• 한국임상약학회지
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• 제9권2호
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• pp.109-118
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• 1999

The need for and components of a contemporary community pharmacy externship for pharmacy students have not been clearly identified in Korea. Mail survey was performed among 20 college of pharmacy deans and 800 community pharmacists to analyze the current status and develop a consensus regarding major focus area and criteria of community pharmacy externship to be implemented under the separation of dispensary from medical practice in year 2000. Mail survey yielded $80\%\;and\;23.5\%$ response rate for pharmacy school deans and community pharmacists, respectively. Of the 16 pharmacy schools that responded 14 said they have externship program in hospital pharmacy, and only 8 pharmacy schools responded of having externship program for community pharmacy. However, these community pharmacy programs lacked criteria and standard guideline for the externship. The results of survey revealed that community pharmacy externship program for students should be organized and directed toward developing expert knowledge and skills in pharmacy practice activities, clinical services, communications, pharmacy management, and professionalism. Pharmacy practice components should include competencies and skills in computer application, prescription processing, dispensing, pharmaceutical compounding, Narcotics Control Law application, maintenance and provision of drug information, and laws and regulations. Clinical service components should include the ability to identify patient's drug-related problems, provide long-term patient care and appreciate drug therapy services. Communication skills should be taught to effectively express his/her professional opinion, deduce the needs of others, utilize appropriate techniques and media to communicate ideas and conduct a patient interview and to obtain patient drug history. Pharmacy management skills should be taught to be efficient in medical insurance and drug control process. It was found that professionalism, morality, pharmacy practice experience, ability to provide clinical services, collect and provide drug information and regality are important criteria of preceptors. Externship sites should possess the ability to stock various drugs, access and provide diverse pharmacy services and should have private patient counseling area. Most pharmacists agreed that top 200 drugs' generic and brand name, indications, dosage, side effects, and contraindication should be instructed during the externship. It was also found that student and preceptor should be evaluated for their performances during the externship. This information will be incorporated into teaming objectives for students and to develop Academic Extemship Program Guidelines.

• ETRI Journal
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• 제45권6호
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• pp.1007-1021
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• 2023

Stroke is the leading cause of permanent disability in adults, and it can cause permanent brain damage. According to the World Health Organization, 795 000 Americans experience a new or recurrent stroke each year. Early detection of medical disorders, for example, strokes, can minimize the disabling effects. Thus, in this paper, we consider various risk factors that contribute to the occurrence of stoke and machine learning algorithms, for example, the decision tree, random forest, and naive Bayes algorithms, on patient characteristics survey data to achieve high prediction accuracy. We also consider the semisupervised self-training technique to predict the risk of stroke. We then consider the near-miss undersampling technique, which can select only instances in larger classes with the smaller class instances. Experimental results demonstrate that the proposed method obtains an accuracy of approximately 98.83% at low cost, which is significantly higher and more reliable compared with the compared techniques.

• 한국컴퓨터정보학회논문지
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• 제4권4호
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• pp.251-259
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• 1999

서비스과업요인 변수가 고객만족과 어떠한 관계가 있는지를 서울, 인천 경기도의 병원(대학. 종합, 개인, 한의)을 대상으로 하여 의료서비스 과업의 요인(유형적품질, 유연성. 비용. 시간 및 관리기술) 그리고 기대요인, 고객만족의 각 요인 항목을 토대로 통계분석을 통해서 연구가설의 현실적 적합성을 연구하였다.

• 성인간호학회지
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• 제12권3호
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• pp.323-333
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• 2000

The purpose of this study was to determine the impact of situational, clinical and psychsoical factors on treatment-seeking behavior among those with acute myocardial infarction(AMI). This study used a retrospective, descriptive design. The sample consisted of 72 patients aged over 30 and who were diagnosed with an acute myocardial infarction at two large university-affiliated medical centers from July 1, 1998 to March 30, 2000. But of 72, patients 5 who were an outlier in treatment-seeking time were deleted. Data were collected by using questionnaires, which included demographic data, situational, clinical and psychosocial data. Also patient interviews and chart review were used to obtain information related to treatment-seeking time. The results of this study were summarized as follows ; 1. Mean time from the onset of AMI symptoms to arrival at the hospital was $12.09{\pm}11.44$ hours; 2. Treatment-seeking time was not significantly different by age, gender, or education; 3. Most(44 or 65.78%) patients were at home when they began having AMI symptoms. The remaining patients were either in a public area, workplace or in a car. Patients at home delayed longer than those who had their first symptoms elsewhere, but not significantly different. Also, most patients were with another person when they began to experience AMI symptoms: a spouse(25 or 37.3%), other family member(31 or 46.3%); the remaining 11 were alone. There were no significant differences in treatment-seeking time based on whether alone or with others. Most patients(46 or 68.7%) used an ambulance rather than taking private transportation, and patients who used an ambulance were delayed longer than those who used private transportation, but there were no significant differences; 4. Time to treatment-seeking was not significantly different by blood pressure, heart rate on admission and the peak CK-MB, CPK and Cholesterol level, Killips class; 5. There were no significant statistical differences in treament-seeking times by anxiety level, mood status or control ability.

• 한국병원경영학회지
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• 제21권2호
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• pp.37-49
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• 2016

The purpose of this study is to investigate the level of competition between Public Health Centers (PHCs) and private clinics (PCs) by examining the number of patients that used PHCs vs. PCs, estimating the total amount of revenue generated from outpatient services at both PHCs and PCs, thereby analyzing the financial impacts on PCs derived from the PHCs. We utilized 2011 National Inpatient Sample data (NIS). Using the 20 table containing general information on each individual claims, we integrate it with the 40 table which contains all the diagnostic codes for each claim. Then, we disaggregate the bundled claims into the original individual claims. Overall, 3.1% of outpatient visits are made at PHCs while the rest was made at the PCs (96.9%). Among the total claim costs of 6.34 billion USD (as of 2011), PHCs occupy 2.0% (124 million USD), and 98.0% are contributed to PCs (6.21 billion USD). The estimated economic losses of PCs due to PHCs are summarized as follow; the maximum potential loss is estimated at 198 million USD in total and 7,099 USD per clinic when we include all patient types; the minimum loss is estimated at 71 million USD in total and 2,540 USD per clinic where Medical Aid recipients and the elderly (aged 65 and over) are excluded. Our results confirm the potential economic effect on PCs due to PHCs providing outpatient services. PCs and PHCs are the most important players providing primary care in Korea. Unnecessary competition between PCs and PHCs is not desirable. Health authorities should carefully examine the healthcare services currently provided by PHCs and their impacts on PCs.

• 대한응급의학회지
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• 제29권5호
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• pp.399-407
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• 2018

Objective: Regionalization is one of the principal subjects for the advancement of rural emergency medical service systems in South Korea. This study shows the characteristics of interhospital transfer and status of the incidence of three major emergency disorders (acute myocardial infarction [AMI], acute stroke, and severe trauma) in one local province. Methods: A retrospective study was conducted for patients with three major emergency disorders who visited emergency medical facilities in one local province from January 2013 to December 2015, on the basis of the National Emergency Department Information System (NEDIS) data. Results: The incidence of three major emergency disorders had increased annually. Patients with each of these disorders tended to choose distinguishing methods of visiting emergency medical facilities. AMI patients tended to visited emergency medical facilities using private cars or on foot, while severe trauma patients usually visited by 119 ambulance, and acute stroke patients used 119 ambulance and private car in similar amounts. Overall, 65% of AMI patients were treated in intraregional medical facilities, but about 70% of acute stoke and severe trauma patients were transferred outside of the region. Conclusion: Because each of these disorders has an individual characteristic, it is difficult to expect a solution for the problems associated with emergency disorders just by assuring the availability of medical resources. Based on regionalization, a policy to provide the optimal treatment for those emergency disorders should be developed by planning public medical service systems based on the individual characteristics of emergency disorders, the standardized transfer plans of emergency patients and the assurance for mobilization and sharing of confined medical resources.

• 한국정보통신학회논문지
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• 제8권8호
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• pp.1777-1782
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• 2004

본 논문에서는 XML을 기반으로 한 처방전 전송 시스템을 제안하고, XML/EDI의 암호화를 위하여 XML 문서에만 전자서명을 첨부하는 것이 아니라, DTD에 전자 서명을 첨부하는 방법을 사용함으로써 보다 안전한 처방전 전송 시스템을 구축하고자 한다. 처방전 DTD는 앞서 살펴본 처방전의 각 구성요소에 따라 처방전 정보, 환자 정보, 의료기관 정보, 처방내역 정보, 조제내역 정보 엘리먼트를 정의하고 그 하위에 정보 전송에 따른 정보를 관리하기 위한 하위 엘리먼트를 정의하였다. 안전한 처방전전송을 위하여 DTD파일을 읽어 들이면서 파싱을 하고 여기서 추출되는 엘리먼트나 속성, 엔티티들을 해시테이블에 저장한다. 파싱이 종료되면 해시 테이블을 읽어 들여서 메시지 다이제스트를 수행하고 이를 개인키와 합성하여 전자 서명을 생성한다.

• 한국정보통신학회논문지
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• 제11권4호
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• pp.722-727
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• 2007

본 논문에서는 XML을 기반으로 한 처방전 전송 시스템을 제안하고, XML/DTD의 암호화를 위하여 XML 문서에만 전자서명을 첨부하는 것이 아니라, DTD에 전자서명을 첨부하는 방법을 사용함으로써 보다 안전한 처방전 전송시스템을 구축하고자 한다. 처방전 DTD는 앞서 살펴본 처방전의 각 구성요소에 따라 처방전 정보, 환자 정보, 의료기관 정보, 처방내역 정보, 조제내역 정보 엘리먼트를 정의하고 그 하위에 정보 전송에 따른 정보를 관리하기 위한 하위 엘리먼트를 정의하였다. 안전한 처방전 전송을 위하여 DTD 파일을 읽어 들이면서 파싱을 하고 여기서 추출되는 엘리먼트나 속성, 엔티티들을 해시테이블에 저장한다. 파싱이 종료되면 해시 테이블을 읽어 들여서 메시지 다이제스트를 수행하고 이를 개인키와 합성하여 전자 서명을 생성한다.

• 의료법학
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• 제13권1호
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• pp.359-395
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• 2012

In a broad term, health and medical data means all patient information that has been generated or circulated in government health and medical policies, such as medical research and public health, and all sorts of health and medical fields as well as patients' personal data, referred as medical data (filled out as medical record forms) by medical institutions. The kinds of health and medical data in medical records are prescribed by Articles on required medical data and the terms of recordkeeping in the Enforcement Decree of the Medical Service Act. As EMR, OCS, LIS, telemedicine and u-health emerges, sharing and protecting digital health and medical data is at issue in these days. At medical institutions, health and medical data, such as medical records, is classified as "sensitive information" and thus is protected strictly. However, due to the circulative property of information, health and medical data can be public as well as being private. The legal grounds of health and medical data as such are based on the right to informational self-determination, which is one of the fundamental rights derived from the Constitution. In there, patients' rights to refuse the collection of information, to control recordkeeping (to demand access, correction or deletion) and to control using and sharing of information are rooted. In any processing of health and medical data, such as generating, recording, storing, using or disposing, privacy can be violated in many ways, including the leakage, forgery, falsification or abuse of information. That is why laws, such as the Medical Service Act and the Personal Data Protection Law, and the Guideline for Protection of Personal Data at Medical Institutions (by the Ministry of Health and Welfare) provide for technical, physical, administrative and legal safeguards on those who handle personal data (health and medical information-processing personnel and medical institutions). The Personal Data Protection Law provides for the collection, use and sharing of personal data, and the regulation thereon, the disposal of information, the means of receiving consent, and the regulation of processing of personal data. On the contrary, health and medical data can be inspected or delivered of the copies, based on the principle of restriction on fundamental rights prescribed by the Constitution. For instance, Article 21(Access to Record) of the Medical Service Act, and the Personal Data Protection Law prescribe self-disclosure, the release of information by family members or by laws, the exchange of medical data due to patient transfer, the secondary use of medical data, such as medical research, and the release of information and the release of information required by the Personal Data Protection Law.

• 융합보안논문지
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• 제9권2호
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• pp.49-58
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• 2009

의료기관에서 환자의 개인건강정보는 진료를 위해 의료진의 정보열람이 반드시 필요한 사항이다. 그러나 이러한 정보의 불필요한 노출은 개인정보보호와 관련이 있어 민감하게 취급되어야 하며, 의료기관에 종사하는 사용자들이라 할지라도 접근에 있어 역할에 따른 제한이 필요하다. 따라서 본 논문에서는 의료진과 그 이외의 직원들 간의 사용자 식별을 통한 개인건강정보의 접근 통제뿐만 아니라 업무에 따른 조건을 추가하여 사용자 직종 내에서도 상황에 따른 접근 통제에 대해 연구하였다. 응급상황, 담당과 여부에 따른 접근 통제, 그리고 환자가 정하는 본인의 개인정보에 대한 접근통제를 포함하여 확장된 개념의 역할기반 접근제어를 합으로써 의료기관내에서 환자의 개인건강정보의 불필요한 접근이나 유출을 최소화 할 수 있다.