct answer. Health care service providers were found to get 3.82 point on a 5 point-scale in cultural perception, 3.53 points in cultural sensitivity, and 2.85 points in cultural skills. Chinese medical tourists were analyzed to give 4.08 points on a 5-point scale to satisfaction on health care service, followed by 4.01 points to health care service quality, 4.00 points to perceived value of health care service, and last 3.85 points to a health care service providers' cultural skills. However, there was a difference in points in cultural skills between health care service providers and Chinese medical tourists. Chinese medical tourists' satisfaction with health care service in Daegu was found to be comparatively high, but in relation to satisfaction with communication, it was found to be relatively low. Conclusion: Through this research, health care service providers' knowledge level of Chinese culture and cultural skills were low while they seemed to take a half-hearted attitude towards educational experience for building up cultural competence and foreign patient service response.

• Health Policy and Management
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• v.26 no.4
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• pp.390-398
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• 2016

Background: This study aims to analyze the impact of levels of health care coverage on the trajectory of self-rated health, comparing the near-poor which tends to be excluded in traditional health care systems with the upper middle class. Methods: The study participants were 3,687 people who sincerely responded questions regarding health care expenditures, unmet medical needs, and self-rated health in the Korea Health Panel data in 2009-2012. Results: The higher health care expenditures and the presence of unmet medical needs were significantly associated with the lower level of self-rated health. However, both factors did not significantly predict the steeper decline in the self-rated health. The results from multiple group analyses showed that health care expenditures and unmet medical needs had greater impact on the near-poor compared to their higher income counterparts. Conclusion: Public health care coverages need to be enhanced as well as reducing health care expenditures and unmet medical needs.

• Health Policy and Management
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• v.32 no.4
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• pp.389-399
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• 2022

Background: This study aimed to analyze changes in medical utilization and cost before and after long-term care (LTC) implementation. Methods: We used the National Health Information Database from National Health Insurance Service. The participants were selected who had a new LTC grade (grade 1-5) for 2015. Medical utilization was analyzed before and after LTC implementation. Segmented regression analysis of interrupted time series was conducted to evaluate the overall effect of the LTC implementation on medical costs. Results: The total number of participants was 41,726. A major reason for hospitalization in grade 1 was cerebrovascular diseases, and dementia was the top priority in grade 5. The proportion of hospitalization in grade 1 increased sharply before LTC implementation and then decreased. In grade 5, it increased before LTC implementation, but there was no significant difference after LTC implementation. As for medical cost, in grades 1 to 4, the total cost increased sharply before the LTC implementation, but thereafter, changes in level and trend tended to decrease statistically, and for grade 5, immediately after LTC implementation, the level change was decreasing, but thereafter, the trend change was increasing. Conclusion: Long-term care grades showed different medical utilization and cost changes. Long-term care beneficiaries would improve their quality of life by adequately resolving their medical needs by their grades.