• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제17권3호
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• pp.35-42
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• 2011

Efficient space plans are built upon relations of both human and physical compositions, and the standard of the interaction is basically the human scale. Especially in medical areas, the character of the users within human scale design environment is quite significant. Unlike large hospitals with great plans and scalability performed by experts, mid-sized clinics tend to have limited space, designed by non-specialists who highlight aesthetics over functionality in floor plans which leads to poor quality in medical service. For this reason, this study will include the application of human scale based therapy rooms within the clinic from a physical standpoint and will further analyze and pinpoint any room for improvement to further enable more efficient ergonomic space planning. In this study, theoretically will contemplate over human scale, mid-sized clinic, therapies, and therapists, while the case study will include status of the recent human scale based mid-sized clinic from a physical viewpoint, classification and analysis amongst human and physical compositions chosen by discretion from either a newly opened or a newly re-modeled clinic within the last 2 years, which has 15 beds or more, minimum 3 physical therapists, with more than 5 different therapy facilities in the metropolitan area in order to measure the human scale of therapy rooms in a mid-sized clinic. As a result, the area where improvement can practically be applied is the physical composition, which does not include human scale like human composition factors as therapists and patients, and hence, I suggest the human scale applied efficient medical space plan become the base of this study and look forward to subsequent improvement in the quality of medical services.

• 한국의료질향상학회지
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• 제22권1호
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• pp.29-37
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• 2016

Readmission which reflects capacity to manage patients and general level of medical services has been known for one of the causes of medical expenditure due to inefficient service. Compared to disease-specific readmission, hospital wide readmission (HWR) is relatively easy to understand, and has merit to get over limitation of collateral medical services assessment; therefore, a growing interest in development and usage of readmission indicator as quality of care indicator focusing on all-disease is detected. In this study, we investigate current state of risk standardized readmission rate indicator used in the United States, the United Kingdom, and Canada, and examine the considerations when using readmission rate as quality indicator in Korea. Differences in risk-adjustment methods were showed among countries. The United States do not control race not to hide socio-demographic factors on readmission. Canada shows differentiation compared to other countries about reflecting community factors. All three-countries utilize readmission rate as monitoring quality of care rather than incentives or penalty due to the fact that readmission rate could not represent the whole quality of hospital and has a limitation at controlling socio-economic factors. Therefore, for usage readmission rate as quality indicator in Korea, preparing readmission classification standard for Korean medical environment and additional methods for acquiring information by using discharge summary is need. Moreover, continued discussion with clinical specialists is needed for obtain clinical reliability and validity.

• 한국병원경영학회지
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• 제16권2호
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• pp.78-97
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• 2011

The purpose of this study is to analyze activating factors of medical tourism at Busan, and then decide on priority on the factors. As research methods, this study deduced priority of specialists' opinions by AHP analysis technique through structuralized questionnaire on the medical tourism's factors having been suggested from existing prior studies. The analysis results were same as followings. First, as a result of analysis on the main criteria, relative levels of importance were appeared high such as 'competitiveness', 'policy assistances from the government', 'medical care's infrastructure', and 'connectedness with regions' in order. Second, as a result of integrated results analyzing detailed criteria on the main evaluation standards, relative levels of importance were appeared high such as 'medical quality', 'health-related institution's improvement', 'medical infrastructure', 'medical charge', 'tourism-related institution's improvement', 'convenience', 'medical cooperation possibilities', and 'local industry compliance' in order. In conclusion, it is judged that activation of medical tourism shall be propelled after considering relative levels of importance on many policies or activating factors same as suggested in this study.

• Pediatric Infection and Vaccine
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• 제25권1호
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• pp.17-25
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• 2018

목적: 국내에서 소아를 대상으로 시행하는 혈액배양의 적응증과 방법, 정도 관리 현황을 파악하고자 하였다. 방법: 종합병원에 근무하는 소아감염분과 전문의(소아감염)와 신생아집중치료센터를 운영하는 병원에 근무하는 신생아분과 전문의(신생아)를 대상으로 온라인 설문조사를 하였다. 결과: 소아감염의 81.1% (30/37)와 신생아의 72.2% (52/72)가 설문에 응하였다. 적응증과 무관하게 정규 검사로 혈액배양을 실시하는 경우는 소아감염의 33.3%, 신생아의 59.6%였다. 소아감염의 40%와 신생아의 65.4%가 균혈증 의심 환자에서 혈액배양을 1회 시행한다고 했다. 가장 많이 사용되는 피부 소독제는 포비돈-아이오딘이었고, 여러 피부 소독제를 사용하는 경우 그 순서는 기관마다 다양하였다. 배양 양성률 및 오염률을 모니터링하는 기관은 전체의 2/3 정도였으나 결과를 채혈자에게 피드백하는 곳은 적었다. 채혈 담당자에게 정기적인 교육을 하는 곳은 전체의 1/2 이하였다. 결론: 기관별로 혈액배양의 적응증과 방법이 다양하였으며 정도 관리를 적극적으로 시행하는 병원은 적었다. 소아에서 실시되는 혈액배양의 질 향상을 위해 표준 지침의 정립이 필요하며 정도 관리를 위한 기관들의 노력이 요구된다.

• 한국의료질향상학회지
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• 제1권2호
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• pp.34-43
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• 1994

Background: The average hospital stay in most Korean teaching hospitals is longer than that of hospitals in developed countries. The investigation of average hospital stay of teaching hospitals is considered as an important measure to evaluate the effectiveness of hospital management. In this article authors analyzed the relationship of several variables (hospital ownership, number of beds, location of hospitals, number of physician) to length of hospital stay in each clinical department. Methods: The average hospital stay of each clinical department of 184 teaching hospitals was investigated. Authors reviewed the papers of teaching hospitals, that was reported to the Korean Association of Hospitals. Results: The means of hospital stay day of hospitals were not significantly different according to the number of hospital beds and location of hospitals. Only the difference of hospital stay according to ownerships was significant. The length of stay was the highest in public hospitals and the lowest in juridical hospitals. Conclusions: The number of beds and location of hospitals were not associated with the average hospital stay. But ownerships affected the average hospital stay. The national or public hospitals had the longest length of hospital stay. Number of specialists and number of all physicians were closely related to the average hospital stay.

• 정보관리학회지
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• 제29권4호
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• pp.165-189
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• 2012

본 연구는 국내 대학도서관 웹사이트를 조사하여 온라인 주제가이드의 현황을 분석하고 개선 방안을 제언하였다. 조사된 100개 대학 중 14개 대학만이 온라인 주제가이드를 제공하고 있는 것으로 나타나 국내 온라인 주제가이드의 구축은 초기 단계인 것으로 나타났다. 온라인 주제가이드들은 내용 구성면에서 볼 때 접근성, 포맷의 일관성, 자원통합성 영역은 우수한 것으로 평가되었으나 주제 다양화, 이용자 교육, 검색 영역에서 낮은 수준에 머물러 있는 것으로 나타났다. 향후 온라인 주제가이드가 지향해야 할 방향은 신속한 정보자원으로의 접근, 주제 특화된 이용자 교육, 사서와의 원활한 커뮤니케이션을 제공하는 원스탑(one-stop) 서비스가 되어야 할 것이다.

• Computers and Concrete
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• 제3권1호
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• pp.29-42
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• 2006

In this study, a novel education system for inspection of concrete bridges is presented. The new education approach uses virtual reality (VR) and three-dimensional computer graphics (3DCG) in training engineers to become bridge inspection specialists. The slow time-dependent deterioration of concrete bridges can be reproduced on the computer screen in any chosen time frame, thus providing the trainees with illustrative and educative insight into the deterioration problem. In the proposed VR/3DCG approach a three-dimensional model of concrete bridge, including surfaces, viewpoints and walkthrough paths is created. With the help of this virtual bridge model, an experienced bridge inspection specialist teaches the different deterioration phenomena of concrete bridges to the trainees. The new system was tested, and the inspection results from the case bridge showed that in comparison with the traditional Japanese bridge inspection education system, the new system gives better results. In addition to the improvement of quality of bridge inspections, the new VR/3DCG system-based education brings along some other, more intangible benefits.

• The Journal of Korean Physical Therapy
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• 제34권1호
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• pp.26-37
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• 2022

Purpose: Japan established the convalescent rehabilitation wards, corresponding to Korea's rehabilitation medical institutions, in 2000 and developed it into the present system through continuous revisions. This study sought to analyze the issues and tasks faced by Japan segregated by the period of revision of convalescent rehabilitation ward-related medical fee regulations, through a literature review and further aimed to explore the direction of development of domestic rehabilitation medical institutions. Methods: Ten revisions of the medical fee regulations were classified into three stages based on quality evaluation: (1) the quantitative expansion stage (2000-2006); (2) quality evaluation introduction stage (2008-2014); and (3) quality evaluation maturity stage (2016-2020). Results: The following issues and tasks emerged: (1) For the quantitative expansion stage; insufficient rehabilitation within the ward, insufficient after-hour rehabilitation, insufficient connection with acute-stage hospitals and maintenance facilities, and the low ratio of specialists. (2) For the quality evaluation introduction stage; disparity in the manpower between institutions, the necessity of a 365-day rehabilitation system, avoidance of critical patients, and the problem that an increase in the amount of rehabilitation did not lead to a qualitative improvement. 3) For the quality evaluation maturity stage; cream-skimming issues in selecting patients, inappropriate evaluation of rehabilitation effects, and the necessity of follow-up measures after discharge. Conclusion: It is worth referring to the established regulations in Japan, and concurrently it is necessary to strengthen the evaluation of the structures, processes, and results when operating and evaluating rehabilitation medical institutions in Korea taking into account the side effects that could be identified in Japan.

• 한국의료질향상학회지
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• 제10권2호
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• pp.204-215
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• 2003

Background : ICD-10 Classification, which is used domestically as well as internationally, has limited use in the clinical practice since it is developed for at disease statistics and epidemiology. Therefore, the purposes of this study were to improve the quality of diagnosis by constructing a new disease classification based on the diagnoses doctors currently make in the clinical setting and connecting this classification with OCS and EMR, and to meet the demands of doctors for high quality medical study data in medical research. Methods : The specialists in each ophthalmic subfield collected clinical diagnoses and abbreviations based on the ophthalmology textbooks and confirmed the classifications. Total number of clinical diagnoses collected was totaled 672, for which ideal diagnoses had been selected and a new model of disease classification model in connection with ICD-10 was constructed. The constructed classification of clinical diagnoses consisted of six steps: the first step was the classification by ophthalmic subspecialty field; the second to fifth steps were the detailed classification by each specialty field; the sixth step was the classification by site. Results : After introducing the new disease classification, research on the use and a pre-post comparison was conducted. The result from the research on the use of the clinical diagnoses in inpatient and outpatient care has shown a gradually increasing tendency. From the pre-post comparison of EMR discharge summary diagnoses, the result demonstrated that the diagnosis was stated correctly and in detail. Since the diagnosis was stated correctly, code classification became correct as well, which makes it possible to construct high quality medical DB. Conclusion : This construction of clinical diagnoses provides the medical team with high quality medical information. It is also expected to increase the accuracy and efficiency of service in the department of medical record and department of insurance investigation. In the future, if hospitals wish to construct a classification of clinical diagnosis and a standard proposal of clinical diagnosis is presented by a medical society, the standardization of diagnosis seems to be possible.

• 대한간호학회지
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• 제53권4호
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• pp.412-425
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• 2023

Purpose: Nurses play an important role in ensuring patient rehabilitation and are involved in all aspects of multidimensional rehabilitation. Therefore, strengthening rehabilitation nursing education is vital to ascertain high-quality rehabilitation and optimum outcomes. This study examined the effectiveness of a new teaching reform-a modified Six-Sigma-based training program-against a conventional educational program on rehabilitation specialist nurses' core competencies, post-training performance, and satisfaction. Methods: A quasi-randomized controlled trial was conducted to assess the effectiveness of the modified training program. We recruited 56 learners from the 2020 training course at the Hunan Rehabilitation Specialist Nurse Training Base as the control group. Sixty learners from the base's 2021 training course were recruited as the intervention group. Data were collected in a consistent manner from both groups after the training program was implemented. Results: Those who underwent the modified training program showed better improvement in all core competencies than those who underwent the conventional training program (p < .05); the scores for theoretical knowledge, clinical nursing lectures, reviews, and nursing case management improved significantly following the teaching reform (p < 0.05). Further, overall satisfaction as well as base management and theoretical teaching satisfaction improved significantly (p < .05). Conclusion: The modified training program strengthens rehabilitation nurses' base management abilities; enhances their core competencies; expands their interest in and breadth, depth, and practicability of theoretical courses; and updates the teaching methods.