• 한국의사학회지
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• 제26권2호
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• pp.175-185
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• 2013

Purpose : The current Medical Law and the Pharmaceutical Affairs Act, which are incapable of utilizing the research results and the advanced academic, clinical, and pharmaceutical system of the present-day Korean (Oriental) medicine, have limitations and create a paradox by provoking social conflict among the professionals in the field. The aim of this study was to find out the legal and systematic problems that contributed to a complicated conflict amongst Korean (Oriental) medicine doctors, doctors, pharmacists, and Korean (Oriental) pharmacists regarding the classification of their functions. Methods : We reviewed the history and characteristics of the legislation regarding the duties of Korean (Oriental) medicine doctors and Korean (Oriental) pharmacists as well as the relevant and important public health policies since the enactment of the National Medical Services Law in 1951. We focused on the laws and regulations that are made in the process of the separating functions of physicians and pharmacists and the dispute between the Korean (Oriental) medicine doctors and the Korean (Oriental) pharmacists in the 1990s and 2000s. Results : The legislations and amendments of the medical and pharmaceutical laws and regulations that reflect the modern academic, clinical, and pharmaceutical system of the Korean (Oriental) medicine and the research results could be summarized as follows: 1) A partial amendment of the Medical Law in 1987, which added the provision of "Oriental health guidance" as one of the duties of Korean (Oriental) medicine doctors, assured a place for Korean (Oriental) medicine doctors in the field of public health. 2) A partial revision of Pharmaceutical Affairs Act in 1994 established a new system for Korean (Oriental) pharmacists, bringing about the creation of dualistic pharmaceutical system that complements the dualistic medical system. 3) The Promotion of the Research and Development of Wonder Drugs by Using Natural Substances Act was legislated in 2000 in order to stimulate research and development of Korean (Oriental) medicine and its industrialization. 4) Oriental Medicine Promotion Act in 2003 was enacted to lay foundation to specify and promote technology and industry that are related to Korean (Oriental) medicine. Discussions and conclusions : Although the dualistic medical and pharmaceutical system is set up by the Medical Law and Pharmaceutical Affairs Act, it is shown that the relevant regulations have been developed from a perspective of the western medicine.

• 한국콘텐츠학회논문지
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• 제17권10호
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• pp.19-29
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• 2017

본 연구는 공공병원 질 관리 전담자들의 병원 진료부문과 전반적 질 향상 활동의 경험 탐색을 통해 공공병원 질 향상 활동 방안을 수립하고자 수행되었다. 공공병원의 질 관리 전담자 10명을 대상으로 질 향상 활동 경험에 대해 포커스 그룹 면담을 수행하였다. 질 향상 경험 면담을 통해 '진료 부문과 전반적 의료질 향상 활동에 대한 성공과 실패', '현재 질 향상 활동의 활성화 정도', '공공병원 질 향상 활동의 특성' 그리고 '향후 질 향상 활동의 활성화를 위해 필요한 것들'의 범주화를 통해, '공공병원 고유의 특성에 따른 질 향상 활동의 성공', '리더십과 역량강화를 통한 공공병원 질 향상 활동의 활성화', '공공병원의 지역 중점 병원의 역할 재정립'의 주제를 도출하였다. 공공병원 진료 부문의 질 향상 활동은 의사의 참여가 중요하며 이러한 의사참여를 이끌어내기 위해서는 의사의 질 향상 활동의 성공적 경험을 공유하고 질 향상 활동에 필요한 지식을 제공하여 질 향상 전문성과 자율성을 보장하는 지원들이 필요하다. 또한 공공병원의 질 관리 전담자는 국가 의료 질 향상을 위한 핵심위치에서 질 향상 활동의 견인역할을 하고 지역 의료기관간 협력적 소통을 통해 의료 질 향상 활동을 이끌어가야 한다.

• Journal of Korean Neurosurgical Society
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• 제61권1호
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• pp.105-113
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• 2018

Objective : In respect of the health and safety of the public, universal access to health care is an issue of the greatest importance. The geographic distribution of doctors is one of the important factors contributing to access to health care. The aim of this study is to assess the imbalances in the geographic distribution of neurosurgeons across Korea. Methods : Population data was obtained from the National Statistical Office. We classified geographic groups into 7 metropolitan cities, 78 non-metropolitan cities, and 77 rural areas. The number of doctors and neurosurgeons per 100000 populations in each county unit was calculated using the total number of doctors and neurosurgeons at the country level from 2009 to 2015. The density levels of neurosurgeon and doctor were calculated and depicted in maps. Results : Between 2009 and 2015, the number of neurosurgeons increased from 2002 to 2557, and the ratio of neurosurgeons per 100000 populations increased from 4.02 to 4.96. The number of neurosurgeons per 100000 populations was highest in metropolitan cities and lowest in rural areas from 2009 to 2015. A comparison of the geographic distribution of neurosurgeons in 2009 and 2015 showed an increase in the regional gap. The neurosurgeon density was affected by country unit characteristics (p=0.000). Conclusion : Distribution of neurosurgeons throughout Korea is uneven. Neurosurgeons are being increasingly concentrated in a limited number of metropolitan cities. This phenomenon will need to be accounted when planning for a supply of neurosurgeons, allocation of resources and manpower, and the provision of regional neurosurgical services.

• 한국임상약학회지
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• 제28권2호
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• pp.131-137
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• 2018

Background: In South Korea, 22.3% of women ${\geq}50years$ of age and 37% of women ${\geq}70years$ of age visit the doctor to obtain treatment for osteoporosis. According to the analysis of the National Health Insurance Services claim data between 2008 and 2012, the number and incidence of hip and vertebral fractures increased during the same period. Denosumab, a newly marketed medicine in Korea, is the first RANK inhibitor. Methods: A cost-utility analysis was conducted from a societal perspective to prove the superiority of denosumab to alendronate. A Markov cohort model was used to investigate the cost-effectiveness of denosumab. A 6-month cycle length was used in the model, and all patients were individually followed up through the model, from their age at treatment initiation to their time of death or until 100 years of age. The model consisted of eight health states: well; hip fracture; vertebral fracture; wrist fracture; other osteoporotic fracture; post-hip fracture; post-vertebral fracture; and dead. All patients began in the well-health state. In this model, 5% discounted rate, two-year maximum offset time, and persistence were adopted. Results: The total lifetime costs for alendronate and denosumab were USD 5,587 and USD 6,534, respectively. The incremental cost-effectiveness ratio (ICER) for denosumab versus alendronate was USD 20,600/QALY. Given the ICER threshold in Korea, the results indicated that denosumab was remarkably superior to alendronate. Conclusion: Denosumab is a cost-effective alternative to the oral anti-osteoporotic treatment, alendronate, in South Korea.

• 한국병원경영학회지
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• 제25권3호
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• pp.78-86
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• 2020

Purposes: This study purposed to identify factors influencing the composite quality score from the quality assessment program for long-term care hospitals Methodology: The study variables was obtained from HIRA(Health Insurance Review and Assessment Service): the composite quality scores and hospital variables such as number of doctors, nurses, beds, medical technicians, medical equipments, administrative region, ownerships from 3rd (2010) to 7th (2018) quality assessment program. National Statistical Portal(www.kosis.go.kr) provided the number of senior citizens aged over 65 in city·county·district area. SAS 9.4 was used for the data processing and used to analyze the data. Findings: The results showed that composite quality score increased past 9 years. Hospital variables such as number of doctor, nurse, medical technicians, bed and public hospitals had significant positive relationship with the composite quality score. Administrative region(district) showed higher scores compare to that of city. Compare to the score of quality assessment year(2010), as the assessment year move to 2012, 2013, 2015, 2018, results showed higher significant positive coefficients. Practical Implication: Continuously improve the performance of long-term care hospitals, current quality assessment program are needed to update their system such as adopting indicators measuring the service process, or compensating the cost for quality assessment program. It will enable to provide more reasonable and accurate performance assessment scores.

• Journal of Preventive Medicine and Public Health
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• 제9권1호
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• pp.65-75
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• 1976

To compare the maternal health status between women in island and land, the study was conducted to adjacent land (kukdong) and island (kyonghodong) areas in Yosoo city during April 1976. The results obtained from 174 interviewee in island and 192 in land areas were the same as follow, 1. General characteristics of both area. Age: Land, group 20-29 year of age was the largest. Island, 30-39 year of age was the largest. Education; Low educated group, less than primary grade (land 88.6%, island 93.1%), was predominant in both area. Occupation of herself; agriculture and labor was the main occupation (land 50%, island 82.2%) in both area. Occupation of husband: labor and fishery was general (81.2%) in land, and agriculture and fishery was general (81.6%) in island. Duration of residence; Land, 25.0% being resided here more than 10 years. Island, 64.3% being resided here more than 10 years. 2. Marriage, Pregnancy, and Present children. Average age at marriage; Land, 20.7 years. Island, 20.9 years. Average frequency of pregnancy; Land, 4.4 times. Island, 4.3 times. Wastage of pregnancies: Land, 236 per 1000 pregnancies. Island, 151 per 1000 pregnancies. Wastage occupied by induced abortion; land, 73.5%. island, 60.5%. Number and sex of present children; Land, 3.3 per family, sex ratio 52.4 to 47.6. Island, 3.6 per family, sex ratio 53.3 to 46.7. 3. Prenatal and postnatal care. Prenatal consutation: Land, 16.1% received by doctor or midwife. Island 9.2% received by doctor or midwife. Complications during last pregnancy; Land, 46.6% complained. Island, 51.1% complained. Return to work within 1 week after delivery; Land, 40.6%. Island, 50.6%. 4. Delivery environment Home delivery; Land, 97.4% Island, 97.3%. Delivery attdended by non medical professions at home; Land, 80.2% Island, 93.7%. Solo home delivery; Land, 13.0%, Island, 12.9%. Delivery attended by layman without taking any disinfective preparations; Land, 48.1%, Island, 49.1%. Material mainly used to cut umbilical cord at home; Land, scissors (97.4%). Island, scissora (98.8%). Cord cutting material used without giving any disinfective preparations; Land, 79.9%, Island, 84.0%. Delivery sheets used at home; Cement bag paper (land 50.0%, island, 31.3%). Vinyl sheets (land,17.5%, island, 27.6%). News paper (land, 3.2%. island, 11.7%). No sheets (land 19.5%. island, 12.9%). etc. Maternal Meal; Seaweed soup with rice was the most general in both area. (land 95.3%, island, 91.4%).

• 농촌의학ㆍ지역보건
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• 제27권1호
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• pp.143-153
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• 2002

경상북도 일개면 지역에 거주하는 65세 이상 재가노인 355명을 대상으로 방문보건의료 요구도를 알아봄으로써 향후 보건기관의 효율적이고 효과적인 방문보건의료서비스 제공방안의 기초자료를 제시하고자 하였다. 주관적 건강상태는 64.5%가 허약하다고 하였고, 저ADL과 저IADL이 각각 14.1%, 14.9%였다. 의료인의 도움을 받아야할 건강문제가 있다고 응답한 노인이 73.5%이었는데, 성, 연령, 결혼상태, 의료보장상태, 직업유무, 경제적 상태, 치료여건, 주관적 건강상태, 일상생활수행정도, 수단적 일상생활수행정도에 따라 차이가 있었다(p<0.05). 의료인의 도움을 받아야 할 건강문제가 있다고 느끼는 노인의 주관적인 방문보건의료 요구도는 19.5%였다. 방문보건의료 요구도는 75세 이상인 경우(p<0.05), 직업이 없는 경우(p<0.01) 유의하게 높았고, 가족이 화목하지 않을수록, 주관적 건강상태가 허약한 경우, 저 IADL인 경우 유의하게 높았다(p<0.01). 방문보건의료를 받기를 원하는 경우 이유는 돌봐줄 사람이 없어서가 64.7%로 가장 높았고, 거리가 너무 멀어서(지역적 문제)가 23.5%로 그 다음이었다. 제일원하는 방문보건의료서비스는 투약이 82.3%로 가장 높았다. 방문보건의료를 원하지 않는 경우 이유는 거동이 가능하므로 60.0%, 의사와 직접 만나기를 원하므로 25.7%의 순이었다. 방문보건의료 요구여부를 종속변수로 한 다중 로지스틱 회귀분석 결과, 가족이 화목하지 않을수록, 주관적 건강상태가 허약할수록 방문요구도가 높았다(p<0.05).

• 한국병원경영학회지
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• 제8권1호
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• pp.112-134
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• 2003

The purpose of this study is to analyze the consumer's expectation before the health care service and the consumer's satisfaction after it. The participants of the study are inpatients in a general hospital located in Seoul. The resources were collected from the self-administration questionnaire survey run parallel with face to face interview. In order to measure the degree of the consumer's expectation, 349 samples were collected from the first questionnaire survey on the date of admission to the hospital. The second questionnaire survey was carried out on the date of discharge to the hospital with the participants responding to the first questionnaire survey. There are 154 samples collected from this survey. The results from the analysis of these resources are as follow. First, the survey shows that one of the highest consumers' expectations was about the generosity, kindliness and sincerity from the staff at the hospital, specially from doctors. Second, according to the analysis of the factors affecting the expectations of the consumers, with regard to path of admission to a hospital relating to patient's features, outpatient who gets into a hospital expected good medical care much more than the other patients. In regard of doctor's features, patients usually and highly expect good medical care from doctors who have good carrier and much experience. Third, according to the second questionnaire survey, what patients are satisfied most with is about the generosity and sincerity from staff at a hospital, especially from doctors and their gem attitudes. The results from survey show that the differences among the degree of consumers' satisfaction are very variable, depending on surrounding environments and facilities. The only fact that expectation didn't meet with satisfaction appeared to the case about technology and skill of medical care and the case about updated medical skills and equipments. Fourth, comparing the degree of expectation with the degree of satisfaction of consumers, correlative analysis was concerned significantly and specifically about the part of overall cleanliness relating to facilities and surrounding environments, the items about medical examination and test plan procedure relating to skill of medical care, professional specialties and convenience for procedure, and the items about satisfying explanations and concern about patients from doctors relating to staff's generosity and sincerity. Fifth, the analysis of the factors affecting the degree of how much patients are satisfied with shows that relating to sociodemographical features, patients are not satisfied with the case when the time and process of medical treatment are getting longer. It is surveyed that consumer were satisfied with the motivation to visit a hospital and the insurance type in patient's feature and so were the medical department and the factor of the degree of the expectation in disease's feature. Sixth, according to analysis based on the survey, patients would join again a hospital when they get satisfaction from the medical care and also they want to come again regarding to doctor's capability. For example, when doctors are old, have a good carrier and much experience, patients would come again. As seen from the above, consumers are usually satisfied with the medical treatment more than that they expected before. They would intend to use again when they get satisfaction from the medical care provided at a hospital. Patients and consumers highly expect good attitude as well as capacity from medical doctors and they are also generally satisfied with those things. Therefore, in order to increase the degree of consumer's satisfaction and their intention to come again, the hospital staff would have to commit themselves to achieve high quality service continuously and would have to make an effort to offer the finest quality service.

• 대한예방한의학회지
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• 제19권2호
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• pp.57-66
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• 2015

Objective : This study aims to investigate the priority of education needs of managerial competencies for Korean Medicine doctors. Method : Self-administered questionnaires were sent via on-line survey system to 4,107 Korean Medicine (KM) doctors who were registered in the Association of Korean Medicine and whose business places were in Seoul. The cognition of necessities, present levels, and future importance of managerial competencies were measured. To measure the degree of educational needs on health management, t-test and Borich method were used. Results : The response rate was 1.9%(79 persons) and 68 responses were included in the analysis. The cost-effectiveness studying ability and the public relations ability were the most important competencies. Analyzing the competency groups by t-test and Borich method, the marketing group was the most important competency group. Many KM doctors (53 persons; 68.9%) who answered this questionnaire expressed needs of the business administration course. Conclusion : KM doctors conceded the necessity of business competency to manage their hospitals or clinics. Academic institutions needs to consider the implementation of business administration courses for KM students in accordance with needs of the managerial competencies.

• Journal of Preventive Medicine and Public Health
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• 제49권6호
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• pp.343-348
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• 2016

Since noncommunicable diseases (NCDs) are generally controllable rather than curable, more emphasis is placed on prevention than on treatment. For the early detection of diseases, primary care physicians (PCPs), as well as general practitioners and family physicians, should interpret screening results accurately and provide screenees with appropriate information about prevention and treatment, including potential harms. The concept of quaternary prevention (QP), which was introduced by Jamoulle and Roland in 1995, has been applied to screening results. This article summarizes situations that PCPs encounter during screening tests according to the concept of QP, and suggests measures to face such situations. It is suggested that screening tests be customized to fit individual characteristics instead of being performed based on general guidelines. Since screening tests should not be carried out in some circumstances, further studies based on the concept of prevention levels proposed by Jamoulle and Roland are required for the development of strategies to prevent NCDs, including cancers. Thus, applying the concept of QP helps PCPs gain better insights into screening tests aimed at preventing NCDs and also helps improve the doctor-patient relationship by helping screenees understand medical uncertainties.