• 제목/요약/키워드: Medical charge

검색결과 519건 처리시간 0.034초

A Study on Factors for Improving CPR based on Health Care Professionals Treating Cardiac Arrests

  • Bae, Soo Jin;Hong, Sun Yeun
    • International Journal of Internet, Broadcasting and Communication
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    • 제13권1호
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    • pp.229-237
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    • 2021
  • This study aimed to help build a quality control program to improve cardiac arrest treatment via analysis of medical records in a local tertiary general hospital to evaluate factors that influence clinical outcomes of in-hospital cardiac arrest. At first, the medical records of in-hospital cardiac arrest were analyzed, and targeted surveys about functional and structural factors associated with cardiopulmonary resuscitation (CPR) were conducted amongst the workforce in charge of cardiac arrest treatment. From January 2012 through June 2013, a total of 486 adult cases of in-hospital cardiac arrests, except for those occurring in the emergency room, were enrolled in this study. Among the patients, those of recovery of spontaneous circulation were 57.8%; 13.8% of patients were discharged alive; 8.9% of patients were discharged without significant neurologic sequela. Despite CPR is usually successful when administered as quickly as possible, in this analysis showed that prompt reaction after initial recognition was significantly lower in nurses compared with doctors. Analysis of survey results showed that confidence in performing CPR was significantly associated with the experience of CPR in doctors, while in nurses educational experience showed a correlation. In order to improve quality of in-hospital CPR system maintaining and increasing confidence of CPR performance is the most important factor. Therefore it can be helpful to develop and apply a phased, customized education program using training simulators as well as personalizing them to increase the personnel's confidence in CPR performance.

한국 재난관리 체계에서 민간 방재조직의 전문성 제고 방안 - 지역자율방재단을 중심으로 - (A study on enhancing professionalism of civil anti-disaster organizations for public safety in Korea: with a focus on CAIND)

  • 채종식
    • 한국응급구조학회지
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    • 제25권3호
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    • pp.163-178
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    • 2021
  • Purpose: This study explored a plan for improving the overall preventive activity of Korean Citizen-Corps-Active-in-Disaster (CAIND). Methods: The study used the documentary survey and the technical approach methods. This way, detailed information regarding civil anti-disaster organizations was found in scholarly monographs, specialty publications, and master's/doctoral dissertations. It further utilized the statistical yearbooks between 2015 and 2018 from the Korean Ministry of Public Administration, Security, and Fire Service, and the National Statistical Office, to discover practical problems through a statistical analysis. Volunteer activities being inherent, related issues were reviewed at the same time to for purposes of clarifying the characteristics of disaster prevention activity by CAIND. Results: The study provided four major suggestions for improvement. First, the quota management system of Korean CAIND considering the characteristics of rural areas should be supplemented. Second, the education and training systems of Korean CAIND should be established to satisfy regional conditions. Third, management members' readership competency in operating organizations, including that of the Korean CAIND captain in charge, should be strengthened. Fourth, the reward system for Korean CAIND activities should be improved. Conclusion: In the future, the results of this study are expected to be utilized as a basic data to develop Korean CAIND.

'첨단재생의료 및 첨단바이오의약품 안전 및 지원에 관한 법률' 개정에 따른 '기관생명윤리위원회(Institutional Review Board)' 역할 및 '임상시험 및 대상자보호프로그램(Human Research Protections Program)' 강화의 중요성 (The Importance of Strengthening the Role of the Institutional Review Board and the Human Research Protections Program following the Revision of the Act on the Safety and Support of Advanced Regenerative Medicine and Advanced Biopharmaceuticals)

  • 김병수
    • 대한기관윤리심의기구협의회지
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    • 제6권1호
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    • pp.1-4
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    • 2024
  • The strengthening of Institutional Review Board (IRB) and Human Research Protection Program (HRPP) for clinical research on advanced regenerative medicine reflecting the 3 Principles of the Belmont Report (Respect, Beneficence, Justice) is very important. The research institution IRB should naturally be in charge of managing the clinical research process. And it is crucial to reinforce HRPP for the protection of research subjects in institutions conducting advanced regeneration clinical research. So, it is needed to establish a Protection System for Advanced Regenerative Medical Research Subjects composed of clinical research management communication system for advanced regenerative medicine between KAIRB (Korean Association of IRB) of research institutes and National Management Agency for Advanced Regenerative Medical Research. In advanced regenerative medicine clinical research to verify safety and efficacy of the investigational drugs to the subjects with rare and incurable diseases rather than to treat the patients, it is hoped that a management system that guarantees the scientific characteristics of research and the rights of research subjects would be well organized and operated.

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흰쥐 교감신경 뉴론 N형 칼슘전류의 비활성화에 미치는 칼슘효과 (Role of $Ca^{2+}$ for Inactivation of N-type Calcium Current in Rat Sympathetic Neurons)

  • Goo, Yong-Sook;Keith S. Elmslie
    • 한국의학물리학회지:의학물리
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    • 제14권1호
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    • pp.54-67
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    • 2003
  • N형 칼슘전류의 비활성화 vs 전압곡선은 U형을 보인다 - 즉 칼슘 내향전류의 크기와 비활성화 정도가 어느 정도 일치한다. 이러한 U형 비활성화는 순수한 전압의존성 기전으로 설명되어져 왔으나 칼슘의존성 비활성화 기전 또한 보고되었다. 이 연구에서는 흰쥐 상행 경동맥 결절뉴론을 단일 세포로 얻은 후, whole cell patch clamp technique를 사용하여 N형 칼슘전류를 기록하고, 세포외액의 charge carrier 로서 바륨과 칼슘을 사용하면서, 칼슘이 N형 칼슘통로의 비활성화에 미치는 역할을 알아보았다. charge carrier 로 칼슘을 사용하였을 경우에 바륨을 사용하였을 때에 비하여 비활성화 정도가 증가하였으며 이러한 증가는 세포속 $Ca^{2+}$ Chelator가 11 mM EGTA 로부터 20 mM BAPTA 로 치환되어도 계속 관찰되었다. 비활성화 vs 전압 곡선은 바륨과 칼슘 모두에서 U형이었다. charge carrier 를 칼슘으로 치환시 추가로 유도되는 비활성화 정도는 바륨사용시의 비활성화 정도와 역비례관계를 보여 두 이온에서 같은 기전으로 비활성화가 일어날 가능성을 시사하였다. 이러한 가능성을 지원해 주는 결과로 5초의 긴 저분극 자극시 바륨과 칼슘을 써서 얻은 전류기록은 2중 지수함수로 잘 그려낼 수 있었고, 그 결과 빠른 성분(시정수: -150 ms) 과 느린 성분(시정수 -2500 ms) 를 얻었다. 칼슘이 각각의 성분에 미치는 효과는 각기 달라서 빠른 성분의 amplitude는 증가하였고 느린 성분의 시정수는 빨라졌다. 칼슘에 의해 빠른 성분의 amplitude는 증가하였으므로 이는 더 많은 채널이 빠른 경로로 비활성화되었음을 시사한다. 빠른 성분의 시정수는 변화하지 않았으므로, 이는 비촬성화의 빠른 경로는 칼슘과 바륨에서 같음을 시사하며 즉 비활성화 기전이 칼슘의존성이 아님을 보여주는 증거이다. 그러나 비활성화의 느린 성분은 칼슘에 의해 그 시정수가 빨라졌으므로 칼슘의존성일 가능성이 있다.

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Veterans Hospital Medical Expenses Increase & Decrease Characteristics and Convergence Phenomenon-Focusing on the implications of the medical support system for national veterans-

  • Yu, Tae Gyu
    • International Journal of Advanced Culture Technology
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    • 제9권1호
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    • pp.16-21
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    • 2021
  • As the average age of national veterans has increased from 69 years old(2011) to 71 years old(since 2015) over the past five years, the overall medical service cost of veterans has increased by about 20%. The main cause of this phenomenon is 'ultra-aging', which accounts for 67% of veterans, while the proportion of health insurance patients aged 70 or older is 9%. Therefore, it is judged that the analysis of the trend of use of medical services at veterans hospitals in each region that is in charge of severe medical services of national veterans can serve as an opportunity to seek countermeasures for the severe medical system of national veterans. First of all, based on the details of major medical expenses (hospitalization, outpatient, pharmaceutical expenses) by region for the last 10 years(2010-2019), data significance was performed through a chi-square test, and the Central Veterans Hospital and Non-Central Veterans Hospital using EXCEL. 'Expected frequency' was calculated by year. By applying the CHITEST(observation frequency, expected frequency) function again, the p-value(p<0.05) was calculated, and the profit bias of each region's veterans hospital could be determined. The specific research method is for the last 10 years(2010-2019) for state-sponsored patients_outpatient treatment income, state-sponsored patients_hospitalization income, exempt patients_outpatients at the Central Veterans Hospital, Busan Veterans Hospital, Gwangju Veterans Hospital, Daegu Veterans Hospital, and Daejeon Veterans Hospital. A one-way analysis of variance was conducted to verify the significance of the difference between group averages on the status of 5 medical revenues of veterans hospitals in each of the 5 regions, including medical treatment income, reduced patients_hospitalization income, and reduced patients_medicine expenses. It was found to be significant(p<0.05) at all levels, including region and type. Finally, the bias in the profit structure of regional veterans hospitals was the highest in 2017(p=0.0004) and the lowest in 2013(p=0.0349). In addition, in the profit structure of the Veterans Hospital, the year in which the'regional' variable worked the most was 2019, and the year with the least affected was 2010. The order of the former is Jungang(=31,674,713), Busan(=12,314,614), Gwangju(=11,957,038), Daegu(=10,168,015), and Daejeon(=6,991,034), and the order of the latter is Jungang(=57,868,791), and Busan(=19,183,194). Gwangju(=17,904,712), Daegu(=15,656,034), and Daejeon(=14,377,395). In conclusion, the profit bias of veterans hospitals repeatedly raced the lowest(p=0.01986) and highest(p=0.03499) for the past five years(2010-2014) year by year, with the 'regional' variable being the most in the veterans hospital's profit structure It was identified as a major influence factor. On the other hand, for the last 5 years (2015-2019), the influence factors of the'regional' variable every year were in 2015(p=0.02015), 2016(p=0.01741), 2017(p=0.00045), and 2018(p=0.00394). in 2019(p=0.00227), a significant difference was confirmed at a very low level.

Impact of Coronavirus Disease 2019 on Gastric Cancer Diagnosis and Stage: A Single-Institute Study in South Korea

  • Moonki Hong;Mingee Choi;JiHyun Lee;Kyoo Hyun Kim;Hyunwook Kim;Choong-Kun Lee;Hyo Song Kim;Sun Young Rha;Gyu Young Pih;Yoon Jin Choi;Da Hyun Jung;Jun Chul Park;Sung Kwan Shin;Sang Kil Lee;Yong Chan Lee;Minah Cho;Yoo Min Kim;Hyoung-Il Kim;Jae-Ho Cheong;Woo Jin Hyung;Jaeyong Shin;Minkyu Jung
    • Journal of Gastric Cancer
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    • 제23권4호
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    • pp.574-583
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    • 2023
  • Purpose: Gastric cancer (GC) is among the most prevalent and fatal cancers worldwide. National cancer screening programs in countries with high incidences of this disease provide medical aid beneficiaries with free-of-charge screening involving upper endoscopy to detect early-stage GC. However, the coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions to routine healthcare access. Thus, this study aimed to assess the impact of COVID-19 on the diagnosis, overall incidence, and stage distribution of GC. Materials and Methods: We identified patients in our hospital cancer registry who were diagnosed with GC between January 2018 and December 2021 and compared the cancer stage at diagnosis before and during the COVID-19 pandemic. Subgroup analyses were conducted according to age and sex. The years 2018 and 2019 were defined as the "before COVID" period, and the years 2020 and 2021 as the "during COVID" period. Results: Overall, 10,875 patients were evaluated; 6,535 and 4,340 patients were diagnosed before and during the COVID-19 period, respectively. The number of diagnoses was lower during the COVID-19 pandemic (189 patients/month vs. 264 patients/month) than before it. Notably, the proportion of patients with stages 3 or 4 GC in 2021 was higher among men and patients aged ≥40 years. Conclusions: During the COVID-19 pandemic, the overall number of GC diagnoses decreased significantly in a single institute. Moreover, GCs were in more advanced stages at the time of diagnosis. Further studies are required to elucidate the relationship between the COVID-19 pandemic and the delay in the detection of GC worldwide.

"삼국사기(三國史記)"에 기록된 의약내용(醫藥內容) 분석 (Study on Medical Records In ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$)

  • 신순식;최환수
    • 제3의학
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    • 제2권1호
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    • pp.35-54
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    • 1997
  • We tried to observe the features of ancient medical practice by analysing the records related to medicine in the book, ${\ulcorner}$the Historical Records of the Three Kingdom${\lrcorner}$ of which content includes the features of medicine in mythology, plague, delivery of twins, drugs, medical system, shamanism, constitutional medicine, psychiatry, forensic medicine, deformity, a spa, medical phrase, health and welfare work, religion, death. physiological anatomy, Taoist medicine, acupuncture, the occult af of transformation and etc. Our initial concern was about where to draw line as of medical field and we defined medicine in more broad meaning. The book ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ describes the world of mythology by way of medicine which is not clearly a conventional one. There appears records of birth of multiple offsprings 7 times in which cases are of triplets or more. Delivering multiple offsprings were rare phenomenon though such fertility was highly admired. This shows one aspect of ancient country having more population meant more power of the nation. Of those medical records conveyed in that book includes stories of childbirth such as giving birth to a son after praying, giving birth to Kim Yoo-shin after 20 months after mother's dream of conception, and a song longing for getting a laudable child. Plagues were prevalent throughout winter to spring season and one can observe various symptoms of plagues in the record. Of these epidemic diseases, cold type might have been more common than the heat one. Appearance of epidemic diseases frequently coincided with that of natural disasters that this suggests a linkage between plague and underlying doctrine on five elements' motion and six kinds of natural factors. There exists only a few names of diseases such as epidemic disease, wind disease, and syndrome characterized by dyspnea. Otherwise there appeared only afflictions that were not specified therefore it remains cluless to keep track of certain diseases of prevalence. Since this ${\ulcorner}$Historical Records of the Three Kingdoms'${\lrcorner}$ wasn't any sort of medical book, words and terms used were not technical kind and most were the ones used generally among lay people. Therefore any mechanisms of the diseases were hardly mentioned. Some of medicinal substances such as Calculus Bovis, Radix Ginseng, Gaboderma Luciderm, magnetitum were also in use in those days. 53 kinds of dietary supplies appears in the records and some of these might have been used as medicinal purpose. Records concerning dicipline of one's body includes activities such as hunting, archery, horseback riding etc. In Shilla dynasty there were positions such as professor of medicine, Naekongbong(內供奉), Kongbong's doctor(供奉醫師), Kongbong's diviner(供奉卜師). As an educational facility, medical school was built at the first year of King Hyoso's reign and it's curricula included various subjects as ${\ulcorner}$Shin Nong's Herbal classic${\lrcorner}$, ${\ulcorner}$Kabeul classic of acupuncture and moxbustion${\lrcorner}$, ${\ulcorner}$The Plain Questions of the Yellow Emperor's Classic of Internal Medicine${\lrcorner}$, ${\ulcorner}$Classic of Acupuncturer${\lrcorner}$, ${\ulcorner}$The Pulse Classic${\lrcorner}$, ${\ulcorner}$Classic of Channels and Acupuncture Points${\lrcorner}$ and ${\ulcorner}$Difficult Classic${\lrcorner}$. There were 2 medical professors who were in charge of education. To establish pharmacopoeia, 2 Shaji(舍知), 6 Sha(史), 2 Jongshaji(從舍知) were appointed. In Baekje dynasty, Department of Herb was maintained. Doing praying for the sake of health, doing phrenology also can be extended to medical arena. Those who survived over 100 years of age appear 3 times in the record, while 98 appears once. The earliest psychiatrist Nokjin differentiated symptoms to apply either therapies using acupuncture and drug or psychotherapy. There appears a case of rape, a case of burying alive with the dead, 8 cases of suicide that can characterize a prototype of forensic medicine. Deformity-related records include phrases as follow: 'there seems protrudent bone behind the head', 'a body which has two heads, two trunks, four arms.', 'a body equipped with two heads' In those times spa can be said to be used as a place for he리ing, convalescence, and relaxation seeing the records describing a person pretended illness and went to spa to enjoy with his friends. Priest doctors and millitary surgeons were in charge of the medical sevice in the period of the Three Kingdoms by the record written by Mookhoja(墨胡子) and Hoonkyeom(訓謙). Poor diet and regimen makes people more vulnerable to diseases. So there existed charity services for those poor people who couldn't live with one's own capacity such as single parents, orphans, the aged people no one to take care and those who are ill. The cause of affliction was frequently coined with human relation. There appeared the phenomenon of releasing prisoners and allowing people to become priests at the time of king's suffering. Besides, as a healing procedure, sutra-chanting was peformed. There appears 10 cases of death related records which varies from death by drowning, or by freezing, death from animals, death from war, death from wightloss and killing oneself at the moment of spouse's death and etc. There also exist certain records which suggest the knowledge of physiology and anatomy in those times. Since the taoist books such as ${\ulcorner}$Book of the Way and Its Power(老子道德經)${\lrcorner}$ were introduced in the period of Three Kingdoms, it can be considered that medicine was also influenced by taoism. Records of higher level of acupuncture, records which links the medicine and occult art of transformation existed. Although limited, we could figure out the medical state of ancient society.

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2015년 주요 의료판결 분석 (Review of 2015 Major Medical Decisions)

  • 유현정;이동필;이정선;정혜승;박태신
    • 의료법학
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    • 제17권1호
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    • pp.299-346
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    • 2016
  • 2015년 한해에도 의료분야에서 다양한 판결이 선고되었다. 요양원 입소자에 대하여 요양원측 과실로 상해가 발생하여 요양원을 운영하는 사회복지법인이 환자의 진료를 의뢰한 사건에서 진료계약의 당사자 확정 기준이 제시되었고, 뇌사상태에 빠진 환자 가족의 무의미한 연명치료 중단 요구에 대하여 병원이 이를 거부하고 계속 진료한 경우 청구 가능한 진료비에 관한 판단이 이루어졌다. 안전성이 확인되지 아니하여 2011. 2. 보건복지부로부터 사상 초유의 시술중단조치를 받았던 눈미백수술에 관하여 법원은 시술 자체의 위법성을 인정하지는 아니하였으나 임상시험 단계에 있어 비용 대비 효과가 확립되어 있지 않다는 사실을 설명하지 아니한 설명의무 위반으로 전 손해의 배상을 명하였다. 의료과실을 적극적으로 인정한 판결로는 척추수술 후 마미증후군이 발생한 사건들에서 수술과정상 과실이 인정된 사례가 상당수 있었고, 병원감염 사건에서 감염을 유발한 과실을 인정한 판결이 선고되었다. 응급의료에 관한 법률상 응급장비 설치의무와 응급상황 발생시 조치의무를 구분하여 의료과실을 인정한 판결이 선고되었고, 극히 드문 희귀질환이라 하더라도 그에 대한 적절한 조치를 취하지 않은 의료기관에게 과실을 인정한 판결이 선고되었다. 손해배상의 범위와 관련하여 항소심 신체재감정 결과 노동능력상실률이 1심보다 작아지자 시간의 경과에 따라 노동능력상실률을 달리 적용하거나 환자의 상태에 따라 노동능력상실률을 신체감정 결과보다 낮게 인정하는 등 실체진실에 부합하는 판결이 선고되었다. 의료과실로 손해가 발생한 경우 의료사고 후 발생한 진료비에 책임제한이 적용되는지 여부와 관련하여 법원은 병원에서 환자 상태의 치유 또는 악화를 방지하는 정도의 치료만 계속되었다면 환자에게 진료비 지급을 청구할 수 없다는 이유로 병원 측의 상계주장을 배척하였다. 사전심의를 받지 않은 의료광고를 금지하고 그 위반시 처벌하는 의료법 규정에 대하여 사전심의기관인 대한의사협회 등의 행정기관성을 부인할 수 없어 사전검열에 해당한다는 이유로 위헌결정이 내려졌다. 임상에서 흔하게 시행되고 있는 PRP 치료가 법정비급여에 해당하는지 여부에 관하여 법원은 법정비급여 여부는 이론적인 가능성이나 실제 실시 여부 등에 따라 결정되는 것이 아니라 의학적 안전성 유효성을 인정받은 후 요양급여 또는 비급여대상으로의 편입절차를 거쳐야 함을 분명히 하였다. 또한 법원은 요양병원 적정성 평가에 관한 행정소송에서, 구조부문의 조사방식이나 절차상 위법을 인정하면서도 그 위법사유의 정도가 당연무효에까지는 이르지 아니하고 평가기관의 고의 과실이 없다는 이유로 건강보험심사평가원과 국민건강보험공단에 부당이득반환이나 손해배상의무가 없다는 판단을 하였다. 향후 더욱 다양하게 제기되는 쟁점들에 관하여 명쾌한 법리를 통해 실체진실에 다가가는 판결을 기대해본다.

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제주도 119구조·구급대의 활성화 및 전문화 방안 (A Study on the Activation·Specification of 119 Rescue & Care in JeJu)

  • 고재문;김태민;김효식;이영아
    • 한국응급구조학회지
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    • 제6권1호
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    • pp.153-168
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    • 2002
  • Since 1992, conventional fire fighting businesses have been converted into a metropolitan autonomous fire fighting system to be ready for a variety of disasters. However, the corresponding investment has been overlapped due to the non-integration of businesses to prevent any potential disasters, and a series of collaborative systems have been not functioning so well. In the meantime, our fire fighting sector has been trying to set up its own clean and faithful position by abolishing any inconvenient system or outsourcing private sectors, and expanded its work scope from conventional fire fighting even to rescue and emergency works. While focusing on handling disaster, the fire fighting sector has been widely trusted and reliable throughtout our nation. Moreover, our fire fighting sector has secured nation wide mobile organizations, technical personnel by field, special equipments and independent communication network. In addition, the fire fighting sector has knowledges, expertise and capabilities required for managing disasters, while in charge of almost every disaster management works including fire, explosion, collapse, disaster and flood. It becomes an organization for comprehensive disaster management under an absolute national trust, which is based on the system for prevention, preparation and countermeasure against a variety of disasters. Thus, our fire fighting sector must make many efforts and try to modernize conventional education and training. The ways to facilitate rescue and emergency works may include the nurture of technical fire fighting personnel along with modernized equipments, the reinforcement of rescue and emergency education, the facilitation of operating civil defense corps, the facilitation of operating volunteer fire fighting corps, the better arrangement of 119 briefing room for public healthcare in provincial offices, the sterilization of rescue instruments and equipments the better repair education for emergency rescue member, the establishment of regional emergency assistant system and the expansion of fire fighting personnel and equipments. In terms of reinforcing the functions and services of rescue 119 and emergency corps, we must review the following considerations: Building up security system along with operational expansion, building up a system for emergency medical treatment, building up a comprehensive information management system for rescue and emergency, constructing a provincial safety museum and so forth. For the ways to better the works of rescue 119 we can review the following considerations : Improving the education for fire fighting training corps under Jeju Provincial Fire and Disaster Management Department, providing rescue members with more opportunities for clinical practices, enhancing the morale of rescue members, installing a comprehensive briefing room for emergency rescue members, building up medical networks along with reasonable policies for information service, operating the consulting system for rescue 119 and so on. If these requirements are met, it is expected that the fire fighting departments in Jeju province can cope with every accident and disaster a little more rapidly and quickly in compliance with local needs, so that they can keep their own position as a public fire fighting organization which may be trusted by the public.

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지역 의료이용 친화도(RI)와 병원 경영성과의 관계 (Relationship between Relevance Index and Hospital Management Performance)

  • 박종영;이진우
    • 디지털융복합연구
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    • 제17권3호
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    • pp.261-269
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    • 2019
  • 본 연구는 우리나라의 종합병원의 경영성과와 지역 의료이용 친화도를 알 수 있는 RI를 과학적인 방법으로 산출하여 지역의료이용량과 병원 경영성과의 인과 관계에 대한 연구결과를 바탕으로 효율적인 경영전략을 제시하는데 그 연구의 의의가 있다. 연구결과를 보면 첫째, 일반적 특성에 따른 지역친화도 차이에서는 도시구분별 병상 수, 경상이익에서 통계적으로 유의한 차이가 나타났다. 둘째, 지역 의료이용의 친화도(RI)와 변수들 간의 상관관계를 살펴보면, 경상수지비율, 외래환자 초진율, 의료수익의료이익률, 100병상 당 1일 평균 외래환자 수, 100병상 당 1일 평균 입원환자 수, 입원환자 1인 1일당 평균진료비와 유의한 상관관계를 나타냈다. 연구결과를 바탕으로 본 연구의 의의를 살펴보면, 첫째 지역 의료이용 지표인 지역 의료이용 친화도를 산출하여 경영성과와의 연관관계와 유의한 영향을 미치는 변수를 규명하였다는 점에서 본 연구의 의의가 있다고 할 수 있다. 둘째로는 도시규모, 병상규모 등 내,외부적 환경요인에 따라 비교분석하였으며, 향후 병원이 지역 의료이용률를 높이기 위한 병원경영 전략의 수립에 기초 자료를 제공하였다고 할 수 있다.