• Korean Journal of Occupational Health Nursing
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• v.20 no.3
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• pp.299-307
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• 2011

Purpose: The purpose of this study is to establish the standards for duty of Medical Care Client Managers and analyze the extent of accomplishment, importance, and difficulty according to the standards. Methods: The draft for duty of Medical Care Client Managers was formed by the method of developing a curriculum (DACUM) and data were collected from 185 Medical Aid Client Managers in 234 areas to evaluate the actual frequency of accomplishment, importance and difficulty in comparison with the standards for duties. Results: The standard duty draft for Medical Care Client Manager is composed of five separate groups of duties and thirty five tasks. The five duties are Case Management, Extension Approval, External Cause of Injury, Duplicate Claims and Other Administrations. Seven Tasks are allocated to each duty such as Case Management, Extension Approval and External Cause of Injury. Five tasks are allocated to 'Duplicate Claims' duty and nine tasks are allocated to 'Other Administrations' duty. Conclusion: From the results of analysis for duties, it was apprehensive about overburdened responsibilities and carelessness in professional duties. It was necessary to establish specific guidelines for duties because of redundent application or regional variation in frequency of accomplishing other administrative duties. It was necessary to relieve a regional disparity of business charge and also was necessary to propose an alternative plan to relieve the overburdened responsibilities.

• The Journal of the Korea Contents Association
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• v.17 no.8
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• pp.610-618
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• 2017

Sex offense by medical practitioners has been occurring continuously in Korea leading to not only patients but the general public expressing anxiety and increased distrust in the medical field. The government has been pushing ahead with the legislation or revision of law to increase the penalties on sexual offenders in response to requests for a stricter legal framework to address sex offense cases and has expressed a strong commitment to actively resorting to administrative corrective measures towards sexually offending medical practitioners. Unlike such an overall social atmosphere, the Judiciary that is in charge of applying the law seems not to perceive the seriousness of sex offense cases committed by medical practitioners. A doctor who had sexually assaulted a middle school female student during medical treatment at a pediatric hospital was found innocent by the supreme court, which was a ruling in direct contrast to overall public sentiment. As such, this study seeks to analyze the precedent on cases involving sex offense by medical practitioners with a focus on the above-mentioned case and present implications. The study seeks to dispel distrust in the overall medical field by addressing the gap in legal interpretation towards sex offense committed by medical practitioners and thus provide basic data that can help the general public receive quality medical services in a safer environment.

• Korean Medical Education Review
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• v.24 no.1
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• pp.18-34
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• 2022

The purpose of this study is to clarify the background of the controversial attempt to establish a new public medical school linked to compulsory service as a means of strengthening public healthcare in Korea, and to raise anticipated problems with possible solutions. In Korea, healthcare is predominantly provided by the private sector focused on medical care, rather than public healthcare, even under the national health insurance system. The government has been mainly in charge of public health and unmet medical services from a residual perspective, but health inequalities still exist. To resolve this issue, the government created the concept of public health and medical service (PHMS) from a universal perspective and tried to strengthen the infrastructure of public healthcare and to foster core PHMS doctors by establishing a new public medical school linked to compulsory service in medically vulnerable areas. This study investigated the reality and concept of the new public medical school planned by the government, and identified problems such as the possibility of obtaining accreditation and evaluation before its establishment, the side effects of dividing doctors' roles, the waste of huge amounts of resources, and insensitive policies. In conclusion, in order to resolve health inequalities in Korea, we need to train doctors through medical school education that strengthens the social responsibility of doctors along with strengthening public healthcare infrastructure, and to provide a better environment for doctors working in medically vulnerable areas through sophisticated policies.

• Korean Medical Education Review
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• v.24 no.2
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• pp.156-171
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• 2022

The purpose of this study was to establish a model for constructing longitudinal data for medical school, and to structure cohort and longitudinal data using data from Yonsei University College of Medicine (YUCM) according to the established input-environment-output (I-E-O) model. The study was conducted according to the following procedure. First, the data that YUCM has collected was reviewed through data analysis and interviews with the person in charge of each questionnaire. Second, the opinions of experts on the validity of the I-E-O model were collected through the first expert consultation, and as a result, a model was established for each stage of medical education based on the I-E-O model. Finally, in order to further materialize and refine the previously established model for each stage of medical education, secondary expert consultation was conducted. As a result, the survey areas and time period for collecting longitudinal data were organized according to the model for each stage of medical education, and an example of the YUCM cohort constructed according to the established model for each stage of medical education was presented. The results derived from this study constitute a basic step toward building data from universities in longitudinal form, and if longitudinal data are actually constructed through this method, they could be used as an important basis for determining major policies or reorganizing the curricula of universities. These research results have implications in terms of the management and utilization of existing survey data, the composition of cohorts, and longitudinal studies for many medical schools that are conducting surveys in various areas targeting students, such as lecture evaluation and satisfaction surveys.

• Health Policy and Management
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• v.33 no.3
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• pp.253-263
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• 2023

Background: The purpose of this study was to explore the relationship between the local extinction index and total medical service utilization. Methods: A fixed effects model in panel analysis was performed for the 228 administrative districts in Korea. The statistical yearbook on the usage of medical services by region and Korean Statistical Information Service data were used from 2010 to 2019 for analysis. Medical service utilization was represented by the number of visits day, the number of inpatient days, and medical charges. Control variables were selected by using an Anderson model. The local extinction index was calculated using resident registration population data. Results: Descriptive statistics showed that the number of areas at risk of extinction increased from 61 to 95 for the study years. In addition, the number of visits, the number of inpatient days, and medical charges all increased during the study years. After controlling for variables affecting medical service utilization and doing a panel fixed effects model, the result suggested that a one-step increase in the local extinction index was significantly associated with a 12.29% decrease in medical charges of inpatients, a 7.33% decrease in medical charge of outpatient, a 5.21% decrease in the number of inpatient day, and a 5.54% decrease in the number of visits day. Conclusion: This study showed that the higher the region's extinction risks, the higher the region's total medical service utilization. The results of this study suggested that there was a disparity in medical service utilization between areas at risk of extinction and areas not at risk of extinction, so measures should be taken to address this disparity.

• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.139-171
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• 2018

The 「Act on Remedies for Injuries from Medical Malpractice and Mediation of Medical Disputes」(hereinafter referred to as 'the Act on Mediation of Medical Disputes') provides that the state should compensate the victims of medical accidents occurred irresistibly in childbirth despite that health and medical service personnel fulfilled their duty of care for their damage within the range of its budget(Article 46 of the Act on Mediation of Medical Disputes). Given that victims of medical accidents could expect demage recovery only through lawsuits thus far, this act can be said to be a groundbreaking act. However, However, as 30% of the costs for such medical accident compensation projects are borne by those who have records of childbirth among the founders of health and medical institutions (Article 21 of the Act on Mediation of Medical Disputes), there has been a question about whether doctors are held responsible despite that the accidents such as the deaths of mothers and newborn babies occurred irresistibly without doctors' fault. However, recently, the Constitutional Court ruled that 'the range of founders of health and medical institutions' and 'share ratios of finances for compensation' in Article 46 (3) of the Act on Mediation of Medical Disputes' related to the imposition of the share of costs are institutional (Constitutional Court ruling dated April 26, 2018, 2015Heonga13, hereinafter referred to as 'the ruling in the case'). Although the ruling in the case was made based on only the principle of statutory reservation and the principle of ban on comprehensive authorization, this paper added a practical judgment. This paper proved that the share of costs in this case has the nature of burden charges in pursuit of study and does not infringe on the property rights of the founders of health medical institutions even in light of the principle of proportionality because there is a legitimate reason for imposing the burden charge. The imposition of the share of costs in the system for compensation for medical accidents occurred irresistibly is against the principle of liability with fault in part. However, the medical accident compensation projects are rational a national policy for the victims of medical accidents and the medical world clearly gains some benefits from the effect to terminate medical disputes. The expansion of finances for compensation through the payments of the share of costs will reduce the suffering and misunderstanding of victims of medical accidents occurred in the process of childbirth and will be very helpful to the construction of stable treatment environments of medical workers by quickly establishing the medical accident compensation projects as such.

• The Journal of Internal Korean Medicine
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• v.31 no.2
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• pp.264-272
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• 2010

Objectives : This study was carried out to measure perceptions about Traditional Korean Medicine hospitals and provide data for improvement of TKM hospital management. Methods : We surveyed the general population from 1st to 17th December, 2008, and patients visiting a TKM hospital from 1st June to 9th December, 2008. Results : Result as follows. 1. The response ratio for the generally preferred medical institution was in the order of western medical clinic, pharmacy, general hospital, TKM clinic, TKM hospital. 2. The response ratio for the preferred medical institution for herbal medicine treatment was in the order of TKM clinic, herbal medicine store, TKM hospital, pharmacy. The preferred medical institution for acupuncture treatment was in the order of TKM clinic, TKM hospital, acupuncture clinic, public health center. 3. The most common response to reason for receiving traditional Korean medical care was "traditional Korean medical care is more effective than western medical care." 4. The proportion of first treatment and second treatment of patients visiting at TKM hospital was about 1:1. 5. 72.3% of patients had been to another medical institution. 6. The response ratio for the first visited medical institution for the same disease was in the order of general hospital, western medical hospital, western medical clinic, TKM clinic. 7. The response ratio for the concern about TKM treatment was in the order of expensive charge for TKM treatment, uncertainty of TKM treatment effect. Conclusions : Through this research, we can understand the perception about TKM hospital treatment of the general population and patients visiting TKM hospitals.

• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.3-40
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• 2018

Conventionally, there were few cases in which a medical accident became a criminal case in Japan. However, after the serious malpractice such as the Yokohama City University Hospital case, prosecutors came to be less hesitant to prosecute a malpractice. In a medical accident, the attribution of the responsibilities among medical personnel becomes one important element of the proof of negligence. The Supreme Court concluded that, when the attribution of the responsibilities is not established among medical personnel to confirm the identity of the patient like the Yokohama City University Hospital case, all the personnel who were involved bear the responsibilities to identify the patient. For serious cases which requireut most carefulness fortreatment such as the Saitama Medical University Hospital case, not only the chief physician in charge of the case concerned but also the director of the branch at the university hospital bear the responsibilities to confirm the treatment policy of the case. After the acquittal of the Ohno Hospital case, the voice demanding more prudent prosecution of malpractices has become stronger than before. Meanwhile, Ministry of Health, Labour and Welfare introduced Medical Accidents Investigation System for the prevention of medical accident and, has reinforced the third party inspection of medical accidents.

• Health Policy and Management
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• v.29 no.1
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• pp.40-48
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• 2019

Background: As of July 2015, per diem payment was changed from fee for service Therefore, this study aims to analyse changes in medical charges and medical services before and after enforcement of the palliative care, targeting palliative care wards in a general hospital, and provide basic data needed for development of per diem payment. Methods: The subjects of the study were a total of 610 cases consisting of 351 patients of service fee who left hospital (died) from July 2014 to June 2016 and 259 ones of per diem payment at Chosun University Hospital in Gwangju Metropolitan City. Results: The results are summarized as follows. First, after the palliative care system was applied, benefit medical service charges and insurance increased significantly (p<0.001). As benefit medical service charges increased, benefit private insurance payment increased significantly (p<0.001). Second, after the per diem payment was applied, total private insurance payment to medical institutes decreased significantly (p=0.050) and non-benefit also decreased significantly (p=0.001). Conclusion: It is suggested that additional rewards in the obligatory palliative care items should be continuously remedied and monitored to provide good quality hospice palliative care.

• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.545-556
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• 1994

Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. ［P=0.009］ By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.