• Journal of Preventive Medicine and Public Health
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• 제6권1호
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• pp.133-160
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• 1973

1. Introduction Community medicine with the concept of comprehensive medical care and an ideal medical care delivery system not only for an individual or family but for the whole community has emerged. In April 1970, the Presbyterian Medical Center started a hospital based community health service project in order to improve the health of the people in rural areas. Prior to commencing a comprehensive medical care system, a family survey was needed. The major objective of this survey was to obtain information concerning the people and their environment so as to be able to plan and implement a comprehensive medical care program in Soyang-Myun. 2. Survey Method An interview using a family record form was carried out for each household. This family record form was designed to get information about demography, family planning, environmental sanitation and vital statistics. Prior to beginning, the members of the survey team were trained in interviewing techniques for three days. The team consisted of a public health nurse, four nurse-aides, a sanitarian and four health extension workers who are working in our project, The survey was carried out during the period November 1971 to March 1972. 3. Project area 1) Population of Soyang-Myun was 11,668; male, 5,962 and female, 5,706. Sex ratio: 104.5. 2) Households : 1,858 3) Family size: The average household consisted of 6.3 persons. 4) Educational level of householder a. Illiterate 13% b. No schooling but able to read 10% c. Preschool children 19% d. Primary school 47% e. Middle school 7% f. High school 3% g. College or University 1% 5) Occupational distribution of householders a. Farmer 67% b. Laborer 13% c. Office worker 4% d. Merchant 4% e. Industrial worker 2% f. Unemployed 8% g. Miscellaneous 2% 6) Religious affiliation a. No religion 74% b. Buddhist 12% c. Protestant 10% d. Catholic 4% 4. Survey results Living Environment : a. Home ownership 95% b. Kinds of roofing Straw-thatched house 84% Tile-roofed house 10% Slate-roofed house 5% Other 1% c. Floor space Less than 6 pyong 10% 6-10 pyong 53% 11-15 pyong 24% 16-20 pyong 9% More than 20 pyong 4% d. Radio ownership 80% Environmental Sanitation : a. the source of drinking water public well 49% private well 30% drainage water 9% steam water 8% well pump 3% water distribution system 1% b. Distance between well and toilet more than 16meters 38% 6-10 meter 31% 11-15 meters 14% Less than 6 meters 17% c. The status of well management Bad 72% Fair 26% Good 2% d. General sanitary state of house Bad 37% Fair 51% Good 12% e. House drainage system had no house drainage. 77% Family Planning : a. 24% of the people have used contraceptives, but 12% ceased to use them. 76% have never used contraceptives. b. used methods 1oop 68% oral pill 16% vasectomy 4% condom 1% tubal ligation 1% two or more methods 10% Maternal Health : a. The number of conceptions of housewives under 50 years of age. 11 times 26% 6 times 11% 5 times 11% 4 times 9% b. The place of delivery own house 88% hospital 1% others 11% Treatment of general sickness : a. The place of treatment Soyang Health Center 31% Hospital (private or otherwise) 26% Pharmacy 14% Herb medicine 5% Private care 5% No treatment 12% Miscellaneous 7% b. Usual causes of diseases Unknown 46% Tuberculosis 29% Neuralgia 8% CVA 3% Bronchitis 3% Others 11%

• 한국병원경영학회지
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• 제23권1호
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• pp.78-86
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• 2018

Purposes: This study identifies local Chinese consumers' standard for selecting medical care provider and their standard for choosing medical staff, as well as their expectations and concerns regarding Korean medical care providers. Methodology: A survey was conducted in China, to identify Chinese medical care consumers' standards for selecting a medical provider and the factors that influence their use of general hospitals. A total of 1,500 people across three cities, between the ages 18 and 60 participated in the survey. Moreover, a multiple logistic regression analysis was used to analyze the factors that affect Chinese medical care consumers' use of general hospitals. Findings: A total of 75.5 percent respondents chose general hospitals as their most frequently-used medical provider. Those who have health insurance, visit general hospitals as outpatients or are hospitalized more frequently than those who do not have a health insurance. Furthermore, those who have private insurance visit general hospitals as outpatients or are hospitalized more frequently than those who are not signed up for private insurance. Major standards for selecting a hospital included: the doctor's skills, word-of-mouth regarding the hospital, and distance to the hospital from the respondents' home. Standards for choosing medical personnel included word-of-mouth regarding the medical team, recommendations from family members or acquaintances, and medical team's notoriety. Friends and neighbors, family members, television and other media outlets were the channels for acquiring information on a hospital. It was found that Chinese people mostly visit the cardiovascular department of Korean hospitals for treatment. For using Korean hospitals in China, the majority of respondents answered that they were concerned about the cost. Practical Implications: Backed by highly skilled medical experts and cutting-edge technology, Korean medical care providers are attempting to enter China's medical care market. To succeed in China's medical care market, it is vital to conduct a clear and precise analysis.

• Radiation Oncology Journal
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• 제37권1호
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• pp.43-50
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• 2019

Purpose: The aim of this retrospective study was to investigate the use of a radiopaque tissue fiducial marker (TFM) in the treatment of prostate cancer patients who undergo post-prostatectomy radiotherapy (PPRT). TFM safety, its role and benefit in quantifying the set-up uncertainties in patients undergoing PPRT image-guided radiotherapy were assessed. Materials and Methods: A total of 45 consecutive PPRT patients underwent transperineal implantation of TFM at the level of vesicourethral anastomosis in the retrovesical tissue prior to intensity-modulated radiotherapy. Prostate bed motion was calculated by measuring the position of the TFM relative to the pelvic bony anatomy on daily cone-beam computed tomography. The stability and visibility of the TFM were assessed in the initial 10 patients. Results: No postoperative complications were recorded. A total of 3,500 images were analysed. The calculated prostate bed motion for bony landmark matching relative to TFM were 2.25 mm in the left-right, 5.89 mm in the superior-inferior, and 6.59 mm in the anterior-posterior directions. A significant 36% reduction in the mean volume of rectum receiving 70 Gy (rV₇₀) was achieved for a uniform planning target volume (PTV) margin of 7 mm compared with the Australian and New Zealand Faculty of Radiation Oncology Genito-Urinary Group recommended PTV margin of 10 mm. Conclusion: The use of TFM was safe and can potentially eliminate set-up errors associated with bony landmark matching, thereby allowing for tighter PTV margins and a consequent favourable reduction in dose delivered to the bladder and rectum, with potential improvements in toxicities.

• 디지털융복합연구
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• 제11권10호
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• pp.203-215
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• 2013

본 연구는 대한병원협회의 경영실적 통계자료에서 2007년부터 2011년까지 5년간 공공종합병원과 민간종합병원의 패널자료를 추출하여 공공종합병원과 민간종합병원의 부트스트랩 메타맘퀴스트 생산성 지수를 산출하고 이 지수를 분해하여 생산성 변화와 생산성 격차를 분석하였다. 분석한 결과와 시사점을 정리하면 다음과 같다. 첫째, 공공병원그룹의 메타효율성이 민간병원그룹에 비해 높으나 기술격차비율은 민간병원그룹이 공공병원그룹에 비해 높으며 프론티어에 가장 가까워 민간병원그룹의 소수 대형종합병원이 전체 종합병원의 선도적 역할을 수행하고 있었다. 둘째, 그룹별 생산성 증가는 민간병원그룹이 공공병원그룹에 비해 높았는데, 이는 프론티어의 이동효과($FCU^k$)보다는 기술추격에 기인하는 것으로 분석되었다. 그러나 민간병원그룹과 공공병원그룹 간 기술효율성, 생산성 변화와 생산성 격차가 통계적으로 의미 있는 차이를 보이지 않는 것으로 확인하였다. 따라서 공공병원이 환자 진료실적 측면에서 민간병원 수준의 기술효율성과 생산성 변화 및 생산성 격차를 보임에 따라 공공병원이 환자진료실적 측면에서 공공병원으로서 기능과 역할을 수행하는 것으로 판단된다. 그러므로 재정적 측면에서 어려움을 겪는 공공병원이 선두적인 민간병원과의 연계를 통하여 의료기술과 경영기술을 습득하고 공유하는 것이 필요하다는 시사점을 제공한다.

• Journal of Chest Surgery
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• 제23권3호
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• pp.546-549
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• 1990

Spontaneous esophageal perforation occurred rarely but often lead to a high mortality and morbidity. We had experienced one case of spontaneous rupture of esophagus. A 52 - year old male patient was admitted to our hospital because of the chest pain and massive hematemesis after emetic strain. Esophagogram that taken at private clinic revealed leakage of dye into the right pleural space. Under the diagnosis of the thoracic esophageal perforation, two stage operation was planned because the size of perforation was large and pyothorax was developed on the right side. At first, exclusion and diversion of the esophagus were carried out. After six months, the esophageal reconstruction with left colon was performed.

• Tuberculosis and Respiratory Diseases
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• 제55권2호
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• pp.154-164
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• 2003

연구배경 : 1990년대 초반까지 민간 병의원에서의 폐결핵환자 치료효율은 보건소에 비해 낮았다. 보건소에 비해 민간 병의원에서 치료받는 결핵환자의 비율이 최근 계속 증가하고 있지만, 민간부문에서 치료 받는 환자들의 특성과 치료효율은 정확히 파악되지 못하고 있다. 본 연구는 서울에 소재한 한 민간 종합병원에서 최근 진단되고 치료한 폐결핵환자의 특성과 치료효율을 조사하고자 하였다. 방 법 : 2000년 8월 1일부터 2001년 1월 31일까지 6개월간 삼성서울병원에서 진단되어 관할 보건소로 신고된 232명의 성인 폐결핵 환자를 대상으로 진단 시 연령과 성별, 입원여부, 과거 폐결핵 치료력, 객담 항산균 도발과 배양 검사 결과, 약제감수성검사 결과, 치료약제의 종류 및 치료 기간, 치료 결과 그리고 도말 양성 환자에서의 치료성적 등을 조사하였다. 결 과 : 232명의 폐결핵 환자의 평균 연령은 47세(범위 16-86세)이고 남자 136명(58.6%), 여자 96명(41.4%)이었다. 82명(35.3%)의 환자는 진단 당시 입원치료를 받았고, 13명(5.6%)이 치료 도중 사망하였다. 과거 치료력이 없는 신환이 166명(71.6%), 재발이 32명(13.8%)이었다. 도말 양성 환자가 83명(35.8%), 도말 음성 배양 양성 환자가 27명(11.6%)으로 균 양성 환자가 110명(47.4%)이었다. 47명(20.3%)에서는 객담 검사가 시행되지 않았다. 초치료 환자 188명 중 130명(69.1%)에서 INH, RFP, EMB, PZA가 처방되었고, 21명(11.2%)에서 INH, RFP, EMB가 사용되었다. 전체 폐결핵 환자 232명 중 26명(11.2%)과 도말 양성 환자 83명 중 11명(13.3%)이 치료를 중단하였다. 도말 양성 초치료 환자 68명 중 29명(42.6%)가 완치되었고, 18명(26.5%)은 치료를 종결하였으나 균 음전을 확인할 수 없었다. 결 론 : 민간 병의원에서 진단된 폐결핵 환자의 치료효율을 높이고 치료 중단률을 낮추기 위해서는 폐결핵 환자의 진단과 치료에서 대한 결핵 및 호흡기학회의 진료기준을 충실히 따르려는 보다 적극적인 노력과 함께 우리나라 실정에 맞는 적절한 공공-민간 협력체계의 국가결핵관리모델의 개발이 필요하리라 사료된다.

• 보건행정학회지
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• 제10권1호
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• pp.148-173
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• 2000

This thesis is a kind of case report on the managerial difficulties and strategies to overcome them for the rural hospitals in Korea. We examined environmental situations and SWOT(Strength, Weakness, Opportunity, Threat) of the hospitals, and suggested some strategies to improve the hospital business through analysing secondary data and brief survey to staffs and patients at 3 case hospitals. Among the strategies were included establishment of their identity as community hospitals, positioning towards high-touch services rather than high-tech services to improve their competence. For this positioning, patient satisfaction should be emphasized to make rapport with the residents in the community, and a few service areas should be selected and strengthened. Emergency care and geriatric health services are recommended to be covered strongly, because rural hospitals are usually the one and only hospital in the region and rural communities have aged population structure. In addition to these, networking is necessary among rural hospitals nationwide and with local clinics and tertiary hospitals near urban areas. And also, complementary role division with community health post should be developed to lessen the competitive relationship between public and private sectors. To support these strategies, fresh organizational culture should be built up to make hospital staff creative and enthusiastic on their job. Finally, inducement of governmental assistance will be necessary to make the environment advantageous to the rural hospitals.

• 복식문화연구
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• 제14권6호
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• pp.1004-1014
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• 2006

The purposes of this study is to investigate the present condition of nurses' uniform design and to categorize the image of nurses' uniform design. To investigate the nurses' uniform design, total 241 data were collected from the pictures of nurses who work for private hospital and semi-general hospital in Deajeon and Seoul city and Chungnam province and the pictures of uniform for nurses in general hospital presented at nurses' uniform company web sites. This data was evaluated by 3 major garment characteristics, yin/yang, casual/professional, and lightness/ darkness-were used as criteria for categorizing the image of nurses' uniform design. Focus group consisting of 10 experts majored in Clothing and Textiles were evaluated by 7 point Likert type scales. Nurses' uniform design at the present time showed equal distribution in terms of yin/yang and casual/professional. However, in terms of lightness/darkness, nurses' uniform design were partial to light image. Therefore, dark image, specially dark and masculine image in nurses' uniform design were very rare. Nurses' uniform design had some differences by type of hospital, department, and geographical area. The most important meaning from the result through this study was that the nurse uniforms were classified into groups according to the present condition of nurses' uniform design.

• Clinical and Experimental Reproductive Medicine
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• 제27권3호
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• pp.295-300
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• 2000

Objective: To report three cases of monozygotic twinning after IVF-ET transfer. Methods: Private practice in two different assisted reproductive technology clinics. Results: Three intrauterine monozygotic twin pregnancies occurred after IVF-ET. One of them was complicated by cord entanglement, another is progressing normal pregnancy without complication and the other was had a normal pregnancy without complication and delivered twin by cesarean section. Conclusion: The reported prevalence of multiple gestations in IVF-ET is a approximately 30%, and it is only 2.7% to be monozygotic twinning in IVF-ET. We report three cases of monozygotic twining after IVF-ET.

• Journal of Information Technology Applications and Management
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• 제28권1호
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• pp.1-12
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• 2021

The purpose of this study is to analyze the medical ecosystem in the post-corona era. In addition, this study introduces a new medical CRM model that allows primary-level hospitals to overcome the economic difficulties and to occupy a competitive advantage in the post-corona era. The medical environment in the post-corona era is expected to be changed by non-face-to-face treatment, reinforcement of public medical care, the transformation of a medical system centered on the primary-level hospitals, and the use of AI and big data technologies. The medical CRM model presented in this study emphasizes the establishment of mutual customer relationships through close information exchange between patients, primary-level hospital, and the government. In the post-corona era, primary-level hospitals should not simply be approached as private hospital pursuing profitability. These should be reestablished as the hospitals that can provide public health care services while ensuring stable profitability.