• 가정간호학회지
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• 제19권1호
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• pp.11-18
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• 2012

Purpose: The aim of this study is to evaluate the efficiency of the outpatient clinics in a hospital, using DEA. Methods: Data were collected using an activity-based costing system, medical information system, and annual reports of customer satisfaction management team of a general hospital in a city. The input variables were the number of doctors, the number of nurses, and the number of staffs. The output variables were the number of treatment times, the number of outpatient clinic patients, the total profits from outpatient clinic, the patient's satisfaction score, and the number of re-visit appointments. EMS Window version 3.1 was used to measure the efficiency score and benchmarking analysis. Results: The average efficiency score of 24 outpatient clinics was about 82.01%. Thirteen outpatient clinics had 100% efficiency score among them. The lowest efficiency score was 57.56%. Conclusion: According to these results, we found that, generally, outpatient clinics were operated very efficiently. However, some outpatient clinics had low efficiency and they needed specialized outcome improvement strategies. To increase the efficiency of inefficient outpatient clinics, we will recommend using results of DEA, as a benchmark point of the most efficient outpatient clinics.

• Safety and Health at Work
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• 제11권4호
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• pp.385-396
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• 2020

Teachers are facing various job demands with psychosocial aspects being fundamental due to the nature of the occupation. Although teachers' work is associated with different psychosocial health risks, little is known on how to identify and tackle those. Thus, a systematic literature search as per the PRISMA statement was conducted via MEDLINE (PubMed), PSYNDEX (PubPsych), and ScienceDirect. Two reviewers independently screened 2261 titles and abstracts and 169 full-texts. According to the inclusion criteria established a priori, articles from peer-reviewed journals (English or German) on psychosocial risk management in teachers were incorporated. Despite a comprehensive and sensitive search, only four publications could be identified, outlining a process to implement risk management and different assessment tools. Taken together, data presented in the articles were scarce. Recommendations for process steps and the assessment of psychosocial risks can be derived from the findings. To implement effective psychosocial risk management in the teaching profession, further research is needed, though. Effective and practicable approaches, which are accepted by the target group, should be further developed and investigated. Relevant causes of occupational strain in the teaching profession must be identified and assessed reliably. Low-threshold interventions should be implemented, and the outcome must be evaluated afterward.

• 한국실내디자인학회논문집
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• 제13권5호
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• pp.133-142
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• 2004

Recently, the Korean medical system changed with diversification & specialization and the field of medical service is also specialized in these days. And healing environment is proposed as a general concept in the hospital architecture. There is a trend that a establishment of women's hospital is increasing as specialized type. In difference from general hospital, they are providing specialized and integrated services in response to the women's disease and demand. Particularly, Outpatient department space in women's hospital has been changed in terms of area, shape and program. However, there used to be not enough research efforts of responding these changes. This study includes the Outpatient department of s women's hospital in the form of small and medium sized building over a certain level in Korea. And the methods of the study adopted the theoric examination based concept and features of women's hospital, the abstraction of distinctions in the Outpatient department through the analysis of the drawing, and the analysis of distinctions in the Outpatient department of women's hospital with the structural space classified and the analysis of space relation. Therefore, the purpose of this is to study investigates and analyzes the spatial characteristics of the Outpatient department space in women's hospital through a analysis of case study. To conclude, the space composition can be classified into the entry space, the clinic space for patients, the support space of patients' check-up, the reception and waiting space, the rest and convenience space, and the link space in the Outpatient department of women's hospital. The level space can account for the waiting space type, the clinic office type, the type based on the relation between the waiting room and the clinic office with its features. As a result, the results will be applied for the planning & design for the future women's hospital.

• 보건행정학회지
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• 제34권2호
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• pp.196-210
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• 2024

연구배경: 2018년 1월 의원급(의원, 치과의원, 한의원) 노인외래정액제 개선안이 시행되었다. 정액진료비 상한금액인 1만 5,000원 이하 진료를 받은 경우의 본인부담금은 기존과 동일하다. 개선안은 정액진료비 상한금액인 1만 5,000원 초과 진료를 받은 경우의 본인부담금을 차등적으로 인하하였는데, 1만 5,000원 초과 2만 원 이하 구간의 본인부담금은 진료비의 30%에서 10%로, 2만 원 초과 2만 5,000원 이하 구간의 본인부담금은 진료비의 30%에서 20%로 인하하였다. 우리나라는 급격한 인구 고령화로 고령인구와 노인진료비가 빠르게 증가하고 있고, 노인빈곤율이 경제협력개발기구 회원국 중 가장 높다. 연구는 건강보험 지속 가능성 유지와 노인복지 향상을 위하여 노인외래정액제 개선이 고령층의 의료이용에 미친 영향을 종합적으로 확인하려고 한다. 방법: 연구는 한국의료패널 자료를 사용하여 노인외래정액제 개선 이후 고령층의 의료이용 변화를 추정하였다. 연구는 단절적 시계열 연구 중 구간별 회귀분석을 분석에 이용하였고, 진료비 구간별 및 의원 종류별 외래진료 횟수, 입원횟수 및 일수 변화는 포아송 구간별 회귀분석을, 외래 및 입원진료비 변화는 구간별 회귀분석을 이용하여 추정하였다. 구간별 회귀분석은 개입으로 인한 효과와 시간의 흐름에 따른 효과를 구분할 수 있게 해주어, 개입이 없더라도 발생했을 변화와 개입으로 인한 변화를 명확하게 추정할 수 있도록 해준다. 의료이용에 영향을 미칠 것으로 예상되는 성별, 연령, 교육수준, 소득, 배우자 유무, 장애 정도, 지역, 주관적 건강인식, 질병 및 손상으로 인한 일상생활 제한 여부, 응급 및 입원 수술 여부, 응급실 이용횟수, 만성질환 개수, 계절은 통제변수로 포함하였다. 결과: 노인외래정액제 개선 직후 본인부담 변화가 없던 의원, 한의원 진료비 1만 5,000원 이하 구간의 외래진료 횟수가 감소하였다. 그러나 본인부담이 감소한 의원 1만 5,000원 초과 2만 원 이하 구간과 한의원 2만 원 초과 2만 5,000원 이하 구간의 외래진료 횟수는 증가하였다. 치과의원의 외래진료 횟수 변화는 통계적으로 유의하지 않았다. 입원율은 노인외래정액제 개선 직후 감소하였지만, 이후 다시 증가하였다. 외래진료비 중 본인부담금은 노인외래정액제 개선 직후 감소하였다. 입원진료비와 외래와 입원진료비를 합한 총진료비는 노인외래정액제 개선 직후 감소하였다가 이후 다시 증가하였다. 결론: 분석결과를 통해 노인외래정액제 개선 이후 일시적인 의료이용 증가와 본인부담금 감소를 확인할 수 있었다. 총진료비 중 입원이 차지하는 비중이 외래보다 크기 때문에, 노인외래정액제 개선이 고령 환자의 의료비 부담 완화에 미친 영향은 매우 제한적이었다. 장기적으로 고령 환자의 의료비 부담 완화와 건강보험 지속 가능성 유지를 위해서는 본인부담 완화 정책과 질병 악화로 인한 입원을 예방하기 위한 만성질환 관리정책이 함께 이루어져야 할 것으로 보인다. 연구의 결과는 정책을 수립할 때 본인부담 변화가 고령층의 의료이용 행태에 미치는 영향에 대한 기초정보를 제공할 수 있을 것으로 기대된다.

• 대한치과마취과학회지
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• 제13권3호
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• pp.95-102
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• 2013

Background: Sedation or outpatient general anesthesia is a necessary method for a successful dental treatment for children and the disabled who have a difficulty of cooperation. The aim of this study was to assess the patients who had dental treatment under sedation or outpatient general anesthesia at department of pediatric dentistry, Chonnam national university dental hospital and Gwangju dental clinic for the disabled. Methods: 875 patients who had sedation from January 2009 to September 2013 and 88 patients who had outpatient general anesthesia after May 2011 were assessed for this study. Patient's distribution and treatment patterns were examined. Results: The number of patients has been increasing in both sedation and outpatient general anesthesia. In case of sedation, the proportion of male patients was higher and 4-6 years age group was the highest. Most patients have resided in Gwangju buk-gu and the percentage of restorative treatment was the highest. In case of outpatient general anesthesia, the proportion of male patients was higher than that of sedation. Two groups, 10-19 and 20-29 years age, consisted most of patient. Most patients have resided in Gwangju buk-gu and Jeollanam-do, and the percentage of periodontic and preventive treatment was the highest. Conclusions: Sedation or outpatient general anesthesia for dental treatment has been increasing for children and the disabled who have a difficulty of cooperation. Therefore, it is important to improve treatment environment under sedation and general anesthesia through continuous research and studies.

• Clinical and Experimental Reproductive Medicine
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• 제50권1호
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• pp.53-62
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• 2023

Objective: The aim of this study was to investigate the relationships of serum folate (vitamin B9), cobalamin (vitamin B12) levels and diet with semen parameters (semen standard parameters [SSP] and DNA fragmentation index [DFI]) in infertile men. Methods: Sperm samples were assessed for SSP and DFI (using the sperm chromatin dispersion test). Serum vitamin concentrations were measured with an immuno-electrochemiluminescence assay, and men completed a semi-quantitative food frequency questionnaire (FFQ). Results: Serum folate levels were positively correlated with sperm progressive motility and DFI. A comparison of SSP between two groups of patients according to serum folate concentration (B9 <4.840 ng/mL and B9 ≥4.840 ng/mL) showed significantly higher sperm concentration and sperm progressive motility in the latter group. However, there was no difference between these groups regarding DFI. Interestingly, serum folate levels were significantly higher in patients with a high DFI (using the cut-offs of 30% or 18%). FFQ data showed that the consumption of fruits and egg yolk correlated positively with sperm concentration and sperm motility, respectively. Conclusion: Serum folate levels showed significant associations with sperm concentration and sperm progressive motility. However, the positive association of serum folate with DFI raises the need for careful prescription of folate supplements.

• 대한치과의사협회지
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• 제56권1호
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• pp.49-57
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• 2018

The most widely used method of pain control in dental practice is to block the pathway of painful impulses by local anesthesia. For a maximum effect of pain control at outpatient minor operation, regional anesthesia including nerve block must be performed. This issue includes various dental local anesthetic techniques on mandible, maxilla and considerations for selection of dental local anesthetics according to patient's age, duration of operation. Additionally, current conscious sedation technique combined with local anesthesia will be introduced for control of patient's anxiousness. Based on patient's general condition, severity of operation, local anesthesia sometimes must be changed into general anesthesia to avoid failure of dental practice. The exact choice of anesthetic techniques for minor operations at dental outpatient clinic must not be underestimated for complete success of pain control.

• 한국전자거래학회지
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• 제16권3호
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• pp.113-127
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• 2011

RFID 시스템은 초기 공급사슬관리 영역에서 다양한 영역으로 확산되고 있다. 의료분야 또한 환자, 의료진, 의료기기 등의 위치추적 관리 의약품 추적관리 등의 영역에 RFID 시스템 도입을 진행하고 있다. 본 연구는 외래병원에서 태그의 위치추적을 위한 수동형 RFID 기술기반의 시스템 구축 사례를 4계층의 시스템 구조를 활용하여 분석하였다. 특히 일반적으로 수동형 RFID 기술에서 경험하는 불안정한 인식 데이터 문제를 해결하기 위하여 두 계층으로 구성된 데이터 처리 절차를 제시하였다. 본 논문에서 제시한 데이터 처리 절차를 실제사례에서 취합한 데이터에 적용하여 태그의 위치를 정확하게 파악하고 추가적인 업무 정보를 도출하는 것이 가능함을 확인하였다. 마지막으로 보다 안정적이고 효과적인 RFID 시스템 구축을 위하여 사례분석에서 경험한 추가적인 논의사항과 연구방향을 제시하였다.

• 대한치과마취과학회지
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• 제11권2호
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• pp.133-140
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• 2011

Background: Dental treatment under outpatient general anesthesia is an option for disabled person, children and dentally disabled person who have the difficulty of cooperating voluntary with dental care. The aim of this study was to access the patients who had dental management under general anesthesia at Chungnam dental clinic for the disabled. Methods: This survey is consisted of 114 severely disabled and dentally disabled person who undergone dental treatment under general anesthesia from January to June 2011. Data were collected by individual dental and anesthesia records. Results: Of the 114 patients studies, the 45 patients was the dentally disabled and the 69 patients was the severely disabled. Rate of dental treatment among male patients was higher than among female patients. The dentally disabled was an similar age distribution. In the severly disabled, above 13-year-old was higher than below 12-year-old. The most popular induction method of general anesthesia was sevoflurane inhalation after induced sedative effect of nitrous oxide inhalation. The severly disabled who had definitely negative behavior was applied inhalation of high concentration sevoflurane. Conclusions: Chungnam Dental clinic for the disabled provide dental management for the disabled and the dentally disabled.

• Journal of Chest Surgery
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• 제49권3호
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• pp.185-189
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• 2016

Background: For treatment of pneumothorax in Korea, many institutions hospitalize the patient after chest tube insertion. In this study, a portable small-bore chest tube (Thoracic Egg; Sumitomo Bakelite Co. Ltd., Tokyo, Japan) was used for pneumothorax management in an outpatient clinic. Methods: Between August 2014 and March 2015, 56 pneumothorax patients were treated using the Thoracic Egg. Results: After Thoracic Egg insertion, 44 patients (78.6%) were discharged from the emergency room for follow-up in the outpatient clinic, and 12 patients (21.4%) were hospitalized. The mean duration of Thoracic Egg chest tube placement was 4.8 days, and the success rate was 73%; 20% of patients showed incomplete expansion and underwent video-assisted thoracoscopic surgery. For primary spontaneous pneumothorax patients, the success rate of the Thoracic Egg was 76.6% and for iatrogenic pneumothorax, it was 100%. There were 2 complications using the Thoracic Egg. Conclusion: Outpatient treatment of pneumothorax using the Thoracic Egg could be a good treatment option for primary spontaneous and iatrogenic pneumothorax.