• 지역사회간호학회지
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• 제26권3호
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• pp.278-291
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• 2015

Purpose: This study was conducted to examine differences in health care utilization and related costs between before and after the introduction of the designated doctor system, and to find out factors making the differences. Methods: Data were collected from 200 medical aid beneficiaries having one or more chronic diseases, registered in the designated doctor system during the year of 2012, and the relationship between the use of health services and claimed medical expenses was analyzed through paired t-test and multiple regression analysis using the SPSS 18.0 program. Results: There was a decrease in the number of total benefit days and the number of outpatient and medication days, but some cases showed an increase after the designation of medical institution. In general, hospital stay increased after the introduction of the system. However, the number of medical institutions utilized was reduced in most cases after designation. Conversely, medical expenses increased in most cases after the designation of medical institution. Conclusion: These results suggest that a detailed scheme to designate medical institutions should be made in consideration of the seriousness of illness and classification of medical institutions not only for the beneficiaries' enhanced health but for the effective management of medical aid fund.

• 웰빙융합연구
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• 제7권3호
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• pp.43-53
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• 2024

Purpose: his study aims to explore how healthcare provider service characteristics in telemedicine services, which have become more common since the pandemic, affect rapport formation and service satisfaction with healthcare providers. Research design, data and methodology: A group of actual telemedicine users underwent data collection and empirical analysis. After analyzing reliability and validity, hypotheses were tested using a structural equation model. Results: Key perceived attributes of healthcare providers in telemedicine services were identified as doctor effort, doctor listening, and doctor expertise. Each of these variables had a significant positive impact on trust in telemedicine. Moreover, these attributes significantly positively impacted rapport formation and user service satisfaction, which was mediated by trust. However, the direct impact of rapport formation on service satisfaction was not supported. Conclusions: The study's findings have academic and practical implications for expanding telemedicine services. As an initial empirical study on telemedicine services, it confirms the importance of trust and rapport formation even in non-face-to-face medical situations. In order to overcome the limitations of non-physical contact, telemedicine services should strive to develop UI/UX designs that are more interoperable and boost trust in service apps.

• Journal of Preventive Medicine and Public Health
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• 제39권2호
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• pp.141-148
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• 2006

Objectives : We wanted to evaluate the medical underutilization for benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) among Korean elderly men and we wanted to determine their associated factors. Methods : This study was conducted on 239 men with LUTS and 116 men with BPH who were compatible with the diagnostic criteria from a total of 641 participants. These participants were over 50 years old and they were randomly chosen in a community-based study for estimating the prevalence of BPH. Using a self-reported questionnaire, we surveyed the sociodemographics, health status, quality of life, lower urinary tract symptoms, medical utilization and reasons for not seeking treatment. Results : Only 27.6% of the men with LUTS and 31.0% of the men with BPH reported having visited a doctor for urinary symptoms. The reasons for not visiting a doctor were, in order of responses from the group with LUTS: 'considered the symptoms as a part of the normal ageing process', 'not enough time to visit a doctor', 'financial difficulty' and 'the symptoms were not severe or bothersome'. Regarding BPH, the responses were the same as those of the group with LUTS however, 'financial difficulty' placed second. Among the men with experience of visiting a doctor for urinary symptoms, 33.3% of those with LUTS and 28.1% of those with BPH were not treated. The most common reason in both groups was 'the symptoms were not severe to be treated'. On a multiple logistic regression analysis, the larger size household (odds ratio (OR) 3.03, 95% confidence interval (CI)=1.40-6.54) and an unsatisfactory quality of life related with urinary symptoms (OR 2.98, 95% CI=1.23-7.21) were associated with medical utilization in the group of LUTS. For BPH, the current employment status was related with the medical utilization (OR 2.80, 95% CI=1.10-7.11), in addition to the larger size household (OR 3.24, 95% CI=1.14-9.21). Conclusions : Many men with urinary symptoms do not visit a doctor. This medical underutilization for people with LUTS and BPH may be associated with economic status in Korea.

• Journal of Preventive Medicine and Public Health
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• 제42권3호
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• pp.171-176
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• 2009

Objectives : The frequency of visiting clinics in Jejudo for treating atopic dermatitis (AD) has been reported to be higher than that for other counties of Korea. The aim of this work was to estimate the prevalence of AD for the students of the primary, middle and high schools in Jejudo, Korea. Methods : We planned to evaluate about 5,000 students, so classes were randomly selected by random systematic sampling methods. The parents of all the students in the selected classes were asked to respond to a structured questionnaire concerned with the prevalence of AD. Results : The prevalence of AD based on ever being diagnosed by a doctor, on currently being diagnosed by a doctor, on ever being treated for AD by a doctor, on currently being treated for AD by a doctor was 25.57% (95% CI=25.3-25.8), 14.67% (95% CI=14.5-14.9), 21.90% (95% CI=21.6-22.2) and 14.41% (95% CI=14.2-14.6), respectively. Conclusions : On comparing the prevalence of AD, the students in Jejudo had a higher number of recurrence events in spite of their lower number of cases. Further studies are needed to evaluate these aspects of AD.

• 동의신경정신과학회지
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• 제12권2호
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• pp.85-93
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• 2001

Objectives: In order to present an applicative scheme of medical care through the analysis of the Rumenshiqin. Method: This research was done by analyze Zhanzihe's Medical Records and Thought in the Rumenshiqin. Results: 1. Zhanzihe's had recognized that vital-qi is recovered naturally by diaphoretic, purgative and emetic theraphy. 2. He had made an applicative scheme of psychotherapy in Oriental medicine. 3. Zhanzihe's Medical Records and Thought can contribute to madical care of neuropsychiatry 4. He had thought that the doctor's quality and consideration of infant's environment and individual grade is very important. Conclusion: Zhanzihe's Medical Records and Thought in the Rumenshiqin presents an applicative scheme of medical care of neuropsychiatric desease and we need to study more and more about this.

• 한국병원경영학회지
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• 제9권3호
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• pp.1-17
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• 2004

This study is aimed to assess the general population's attitude toward the continuity of medical care and its related factors. Self administered questionnaire was performed on the 1,120 office workers in the C city, Gang-won province. The questionnaire included the attitude of the continuity of medical institute, the intention of medical service use on a given case, and the variables of the related factors. 58.8% of the total respondents agreed to sustaining treatment without changing medical institutes; on the other hand, 41.2% showed negative attitude. In case that a patient would gain a recommendation of a surgery, hospitalization, or a specific examination, the total respondents' 84.9%, 61.8%, and 50.8% of each recommended situation said that they would visit another doctor and gain a diagnosis. As a result of multiple logistic analysis of determinant factor on continuity, reliability of doctors was statistically significant factor. In order to reduce wastefully used medical resources and offer well-qualified medical service, a system of second opinion among peer group or beforehand agreement could be possibly adopted. In addition, improving the image and reliability of a doctor could be an important factor to make better the behavior of medical service shopping; therefore, an effort to improve the relationship between a doctor and a patient, and restore the reliability of doctors should be paralleled.

• 한국의사학회지
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• 제36권1호
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• pp.51-72
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• 2023

IM Won-jun(任元濬, 1423~1500) was an Confucianism Doctor in the former period of Joseon Dynasty. Through IM Won-jun's historical trace we could know the range of Uiseoseubdoggwan(Medical Learning Officer)'s duty not limited to study medical books at that time but extended to medical treat, educate, recommend medical policy, personnel manage, carry out administrative work, carry out all the works concerned with medical books, make new medicines at different official period. Among these after learning duties the Royal Family of the Joseon Dynasty awarded high grades to medical treatment for king and king's mother, but from the viewpoint of advancement of medicine controling the top of medical policy as a chief of Jeonuigam had important meaning. The system of Uiseoseubdoggwan(Medical Learning Officer) in the Joseon Dynasty played the role of cultivating widely the man of ability who leaded medical development by sharing the man of ability between medicine and confucianism which was dominant learning at that time, so the knowledge and professional skill of medicine, Yin-Yang and the Five Elements theory, the spirit of relief of the world were spreaded across to national administration, education, publication culture, putting philosophy of filial piety into practice in the Joseon Dynasty.

• 보건행정학회지
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• 제26권3호
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• pp.195-206
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• 2016

Background: Concentration of patients to large hospitals is serious problem in Korea. The purpose of this paper is to propose appropriate policy direction to relieve concentration of patients to large hospitals. It is focused on evaluation of the possibility of family doctor system as a policy alternative to relieve concentration of patients to large hospital by empirically analyzing the effect of usual source of care (USC) on large hospitals medical care use. Methods: Korea Health Panel conducted 2009, 2012, 2013 by KIHASA (Korea Institute for Health and Social Affairs) and NHIS (National Health Insurance Service) was used for analysis. For dependent variables, first, the ratio of the amount of using large hospital to total amount of using medical care, and second, the amount of using large hospital are estimated. Independent variables are having an USC and type of USC. Panel analysis was done with above variables. Results: Main results are as follows. First, having an USC increases using large hospital. Second, having a domestic clinic type USC decreases using large hospital and ratio of using large hospital. Third, the effect of domestic clinic type USC is greater in older group, less income group, worse health status group, not having private insurance group, and having chronic disease group. Conclusion: These results show that family doctor program can be a policy alternative to relieve concentration of patients to large hospital. Nonetheless, primary care system in Korea is unsatisfied. It is recommended to reinforce primary care system and family doctor system to relieve concentration of patients to large hospitals.

• 대한한의학원전학회지
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• 제19권4호
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• pp.62-69
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• 2006

"HanGaekChiHeom" is a book that arranged the medical records left by a Japanese doctor Junso Higuchi who treated a group of diplomats from Chosun and questions and answers exchanged between him and Chosun's doctor ChoSoongSoo. There are 14 kinds of medical records here with treatments and prescriptions as well as the detailed descriptions about the name, age and symptoms of patients. Various diseases and symptoms are included among them such as bums, common cold, skin diseases, edemas, etc. The characteristics of Junso Higuchi seem to be affected by medicine in Ming Dynasty in China.

• Archives of Plastic Surgery
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• 제36권3호
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• pp.262-268
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• 2009

Purpose: Recently medical dispute about plastic surgery is increasing rapidly as result of growing surgery itself due to high interest in appearance and advertisement of plastic surgery. So we want to find a way to prevent similar medical accident by making better solution of plastic surgery through case analysis of medical dispute. Method: 161 cases about plastic surgery asked for aid at Korea Consumer Agency and 41 cases judged at the court was surveyed and gender, location and kind of hospital, goal and kind of operation, making operation agreement or not, kind of damage, result of process, result of lawsuit was studied from 2004.1.1. to 2006.12.31. Result: Medical doctor have to explain about symptoms of disease, method of treatment, possibility of complication, prognosis to patients before therapy so they can make decision if they take operation by doctor or not. On this survey, among the patients who underwent re - operation or had complication, 88.1%(96 from 109 cases) of them didn't get enough explanation about possibility of complication before surgery They brought lawsuit insisting they would not undergo operation if they got enough explanation about possibility of complication and result of operation before surgery. Conclusion: It is advisable that doctor must observe the duty of explanation before surgery and respect the right to decide of patient, make operation agreement and put down concrete progress note and store the pre and post operative photo to avoid medical accident. It is also needed to have guideline of therapy, Code of ethics, organization which deals with medical dispute, reconsideration of law to control that.