• 임상간호연구
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• 제29권3호
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• pp.327-336
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• 2023

Purpose: This study aimed to identify the factors affecting the practice of medical waste management of nurses in tertiary general hospitals after the coronavirus disease 2019 (COVID-19). Methods: The participants were 154 nurses working in two tertiary general hospitals. Data were collected using structured questionnaires and analyzed using an Independent t-test, One-way ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis using the SPSS/WIN 27.0 program. Results: Factors significantly influencing the subject's practice of medical waste management include medical waste education(β=.18, p=.013), recognition of infection control organizational culture (β=.26, p=.007), and attitudes toward medical waste management (β=.23, p=.011). The explanatory power of these variables for medical waste management practice was 29.0% (F=7.34, p<.001). Conclusion: To improve the practice of medical waste management, a strategy to provide positive attitudes toward medical waste management should be needed when developing medical waste management training programs, and various measures are necessary to make the organizational culture positive for the implementation of infection control guidelines at the organizational level.

• 보건의료산업학회지
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• 제12권4호
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• pp.203-217
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• 2018

Objectives : This study aimed to investigate the clinical practice ability and satisfaction of clinical training of health-medical information management major students. Methods : The data were collected from 68 persons from students finished clinical training at medical record (information) team using self administered questionnaires. The data were analyzed using t-test, ANOVA and correlation with SPSS 22.0 version. Results: Performance of data collection, data management, and data analysis were analyzed in three areas of the job area. In terms of academic characteristics and correlation, they were not related to the level of satisfaction with the practical experience. Conclusions : Research on a virtuous cycle clinical practice program that analyzes the factors by assessing the satisfaction level of clinical practice in each area of health care information management will be conducted continuously.

• 보건의료생명과학 논문지
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• 제8권2호
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• pp.83-93
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• 2020

본 연구에서는 보건의료정보관리사 양성을 위한 대학에서 EMR 교육시스템을 활용하여 교육할 수 있는 실습모델을 연구하였다. 현재 보건의료정보관리사의 직무역량 강화를 위해 도입된 보건의료정보관리교육 평가·인증 기준에 보건의료정보관리를 위한 실습과정이 제시되어 있지 않다. 이에 따라서 보건의료 정보관리교육 평가·인증 편람에서 교육환경으로 제시한 실습프로그램을 EMR 교육시스템에서 실습할 수 있도록 프로그램을 구성였다. 또한 프로그램별로 보건의료정보관리 현장실습지침서에 따라 수행할 수 있는 실습모델을 연구하였다. 보건의료정보관리 교육용 EMR시스템을 이용하여 마스터데이터관리, 환자 등록, 의사처방, 진료비 수납, 건강보험청구관리, 서식관리, 퇴원등록, 암등록, 미비기록관리, 보건의료데이터관리, 보건의료통계, 정보보호/보안관리에 대한 실습을 수행할 수 있도록 실습모델을 연구하였다. 대학에서 체계적이고 표준화된 보건의료정보관리 실습과정을 수행하여 보건의료정보관리 교육의 질적 수준을 높임으로써 보건의료정보관리 전문가로써 역할을 수행할 수 있을 것이다. 이에 따라서 보건의료정보관리사의 실습교육을 통하여 의료데이터 분석을 기반으로 의료서비스를 개발하고 관리하는 보건의료 정보관리 전문가를 양성할 수 있도록 해야 할 것이다.

• 임상간호연구
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• 제24권3호
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• pp.263-272
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• 2018

Purpose: This study was done to develop an evidence-based nursing clinical practice guideline for Moisture associated skin damage (MASD) prevention and management for patients in Korea. Methods: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by the Korean Hospital Nurses Association. It consists of three main phases and 9 modules including a total of 24 steps. Results: The adapted MASD clinical practice guideline consisted of 4 sections, 8 domains and 28 recommendations. The number of recommendations in each section was: 7 on MASD assessment, 14 on MASD prevention and management, 4 on education, and 3 on organizational policy. Of the recommendations, 3.6% were marked as A grade, 28.6% as B grade, and 67.8% as C grade. Conclusion: This MASD clinical practice guideline is the first to be developed in Korea. The developed guideline will contribute to standardized and consistent MASD prevention and management. The guideline can be recommended for dissemination and utilization by nurses nationwide to improve the quality of MASD prevention and management. Regular revision is recommended.

• 보건행정학회지
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• 제23권2호
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• pp.103-111
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• 2013

Seven diagnosis-related groups (DRGs) prospective payment system is going to expand to all hospitals including university hospitals this year. However there are few studies on the change of practice pattern under prospective payment system in the university hospital setting. So This study was intended to predict the practice pattern change after the introduction of 7 DRGs prospective payment system in a university hospital setting. To predict the change of practice pattern, this study used simulation technique. Five hundred and nineteen patients classified as 5 DRGs in a university hospital were selected for simulation. The change of practice pattern were predicted based on clinicians' opinion. We also predicted payment change by service items. Major findings of this study are as follows. First, the total medical payment was reduced by 14.4%. The drug payment change (8.8%) took most of total payment reduction. The followings are the change of treatment material cost (3.2%), the change of laboratory tests cost (1.8%), the change of room charge (0.5%), and other payment change (0.1%), respectively. Second, most of the reduction in total medical payment resulted from the decreased amount of medical services themselves. The transfer of medical services to outpatient setting took up only 4.9% of the total payment reduction. The change of unit price or composition took up 5.5% of the total payment reduction. In this study we found that it is possible to reduce the inpatient services through practice pattern change in university hospital setting. However, it needs to be careful to adjust DRG payment after the reduction of provided services, because most of reduction was not due to service transfer but to service volume reduction. It is desirable to utilize the saving from practice pattern change as incentive to improve quality of care.

• 보건의료생명과학 논문지
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• 제9권1호
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• pp.1-9
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• 2021

본 연구에서는 한국보건의료정보원에서 실시하는 EMR 인증기준울 이해할 수 있도록 보건의료정보관리 실습 프로그램에 인증기준을 추가한 모델을 연구하여 제시하였다. 실습 프로그램은 EMR 인증제의 기능성 기준에 해당하는 환자정보관리를 실습하고 이해할 수 있도록 보건의료정보관리 교육시스템에 환자정보관리에 대한 인증기준 기능을 추가하였다. 환자정보관리를 위한 EMR 인증기준 실습프로그램은 다음과 같은 인증기준으로 구성되었다. 등록번호 및 인적사항 관리, 진료예약 일정관리, 인적사항 수정이력관리, 동명이인 구분자 표시, 다중 등록번호 통합관리, 식별정보를 이용한 환자 검색, 진료형태에 따른 환자 검색, 수술시술 동의서 기록·조회, 개인정보활용동의서 기록·조회, 연명의료결정정보 표시, 외부 의료기관문서 등록·조회, 외부 검사결과 등록·조회. 이와 같이 인증기준에 의한 보건의료정보시스템의 기능을 운영하여 실습해봄으로써 인증기준의 기능성 영역에서 환자정보관리의 인증기준과 내역을 이해하고 실습할 수 있다. EMR 인증 기준에 맞춰 환자정보관리 실습을 수행해봄으로써 전자의무기록시스템에서의 표준화된 환자정보관리를 이해할 수 있다. 또한 EMR 인증기준의 기능을 확인할 수 있기 때문에 의료기관에서 보건의료정보관리사의 전자의무기록시스템의 관리 능력을 향상시킬 수 있을 것이다.

• 보건행정학회지
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• 제15권2호
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• pp.16-36
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• 2005

Due to the existence of asymmetry of information between doctor and patient, it has been believed that doctor might affect patient's decision making process of purchasing medical care. Based on this notion, doctor's reimbursement method has been suggested as an effective policy device of improving efficiency of patient's medical care use by way of its affecting doctor's practice pattern. By using the Community Tracking Study (CTS) household and physician data set, which includes not only various information on patient's medical care use, but doctor's practice arrangements and sources of practice revenue, this paper investigates the effect of community doctor's characteristics of reimbursement method on community patient's medical care use under the control of patient's socio-demographic characteristics and community doctor's practice type. In the process of estimating econometric model, the endogeneity problem of individual health insurance purchase was corrected by using 2818. And due to the existence of sample selection problem, Heckman's two-step estimation method was used for strengthen the robustness of estimation which was adversely affected by sample selection problem The empirical results show that as the average value of community doctor's portion of practice revenue determined by prospective method out of total revenue increases, the community patient's total out-of-pocket medical cost decreases. This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would be more conscious about practice cost, which might affect doctor's practice pattern and by which his/her patient's use of medical care would decrease.

• 의학교육논단
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• 제20권2호
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• pp.91-102
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• 2018

This study explored medical students' major research topics and research methods by analyzing 184 academic articles pertaining to the characteristics of medical students from 2007 to 2017. Results showed many papers dealing with medical students' emotional and cognitive aspects, student counseling, clinical practice education, and curriculum management. According to the medical education accreditation board, research trends were found mostly in the student and curriculum areas of learner characteristics, medical humanities, student counseling, clinical practice education, and curriculum management. Common research topics have been steadily increasing since the introduction of the evaluation accreditation standard in 2012. Medical students predominantly used quantitative research methods for the studies. In the future, it is necessary to ensure that research topics such as CQI, digital- and performance-based clinical practice, and convergent curriculum within the Fourth Industrial Revolution are being studied. In addition, it is crucial to investigate learners' unique, dynamic, and qualitative characteristics through qualitative and mixed methods.

• 보건행정학회지
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• 제21권2호
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• pp.179-194
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• 2011

Although there have been studies regarding the separating policy of dispensary and medical practice, little study have provided a concrete empirical evidence to what extent the policy objectives are achieved. In this paper, we try to provide empirical evidence whether the policy separating dispensary from medical practice achieved the policy objectives, which representatively are reducing the mis-use or over-use of anti-biotic prescriptions and medicines, and decreasing the government spending for the cost of pharmaceutical support. By comparing the average of the rate of change of the number of medicines prescribed, the rate of anti-biotics prescribed, and the government spending for the cost of pharmaceutical support between the areas where the separation policy was implemented and the exceptional areas, we concluded that it is difficult to conclude that the policy separating dispensary and medical practice achieved its policy objects, as it first announced to achieve in the introduction of the policy in 2000. However, the limitation of this study is that the data, that can thoroughly analyze the effect of separating policy of dispensary from medical practice, cannot be collected as expected. Hence, we could not use a parsimonious empirical model to evaluate the effect of the policy introduced in 2000. Rather we used a simple statistical method to extract enough empirical evidence fro m the data available. In the near future, we would expect to see more research that analyze the exact effect of policy separating dispensary and medical practice with concrete empirical model using more sophisticated dataset.

• 한국의료질향상학회지
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• 제4권2호
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• pp.230-240
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• 1997

Background : Hypercholesterolemia is a major independent risk factor of coronary heart disease. Practice guidelines for management of hypercholesterolemia had been made in several developed countries. This study was undertaken to assess the effect of practice guideline reminders and flow-sheets to improve the quality of management of hypercholesterolemia. Methods: Practice guideline reminders and flow-sheets based on National Cholesterol Education Program Adult Treatment Panel II guidelines, were placed on the office desks of outpatient department of family medicine at the Asan Medical Center. Before this intervention, we educated the doctors to use these reminders and flow-sheets. The charts of all patients who had cholesterol levels greater than or equal to 240 mg/dl during 4 months before and after introduction of reminders and flow-sheets, were reviewed retrospectively. We compared the performances of physicians about management of hypercholesterolemia between pre-intervention period and post-intervention period. Results: The detection rate of hypercholesterolemia in post-intervention period was increased to 83.2% compared by 71.5% in pre-intervention period. Risk factor analysis for coronary heart disease increased significantly from 16.9% to 68.7%. Adequacy of management was 19.2% in pre-intervention period and 78.0% in post-intervention period. It showed statistically significant improvement in management of hypercholesterolemia. Conclusion : This study suggested that practice guideline reminders and flow-sheets were the effective methods in improving the quality in management of hypercholesterolemia.