• The Korean Society of Law and Medicine
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• v.22 no.2
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• pp.111-138
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• 2021

'Unlicensed medical practice by a non-medical practitioner' often represented by surrogate surgery or so-called 'ghost surgery,' causes irreparable damage to life or body, and therefore calls for very strict and effective controls. The 'bill on installment of CCTVs in an operating room' to prevent unlicensed surrogate surgery has been discussed for a long time, but due to numerous issues and heated confrontations, it has been pending in the National Assembly. Nevertheless, it is expected that the bill will be discussed again in earnest in the National Assembly because surrogate surgery and factory-type cosmetic surgery, which has been performed mainly in the field of cosmetic surgery, has also been occurring in the field of therapeutic surgery. In general, an operating room is considered as being locked or closed, as well as disallowing implicit complicity among insiders. Hence, if the insiders conspire to commit or cover up an illegal act, or if a surgeon performs rapid cosmetic surgery and then leaves the recipient (or medical institution) so as to perform more operations for profit - even if it is legitimate practice - it may result in serious consequences in terms of the recovery of a patient. In this case, installation of CCTVs can be of great help in identifying an illegal act and assessing any occurrence of negligence. On the other hand, while the fundamental purpose of therapeutic surgery is to restore a patient's life or body - that is, lifesaving - installation of CCTVs may base the relationship between a surgeon and a patient on distrust and surveillance, so it may increase the number of requests for CCTV footage or lead to more disputes, as well as placing a burden on the surgeon when best results are not achieved for a patient. As a result, the surgeon may choose non-invasive treatment contrary to conscience instead of risky but necessary surgery, or he/she may have significant difficulty in determining the timing of surgery, which may limit the provision of effective surgical medical care. Then, in terms of the relationship between a surgeon and patient, and in the long run, there could be significant disadvantages for the public and patients if CCTV footage is allowed. In this paper, we review domestic and overseas cases and issues regarding installation of CCTVs in an operating room, and present various viewpoints and suggestions to promote legislation with minimized legal problems and side effects, thereby contributing to protection of the lives and health of the public, patients, and recipients of surgery.

• Information Systems Review
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• v.9 no.1
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• pp.45-65
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• 2007

In medical industry, health insurance bill audit is unique and essential process in general hospitals. The health insurance bill audit process is very important because not only for hospital's profit but also hospital's reputation. Particularly, at the large general hospitals many related workers including analysts, nurses, and etc. have engaged in the health insurance bill audit process. This paper introduces a case of health insurance bill audit for finding reducible health insurance bill cases using decision tree induction techniques at a large general hospital in Korea. When supervised learning methods had been tried to be applied, one of major problems was data imbalance problem in the health insurance bill audit data. In other words, there were many normal(passing) cases and relatively small number of reduction cases in a bill audit dataset. To resolve the problem, in this study, well-known methods for imbalanced data sets including over sampling of rare cases, under sampling of major cases, and adjusting the misclassification cost are combined in several ways to find appropriate decision trees that satisfy required conditions in health insurance bill audit situation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.3
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• pp.1146-1152
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• 2010

The Korean healthcare industry is rapidly changing along with the competition among hospitals. In the past, hospitals could make profit without designing competitive management strategies. Thus, they did not find importance in listening to customers' voices and identifying their wants. However, nowadays, the increasingly intense competition is encouraging hospitals to seriously consider competitive management strategies and Customer Relationship Management (CRM) activities to gain a competitive advantage and prosper. It tries to compare the expected satisfaction with the satisfaction of out-patient and in-patient and analysis of VOC(Voice of Customer). This survey was done from 27th, April, 2009 to 8th May and each 100 in-patients and out-patients. The paired t-test and descriptive analysis was used to analysis between before and after satisfaction. The result, the replied out-patients were the highest of I.M department, 43% and in-patients, surgery and other department are the highest each 22.0%. Nurses kindness is statistical significant in out-patients. Doctor, Nurse and staff's kindness and rounding service was statistical significant in in-patients. Totally, the satisfaction was lower than expected satisfaction, so the medical care institutions should analyst detailed the patient's satisfaction by VOC.

• The Korean Society of Law and Medicine
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• v.20 no.2
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• pp.173-206
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• 2019

This research examines the characteristic of regulation on Japanese clinical research in recent years. First, Japan has had a severe punishment policy on research misconduct like Korea, but, in recent days, Japan has changed the direction of research ethics policy from restriction to research publicness securement by educational training, in addition, Act of Clinical Research, effected April 2018, has recruited excellent researchers, and then integrated clinical research and medicine clinical trial through raising transparency of funding and integrating ethics screening by mandating announcement on funding information of clinical research. Second, Japan has integrated and organized ethics guideline from dual system that consists of ethics guideline on dynamic research(here after, referred to as 「dynamic guideline」) and ethics guideline on clinical research(here after, referred to as 「clinical guideline」) to ethics guideline on medical research aimed at human(here after, referred to as 「integrated guideline」), thus, it complements repetition and deficit of ethics guideline needed in clinical research and dynamic research, and it has risk evaluation system for protecting human subjects, and also it clarifies the concept of 「invasiveness」, a preliminary consideration of evaluation. 「Evaluation issue of risk and profit」, common contents of international regulation related clinical research, is the method to check whether the research is designed appropriately or not, this is the method for Institutional Review Board to decide whether the risk on human subjects could be justified, and also this is the important standard for future human subjects to participate in clinical trial. Therefore, it is meaningful to define 「invasiveness」 concept, a preliminary consideration of risk evaluation for human subjects. This research examines Japanese clinical trial focusing on change of awareness on prevention of research misconduct, efficiency improvement of research through research screening and integration of human subjects, and clarification and extension of range of 「invasiveness」 concept, a preliminary of risk evaluation to protect human subjects.

• Korea Journal of Hospital Management
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• v.9 no.1
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• pp.66-94
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• 2004

The objective of this study is to examine how to maximize the efficiency of hospital management by minimizing the unit cost of hospital operation. For this purpose, this paper proposes to develop a model of the profit maximization based on the cost minimization dictum using the statistical tools of arriving at the maximum likelihood values. The preliminary survey data are collected from the annual statistics and their analyses published by Korea Health Industry Development Institute and Korean Hospital Association. The maximum likelihood value statistical analyses are conducted from the information on the cost (function) of each of 36 hospitals selected by the random stratified sampling method according to the size and location (urban or rural) of hospitals. We believe that, although the size of sample is relatively small, because of the sampling method used and the high response rate, the power of estimation of the results of the statistical analyses of the sample hospitals is acceptable. The conceptual framework of analyses is adopted from the various models of the determinants of hospital costs used by the previous studies. According to this framework, the study postulates that the unit cost of hospital operation is determined by the size, scope of service, technology (production function) as measured by capacity utilization, labor capital ratio and labor input-mix variables, and by exogeneous variables. The variables to represent the above cost determinants are selected by using the step-wise regression so that only the statistically significant variables may be utilized in analyzing how these variables impact on the hospital unit cost. The results of the analyses show that the models of hospital cost determinants adopted are well chosen. The various models analyzed have the (goodness of fit) overall determination (R2) which all turned out to be significant, regardless of the variables put in to represent the cost determinants. Specifically, the size and scope of service, no matter how it is measured, i. e., number of admissions per bed, number of ambulatory visits per bed, adjusted inpatient days and adjusted outpatients, have overall effects of reducing the hospital unit costs as measured by the cost per admission, per inpatient day, or office visit implying the existence of the economy of scale in the hospital operation. Thirdly, the technology used in operating a hospital has turned out to have its ramifications on the hospital unit cost similar to those postulated in the static theory of the firm. For example, the capacity utilization as represented by the inpatient days per employee tuned out to have statistically significant negative impacts on the unit cost of hospital operation, while payroll expenses per inpatient cost has a positive effect. The input-mix of hospital operation, as represented by the ratio of the number of doctor, nurse or medical staff per general employee, supports the known thesis that the specialized manpower costs more than the general employees. The labor/capital ratio as represented by the employees per 100 beds is shown to have a positive effect on the cost as expected. As for the exogeneous variable's impacts on the cost, when this variable is represented by the percent of urban 100 population at the location where the hospital is located, the regression analysis shows that the hospitals located in the urban area have a higher cost than those in the rural area. Finally, the case study of the sample hospitals offers a specific information to hospital administrators about how they share in terms of the cost they are incurring in comparison to other hospitals. For example, if his/her hospital is of small size and located in a city, he/she can compare the various costs of his/her hospital operation with those of other similar hospitals. Therefore, he/she may be able to find the reasons why the cost of his/her hospital operation has a higher or lower cost than other similar hospitals in what factors of the hospital cost determinants.

• Management & Information Systems Review
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• v.36 no.4
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• pp.1-19
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• 2017

These days, the concept of creating shared value is drawn keen attentions to. This interest comes out of the expectation that Creating Shared Value(CSV) can offer an answer to some social issues by creating societal and economic values on the top of the achievements that existing Corporate Social Responsibility(CSR) has made. However, it is difficult to make a clear distinction between the achievements that the activities of CSR and CSV have made. In this regard, developing a methodology to make an actual proof analysis on the accomplishments of CSV and to verify customer's awareness of and attitude towards the CSV is necessarily required. A company needs to gain a competitive advantage in the marketplace as well as resolve a social issue by innovating value chain. The research has verified the cause and effect relationship between the CSV from the point of view of value chain and the purchase intention aroused by its economic, societal and cultural values through the company image and credibility with actual proof analysis and come up with following results. First, a societal and cultural value resulted in giving positive impact on a company's image, which implies that CSV activities can be the thin end of the wedge through which customers have a good image of the company involved in CSV. Second, a societal value makes a positive influence on the credibility of a company. In this regard, CSV should be recognized not just as a thing that generates a cost, but a way to win-win as well as future development. Third and last, the research results show that both company image and credibility influence on purchase intention. Considering that CSV generates a positive evaluation on a company that will ultimately cause continuous profit-making, the company's ultimate goal of activities, it should be approached from the perspective of making a mid-and-long term strategy.

• Korean Journal of Social Welfare
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• v.57 no.3
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• pp.5-30
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• 2005

Globalization has conflicting effects on pharmaceutical policies. A change into a 'populist competitive nation' due to globalization strengthens policies to reduce drug manufacturing costs while the WTO's TRIPS Agreement that is affected by multinational pharmaceutical companies increases drug manufacturing costs by bolstering the patent rights on new drugs. Currently, the independency of populist nations' policies to reduce drug manufacturing cost is being compromised because multinational organizations(such as the European Union) which represents the interests of the multinational pharmaceutical companies put restrictions on the pharmaceutical policies of populist nations for purposes of promoting the industrial goals of the multinational companies. Korea is no exception. Up until the late 1990s, the main feature of the pharmaceutical policies in Korea was keeping the drug price at the cost level based on a growth-driven ideology, and this was Korea's unique policy tools as a developing nation. However, the increase in the power of multinational pharmaceutical companies currently infringes on the independency of Korea's pharmaceutical policies. Expensive imported drugs were originally covered by the national health insurance plan, but starting from 1999 such drugs began to be covered by the plan. After separation of medical and pharmaceutical services, the use of expensive drugs was increased, and the Korean government planned to introduce the reference price policy in order to contain the cost of the national health insurance plan. However, due to pressures from the U.S. government as well as multinational pharmaceutical companies, implementation of the policy has been postponed. In addition, due to a pressure from the U.S. government, a working group was created which would affect the health care policy of the Korean government. Discussions so far on globalization was about whether the change into populist competitive nations due to globalization resulted in the reduction of welfare spending. However, this study shows not only the reduction of health care cost through policies to reduce drug manufacturing costs but increase in welfare spending by raising the strengths of multinational pharmaceutical companies that are for-profit providers of welfare service. While focusing on the contradictory effects of globalization on pharmaceutical policies of a nation, this study looked at how these conflicting effects end up promoting the interests of multinational pharmaceutical companies by examining the Korean case.