• 대한간호학회지
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• 제36권8호
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• pp.1340-1351
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• 2006

Purpose. To determine and compare the perception among nurses and doctors of the roles and tasks of critical care advanced practice nurses (APNs) in order to establish standardized and formally agreed role criteria for such critical care APNs. Method. This study measured and analyzed the necessity of each of the roles and tasks of critical care APNs, as perceived by nurses and doctors, through a survey of 121 participants: 71 nurses in 7 intensive care units (ICUs) at a general hospital in Seoul, and 50 doctors who used ICUs. Data collection utilized a questionnaire of 128 questions in the following fields: direct practice (79), leadership and change agent (17), consultation and collaboration (15), education and counseling (11), and research (6). Results. Both the nurses' and the doctors' groups confirmed the necessity of critical care APNs, with doctors who frequently used ICUs indicating a particularly strong need. As for the priority of each role of critical care APNs, the nurses considered direct practice to be the most critical, followed by education and counseling, research, consultation and collaboration, and leadership and change agent. The doctors also considered direct practice to be the most critical, followed by education and counseling, consultation and collaboration, research, and leadership and change agent. There was a statistically significant difference between how the two groups regarded all the roles, except for the consultation and collaboration roles. As for the necessity of each role of critical care APNs, the nurses considered research to be the most necessary, followed by education and counseling, consultation and collaboration, leadership and change agent, and direct practice. The doctors, on the other hand, considered education and counseling to be the most necessary, followed by research, consultation and collaboration, leadership and change agent, and direct practice. The responses of the two groups to all the roles, except for education and counseling roles, were significantly different. Conclusion. Nurses and doctors have different perceptions of the roles and tasks of critical care APNs. Thus, it is necessary for the combined nursing and medical fields to reach an official agreement on a set of criteria to standardize for the roles and tasks of critical care APNs.

• 한국심리학회지 : 문화 및 사회문제
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• 제22권1호
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• pp.1-18
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• 2016

이익충돌은 경영, 의학, 연구 등 자문이 필요한 상황에서 윤리문제를 일으키는 주요인 중 하나로 파악된다. 실제 현장에서는 공개를 해결책으로 주로 사용하고 있으나, 공개의 효과에 대한 기존 연구들의 보고는 일관적이지 않다. 본 연구에서는 개인의 이익추구 성향에 따라 공개가 자문 행동에 주는 효과가 달라 지는지를 실험적으로 연구하였다. 참가자는 20대에서 40대의 성인남녀 190명(남: 65명, 여: 125명)으로, 온라인으로 실험과 설문조사에 응답하였다. 실험에서 참가자는 자문가가 되어 가상의 파트너에게 정보를 제공하였다. 이때 참가자는 자문가로서의 역할을 수행하면 적은 보상을 받으나 사익을 추구하면 많은 보상을 받게 되는 이익충돌 상황에 노출되었다. 총 2개의 과제 중 첫 번째 과제를 통해 자문가 역할을 최대화하는 집단과 사익추구를 최대화하는 두 집단으로 구분하였다. 두 번째 과제에서는 이 두 집단에게 각각 이익충돌 상황에 대해 공개 여부를 자발적으로 결정하게 한 뒤 공개여부가 후속적인 자문행동에 어떠한 영향을 주는 지 탐색하였다. 연구 결과, 자문가역할수행집단과 사익추구집단 간 공개여부의 선택비율에는 차이가 없었다. 그러나, 두 집단 간 공개여부에 따라 자문행동에는 차이를 보였는데, 자문가역할수행집단에서는 자발적으로 공개를 선택한 집단이 비공개를 선택한 집단에 비해 파트너에게 정확한 정보를 제공해 주었다. 반면, 사익을 추구한 집단에서는 공개 여부가 자문행동에 영향을 주지 않았다. 이러한 결과를 바탕으로 연구의 의의와 더불어 후속 연구를 위한 제언을 논의하였다.

• 대한한방내과학회지
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• 제38권6호
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• pp.930-943
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• 2017

Objectives: The purpose of this study was to investigate the clinical effects of HongYi pharmacopuncture monotherapy on female voiding dysfunction. Methods: Korean medical practitioners who used HongYi pharmacopuncture to treat female patients complaining of dysuria were surveyed. They performed a retrospective chart review of 31 female patients who visited their Korean medical clinic for dysuria. General characteristics, marital status, urologic medical history, International Prostate Symptom Score (IPSS), International Consultation on Incontinence Modular Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS), and related adverse events were examined. Results: Of 31 cases received, 29 were selected for analysis. Two cases were excluded because treatment was not continued through four weeks. In all cases, IPSS and ICIQ-FLUTS scores were significantly decreased after treatment. Adverse reactions occurred during treatment in four cases. Conclusions: These results suggest that treatment by HongYi pharmacopuncture is effective in improving lower urinary tract symptoms in women. Further studies will be needed for evaluation of clinical responses, to evaluate the safety and efficacy of HongYi pharmacopuncture treatment for female patients complaining of dysuria.

• 동의신경정신과학회지
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• 제29권4호
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• pp.239-253
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• 2018

Objectives: This is one of the manuals of East-West integrative medicine, which was created by the Committee on integrative medicine of Chung-Yeon Korean Medicine Hospital. To support clinical decision making and communication in the East-West cooperative treatment of mild cognitive impairment. Methods: Drafting was based on literature review from the MEDLINE, EMBASE, OASIS, and CNKI databases using search terms such as 'mild cognitive impairment', 'mild neurocognitive disorder', 'acupuncture', 'herbal medicine' and 'traditional Chinese medicine'. An amendment reflecting the goal of consultation and detailed treatment contents was made by reviewing the draft and holding discussion with the rehabilitation specialist of western medicine. The committee then agreed to adopt the manual through the process of review and feedback in addition to face-to-face discussions. Results: This manual contains the diagnosis of mild cognitive impairment, the goal of consultation, and the cooperative treatment contents of the East-West medicine for mild cognitive impairment. Conclusions: This manual provides significant information about the decision making process and contents of treatment in one medical institution for East-West cooperative treatment of mild cognitive impairment.

• 대한인간공학회지
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• 제29권4호
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• pp.473-478
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• 2010

For the medical approaches of work-related musculoskeletal diseases, it is important to consider occupational relatedness and occupational fitness. Clinical approach includes physical examination, radiologic tests and other related tests and we should choose proper management which is suitable to workers' status for the prevention of early disease's progression and later disabilities. Also, it suggests that occupational prevention program consultation for work-related musculoskeletal diseases considering workers' variable circumstances should be done via occupational relatedness and occupational fitness.

• 대한치과의료관리학회지
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• 제10권1호
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• pp.1-8
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• 2022

This study introduces research on the quality of medical services, optimization of medical services, dental medical services, implant medical services, and time schedules, as well as the effective process of dental implant medical services, which is expensive and requires a long treatment period. For improvement, it is suggested to evaluate using a time schedule. In this method, a time schedule is prepared in which each step, starting from the patients appointment until the completion of the treatment process, is allotted a certain time. This schedule was finalized in consultation with the employees. When performing all implant operations, the starting time of each item was checked to evaluate the degree of compliance and to understand any reasons for delay in each step. After identifying the causes for delay at each step, suitable steps to rectify the drawbacks were developed, and an optimal plan for patient management was determined. Changes in waiting time and human resource utilization were shown as concrete data, suggesting that such a schedule is meaningful as a decision-making support tool.

• 의료법학
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• 제13권2호
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• pp.11-38
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• 2012

The Supreme Court stand in the position in specific lawsuit that it doesn't allow the discretionary not covered service, but recently in revocation suit of fine disposal that is imposed on medical fee of leukemia patient, it altered the existing adjudgement and admitted the discretionary not covered service exceptionally. It put forward the allowable condition roughly in that case. According as this alteration, it has become more important to embody the allowance conditions of exceptions. The Supreme Court presented three things, which are procedural condition, medical condition and subscriber's agreement. Concerning procedural condition, several present conciliation procedures are as follows: medical care benefit arret request, relative value conciliation etc, prior request on anti-cancer drug among chemicals which exceed acceptance criteria, request of non benefit object on common drugs. To be granted the existence of those system, there should be no obstacle to use that. Even if it were so, we should take circumstances into consideration; individual situation is unescapable concerning substance and urgency of the discretionary not covered service, process of the procedure, time required etc. Regarding medical condition, safety and effectiveness will be verified through evaluation procedures of new medical skill. About the necessity, the Supreme Court made clear through a sentence that it allow the discretionary not covered service, in case that needs to treat a patient out of the standard of medical benefit. Strict interpretation is right and it answer the purpose of the sentence that the supreme court permit the discretionary not covered service, exceptionally. We need to differentiate medical necessity and medical validity. Subscriber's agreement should holds true if it entails full explanation, and if it is preliminary, explicit and individual. On this account, it should be difficult to admit that someone agree effectively when he call for the affirmation that he is recipient of medical care. Reasonable expense needs to be a part of review whether the agreement is valid. Meanwhile If we adjust system of medical expense and eventually reorganize a fee for consultation payment system (Fee-for-service controlled by item to DRG (Diagnosis Related Groups)), controversial area of the discretionary not covered service will be decreased and that will guarantee the discretion of the doctor.

• 대한간호학회지
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• 제16권3호
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• pp.38-66
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• 1986

Based on the statistical data of FKMIS during five years from 1981 to 1985, the major findings of studying on the treatments of employee's modical insurance covered people were made as follows. 1. During five years, the total number of trratment case was increased 25.14% annually, and so doubled. The consultation rate was increased from 2.086 to 2.856, showng annual increase of 8.17% and total increase of 36.91%. In the cafe, of in-patient, the rate was from 0.056 to 0.602, . showing annual increase of 2.58%. And in out-patient, the rate was from, 2.030 to 2.794, showing annual increase of 8.31%. The male: female ratio of treatment case was changed from 1 : 1.1 to 1 : 1.2. 2. Case of chronic disease was on the increase .every year. The ratio of medical expenditure of that disease to the total medical expenditure was increased from 22.99% in 1984 to 25.0% in 1985. 3. As a whole, the consultation rate of circulatory disease was increased from 26.10 in 1981 to 46.53 in 1985, showing an nual increase of 15.55 %. The rate of in-patient was increased from 2.06 to 2.94, showing annual increase of 9.30%. The rate of out-patient wag from. 24.04 to 43.59, showing annual increase of 16.04%. 4. The duration (days) of circulatory disease in 1985 by types is as follows. In the case of in-patient, rheumatic fever rheumatic heart disease, (22. 67), ischaemic disease (17.39), cerebrovascular disease (17.18), disease of pulmonary circulation and other from of heart disease (15.82), hypertensive disease (13.18), other disease of circulatory disease(11.55). In the case of out-patient, visiting day (11.57 day) and medical expenditure per case (7,853 won) is lower than that of other diseases (4.39 day, 4,361 won). 5. Cases of circulatory chronic disease were two times as many as those of non-chronic disease. Incidence of the out-patient was shown higher than that of in-patient. In the case of duration per case, the chronic disease(12.92 days) was longer that of non-chronic disease (9.8 day). 6. The male: female ratio of chronic rheumatic heart disease is 34.56 : 65.44 (in-patient) and 34. 67 : 65.33 (out-patient). The consultation rate(case per 1,000 persons) was increased from 1.11 in 1983 to 1.30 in 1985, showing annual increase of 8.22 %. The duration, visiting day, was decreased slightly, but medication day wasincreased from 13.93 in 1983 to 16.72 in 1985, showing annual increase of 9.56%. 7. The male: female ratio of hypertensive disease (case) was 39.36 : 60.64(in-patient) and 40.67 : 59.33 (out-patient). The consultation rate was increased from 19.59 in 1983 to 25.36 in 1985, showing annual increase of 13.78%. Duration, visting day was decreased slightly, but medication day was increased from 11.82 in 1983 to 12.77 in 1985, showing annual increase of 3.94%. 8. The male： female ratio of chronic pulmonary-ischaemic heart disease (case) was 48.90 : 51.10 (in-patient) and 43.66 : 56.34 (out-patient). The consultation rate of chronic pulmonary-ischaemic heart disease was increase from 0.69 in 1983 to 1. 12 in 1985, showing annual increase of 27.40％. Duration, visiting day, was decreased from 2.67 in 1983 to 2.36 in 1985, and medication day was decreased from 0.69 in 1983 to 1.12 in 1985, showing annual decrease of 2.09%. 9. The male: female ratio of cerebrovascular disease (case) was 47.90 : 52.10 (in-patient) and 52.28 : 47.72 (out: patient). The consulatation rate was increased from 2.12 in 1983 to 2.89 in 1985, showing annual increase of 16.76%, Duration, visiting day, was decreased slightly, but medication day was increased from 12. 67 in 1983 to 13.85 in 1985, showing annual increase of 4.55%. 10. In case of artery and capillary disease, the male: female ratio of case was 61.80 : 38.20 (in-patient) and 51.77 : 48.23 (out-patient). But durntion, visiting day, was increased from 3.45 in 1983 to 3.60 in 1985, showing annual increase of 2.15 % and the medication day was increased from 10. 06 to 10.18, showing annual increase of 0.59%.

• 보건행정학회지
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• 제33권2호
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• pp.185-193
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• 2023

Background: This study focuses on the establishment and operation of a stroke patient hotline program to help patients and their caregivers determine when acute neurological changes require emergency attention. Method: The stroke hotline was established at the Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, in June 2016. Patients diagnosed with stroke during admission or in outpatient clinics were registered and provided with stroke education. Consulting nurses managed hotline calls and made decisions about outpatient schedules or emergency room referrals, consulting physicians when necessary. The study analyzed consultation records from June 2016 to December 2020, assessing consultation volumes and types. Outcomes and hotline satisfaction were also evaluated. Results: Over this period, 6,851 patients were registered, with 1,173 patients (18%) undergoing 3,356 hotline consultations. The average monthly consultation volume increased from 29.2 cases in 2016 to 92.3 cases in 2020. Common consultation types included stroke symptoms (22.3%), blood pressure/glucose inquiries (12.8%), and surgery/procedure questions (12.6%). Unexpected outpatient visits decreased from 103 cases before the hotline to 81 cases after. Among the 2,244 consultations between January 2019 and December 2020, 9.6% were recommended hospital visits, with two cases requiring intra-arterial thrombectomy. Patient satisfaction ratings of 9-10 points increased from 64% in 2019 to 69% in 2020. Conclusion: The stroke hotline program effectively reduced unexpected outpatient visits and achieved high patient satisfaction. Expanding the program could enhance the management of stroke-related neurological symptoms and minimize unnecessary healthcare resource utilization.

• International Journal of Internet, Broadcasting and Communication
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• 제10권3호
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• pp.115-120
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• 2018

Current medical tourism is focused on the services of large hospitals and it is hard to find ways to attract the users. Users collect information for medical tourism through various paths in order to receive the medical consultations and customized tour services. To expand medical tourism to small and medium sized hospitals, it is necessary to have the customized medical consultations, tours and interpreter services, which are the key elements of medical tourism. This study suggests ways to provide the services based on information on medical consultations, tours and interpreter services that users had experienced directly, and also based on the platform for the essential items integrated from users, hospitals and guides' viewpoints. With information on hospitals that provide medical consultations and guides who are able to provide professional services in translation, interpretation and customized tour, users may accumulate and share the information about hospitals and customized tours verified by other users from the integrated platform. To match the contents provided by hospitals and guides with information experienced by users into a system, this study suggests the construction plan for the service model that can match the experience information between users and hospitals, between users and guides and between hospitals and guides systematically by operating the data in the universal container.