• 제목/요약/키워드: Relation between patient and doctor

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보건의료현장에서 환자의 권리와 의료소비자로서의 권리 비교 (Compare Patient Right and Consumer Right in Medical Field)

  • 정영훈
    • 보건행정학회지
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    • 제27권1호
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    • pp.3-17
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    • 2017
  • In the traditional medical field, the patient was a person to receive protection from the doctor because there are vertical relationship between the patient and the doctor. But in modern medical field, patients change their role to health-care consumer to be guaranteed their rights more actively. This study compare patient's rights in doctor's vocational ethics and patient's rights in law, consumer rights. This study analyzes what is type of law-relationship between patients and doctor and how can they act health-care as health-care consumer.

선택병의원제가 의료급여 수급권자의 건강에 미치는 영향 (The Effects of the Designated Doctor System on the Health of Medical Aid Beneficiaries)

  • 최정명;오진주
    • 지역사회간호학회지
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    • 제23권4호
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    • pp.438-445
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    • 2012
  • Purpose: Medical Aid Beneficiaries were surveyed to identify differences in health behaviors, adherence to drug regimen, and quality of life between those people in the Designated Doctor System and those who are not. Methods: A total of 1,327 study subjects were separated into three groups: those in the Designated Doctor System for 2 years, those in for 1 year, and those not in the system. Results: After the introduction of the Designated Doctor System, 55.8% and 67.9%, respectively, of the subjects in the Designated Doctor System complained of inconvenience in relation to hospital use and the patient referral process. Also, the rate of emergency room use or hospitalization guided by the Designated Doctor System was only 8.7% and 6.5%, respectively. There were no significant differences in health behaviors and adherence to drug regimens between those in the Designated Doctor System and those who are not. Conclusion: This study was carried out early in the introduction of the system. Therefore, it is necessary to monitor the positive and negative effects of the Designated Doctor System for a full reflection of its impact.

형사상 의료과실 및 인과관계 인정과 관련된 대법원 판례분석 (Judicial Analysis on Supreme Court Precedents Related to Criminal Malpractice and Acceptance of Causal Relation)

  • 박영호
    • 의료법학
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    • 제15권2호
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    • pp.435-459
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    • 2014
  • Supreme Court of Korea has been mitigating the burden of proof on the malpractice and causal relation by a patient in accordance with the practical transfer of such burden of proof on causal relation as well as relieving a doctor's burden of proof on mistake in the civil damage claim suits on the malpractice. However, a prosecutor shall strictly prove the causal relation between malpractice and unfavorable results as well as a doctor's mistake in the criminal cases for making a doctor accept the professional negligence resulting in death or injury in accordance with In Dubio Pro Reo principles. Furthermore, it shall not be allowed to relieve the burden of proof on malpractice and causal relation which has been frequently applied in the civil proceedings. Nevertheless, it was widely known that the front-line courts accepted the malpractice and causal relation by quoting the legal principles on relieving the burden of proof on malpractice and causal relation applied in the civil cases even in criminal cases with no or insufficient proof on malpractice or causal relation. However, the latest precedents in Supreme Court explicitly declared the opinion that there was no reason to apply the legal principle to relieve the burden of proof on the malpractice and causal relation in the criminal cases requiring the proof 'which doesn't cause any reasonable doubt' on malpractice and causal relation in accordance with the legal principles 'favorable judgment for a defendant in case of any doubt' on the basis of the strict principle of 'nulla poena sine lege.' Accordingly, Supreme court definitely clarified that there would be no reason to relieve the burden of proof on malpractice and causal relation in criminal cases by reversing several original judgments accepting malpractice and causal relation even though there were no strict evidence.

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의료계약상 채무불이행과 위자료 (A Breach of Medical Contract and Consolation Money)

  • 봉영준
    • 의료법학
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    • 제14권2호
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    • pp.217-260
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    • 2013
  • In connection to the civil liability of the medical malpractice, plaintiff and courts are solving the medical disputes with theory of the liability based on tort law. because contract law does not enact the right of claim of solatium and a plaintiff's lawyer and courts hesitate to use contract law. Medical treatment of doctor is main debt in medical contract and its in-complete performance gives rise to the violations of human's life, body and health. Consequently a breach of medical contract leads to violations of person-al rights. These violations spring from liability of contract as well as tort and damages from them are recognized based on medical contract law. A duty of explanation of doctor is a independent and appendant debt to the treatment debt. However its breach provokes violations of human's life, body and health as well as a right self-determination. Therefore consolation money claim should be recognized. In case of the violation of patient's life, body and health, patient's family al-so can demand consolation money due to the violation of their's own mental pain. However in case of the violation of only patient's self-determination without informed concent, they can not demand it by reason of the violation of patient's self-determination. But by reason of the violation of patient's life, body and health that were recognized by proximate causal relation between violation of duty of explanation and abd execution, they can do.

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정신질환자의 자살과 의료과오책임 (Negligence liability of hospitals for suicide of patient)

  • 손흥수
    • 의료법학
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    • 제7권2호
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    • pp.9-74
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    • 2006
  • Due to the awareness of their rights for medical liability and the advancement of legal principles, it becomes also not hard to find those who seek damages against hospitals, doctors and nurses for the suicide committed under the protection of psychiatric institute in Korea these days. Judgements on these kinds of cases are not enough yet, so that it may be too early to try to find principles used in these cases, however it is hardly wrong to read following things from above cases. That is, to gain the case, plaintiffs should show (1) there exists an obligation of "due care"(there is a special relation between patients and hospitals), (2) the duty is violated on the basis of the applicable standard of care, (3) whatever injures or damages are sustained are proximately caused by the breach of duty and (4) the plaintiff suffers compensable damages. To specific, whether a psychiatric institute was liable for wrong death or not depends upon the patients conditions, circumstances and the extent of the danger the patients poses to himself or herself; in short, the foreseeability of self-inflicted harm(the doctor should have or could reasonably have foreseen the patient's suicide and the doctor's negligence actually caused the suicide). In this context if a patient exhibit strong suicidal tendencies, constant observation should be required. Negligence has been found not exist, however, when a patient abruptly and unexpectedly dashes from an attendant and jumps out a window or otherwise attempts to injure himself or herself. And the standard of conduct that is required to meet the obligation of "due care" is based on what the "reasonable practitioner" would do in like circumstances. The standard is not one of excellence or superior practice; it only re quires that the physician exercise that degree of skill and care that would be expected of the average qualified practitioner practicing under like circumstances. Most of these principles have been established at cases of the U.S.A and Japan. In this article you can also find the legal organizations of medical liability and medical contacts on the suicide of patients who have psychiatric diseases under Korean negligence law.

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저소득층 방문간호 관리를 위한 제안 - 강북구 방문간호 대상자를 중심으로- (A Proposal on a Management Model Applicable to Visiting Nursing Program for a Low-income Group)

  • 고미자
    • 한국보건간호학회지
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    • 제10권1호
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    • pp.118-138
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    • 1996
  • Because of accelerated urbanization public body visiting nursing project that started according as matter of health on urban class in the lower brackets of income was concentrated on Social interests has a unsatisfied points to propel project efficiently from the lack of rating materials. Therefore centering around written contents in documentary literature of citizen health by household in five years from starting year of project to now. visiting frequency by medical manpower was evaluated quantitatively and qualitatively in aspect of management hereupon. for the sake of giving a basic materials for public health project of this field. This research presents documentary literature of citizen health which become materials is that as one person's charged region of nurse in duty scale. district is Kang-Buck Gu. the object is resident in the lower brackets of income grounded livelihood protection law and who is admitted by the head of organ~chief of health care). and the number of material centering around the head of a household is 415 copy. The result of research is summarized. as follow. 1. Average visiting frequency examinated by medical manpower show difference according to valuables of supervision characteristics namely average visiting. Frequency of nurse has long term residence in case registration season is early and supervision season is the first year and is high incase a kind of house is unlicdnsed mountain town. Average visiting frequency with doctor is high incase supervision season is the first year and the medical insurance system is admitted by chief of health care. That shows that a man of discomfort behavior left alone are yet many in local society. The meaning of this result shows that the continuity of official relation about class in the lowest brackets of income of long term residence goes well between househole who is a user of visiting nursing service of the object according to midway income under management influences a given duty of nurse s and so causes quantitative decrease. 2. In case behavier and condition of health that nurse diagnoses are bad. as the type matter is a lack of health and the number of patient is large. the average visiting frequency of nurse is high. because average visiting frequency with doctor is high as the condition of health is bad and the number of patient is large. That is similar with that of nurse. CD Average visiting frequency of nurse s seen by matter of disease is very high only in apoplexy by 39.50 and is confined within limits from 7.63 to 11.36 in other disease. But average visiting frequency with doctor is double as many as that of nurse but defined in apoplexy hypertension and articulate. (1) Average visiting frequency of nurse by existence in inoculation of hepatitis is low by 6.73 in unidentified group and very high by 26.89 in group of non-inoculation and the case of the antigenic positive man of B type hepatitis or epileptic who can't be inoculated shows 13.00 and that even family nursing service is needed to them. That result shows that though one person nurse of local charge has a large scale of duty. as visting nursing service is given a class who has a large demand preferentially by respectively accurate nursing diagnosis. the number of diagnosis service is similar with it. 3. During five years. average visiting frequency of nurse is 10.84 and average visiting frequency with doctor is 76.50 seeing from the official scale of nurse. visiting by household is performed two more per year to the average. Seeing this by type of service. average visiting frequency of nurse is higher in indirectly nursing than in directly nursing and that suggests that at the time of visiting household nurse performs education of protection lively save patient but at the time of contrastedly visiting with doctor. directly nursing is more contents of service show no difference by man power and medication dressing by demand is 14.3 and 18.6 the aid of hardship term of doctor and nurse is high by 18.7 and 17.00 in the request of hospitalization when seeing by demands. 4. Action by turns exemplified 1994 is well in sequence of 2/4 turn. 3/4 turn. 1/4 turn. 4/4 turn. When seen by average visiting frequency of nurse but gradually is even. Without difference by turns. average visiting frequency of doctor is much higher in 1/4 turn than other turns. Type of service by turns is all even but directly nursing is inactive in 4/4 and indirectly nursing. Very increases in 4/4 and so. Nurse's quantity of duty is plentiful that shows that by evaluation of last turn and plan of project. Contents of service follows that medication and dressing is the highest by' 5.57 in 1/4turn. goes down gradually by turn. becomes 3.57 in 3/4 turn. and increases again by 4.83 in 4/4 turn. the rest service is higher in 2/4 turn than other turns. 5. Total visiting frequency of nurse is explained to total $37.5\%$ by six valuables of visiting frequency of doctor. nursing demand. demand of diagnosis. condition of behavior. year. Special terms and magnitude of influential power is the same as sequence of enumerated valuables. Namely. the higher the visiting frequency of doctor. the bigger nursing and demand of diagnosis is. the worse the condition of behavior is. the older the object is and the more the household of special terms is. the high total visiting frequency of nurse is.

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진료기록에 대한 일반인의 인식과 태도 : 오픈노트(Open Notes) 운동을 중심으로 (A Study of General Population's Awareness and Attitudes Toward Medical Records : Focusing on Open Notes)

  • 최주희;천경주;이상옥;김유리;백주현;장철훈;김성수
    • 한국콘텐츠학회논문지
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    • 제16권9호
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    • pp.512-522
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    • 2016
  • 본 연구는 진료기록에 대한 일반인의 인식과 태도를 오픈노트(Open Notes)운동을 중심으로 알아보고, 우리나라 임상진료현장에서 오픈노트제도의 도입 가능성을 확인하는 것을 목적으로 한다. 연구 결과를 요약하면 다음과 같다. 일반인들은 주로 인터넷을 통해 건강정보를 얻고 있으며, 병원의 진료정보와 관련하여서는 보험회사에 제출하기 위한 진료비관련 기록을 주로 이용하였다. 또한 진료기록에 대해서는 의사나 병원이 위조 혹은 변조할 가능성이 있다고 인식하고 있었으며, 대부분의 응답자가 진료기록을 언제든 확인할 수 있다면 병원이나 의사에 대해 더 신뢰할 수 있다고 응답하였다. 한편 오픈노트 운동에 대해서는 대부분 좋은 아이디어라고 생각하고, 우리나라에서도 오픈노트제도가 시행되어야 한다는데 동의하였으며, 오픈 노트제도가 시행된다면 참여하겠다고 응답하였다. 결론적으로, 진료기록의 투명성을 추구하는 오픈노트제도의 도입은 의사-환자 간 신뢰에 기여하여, 의사-환자 간 커뮤니케이션에도 긍정적인 영향을 기대할 수 있을 것이다.

요양병원 근무한의사의 소진에 영향을 미치는 요인 - 광주.전남지역을 중심으로 - (A study on burn out of K.M.D.s (Korean medicine doctors) work at convalescent hospitals in Kwang-ju and Jeon-nam, Korea)

  • 문준석;신헌태
    • 대한예방한의학회지
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    • 제17권3호
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    • pp.115-128
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    • 2013
  • Objectives : This study was aimed to investigate burn out degree of K.M.D.s(Korean medicine doctors) who work at convalescent hospitals and to find contributional factors for the result. The relationship between burn out and job performance was also studied. Methods : 77 K.M.D.s(Male 49(63.6%), Female 28(36.4%)) participated in this survey that has 62 main questions about burn out, job performance, job environment and Social demographic characteristics. Survey was conducted from 19th Aug. 2013 to 6th Nov. 2013. Results : Average of burn out degree of K.M.D.s was 2.62 out of 5. Emotional exhaustion was highest (2.80) and depersonalization was lowest(2.20) among subordinate concepts of burn out. Work place location and average income of the subjective which are subordinate concepts of social demographic characteristics showed significant correlation with job performance. Role conflict, relation of co-worker, workload were significant factors for emotional exhaustion and meaning of the job, will of patient, challenge were significant factors for lack of feeling of accomplishment by multiple regression analysis. Relation of co-worker, aggression of patient and meaning of the job were also significant factors for depersonalization. Conclusion : Emotional exhaustion and lack of feeling of accomplishment among subordinate concepts of burn out were high in the subjective who participated this study. Significant factors that contribute to burn out of this study, shows different result compare to the studies that show other factors contribute to burn out who works at convalescent hospital or other place.

병원고객관계관리 시스템 도입에 영향을 미치는 요인 연구 (A Study on the Factors affecting the Implementation of HCRM)

  • 전재란
    • 한국산학기술학회논문지
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    • 제10권1호
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    • pp.209-214
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    • 2009
  • 병원 산업계의 경영관리 환경 변화에서 인터넷의 정보 제공 수준이 높아짐으로써 고객의 의료 지능이 높아지고, 병원선택(Hospital Shopping)과 의사선택(Doctor Shopping)을 스스로 하고 있어서, 병원의 경영도 고객(환자)접점 관리가 사업성과를 중요한 결정 요인으로 작용하고 있다. 이러한 결과로 환자와의 접점관리를 위한 고객관계관리(CRM) 시스템을 구축하고 운영하는 병원이 점차 늘어가고 있다. 그러나 이러한 병원CRM시스템 투자 노력에도 불구하고 그 성과는 미미한 수준에 머물고 있거나 대부분의 CRM 시스템이 실패함에 따라 CRM의 적극적인 도입의 지가 줄어들고 있다. 본 연구에서는 병원CRM시스템의 도입 의도에 어떤 영향 변수들이 주요한 변수로 작용하고 있는지에 대하여 연구하였다. 이러한 문제를 해결하기 위해 병원CRM시스템의 구축에 있어서 영향을 많이 끼치는 분야로 병원정보시스템을 선택했고, 이를 위해 구조방정식모형을 이용하여 연구 가설을 검증하고 연구 모형의 유효성을 증명한 독립변수의 측정 변수를 도출하여 향후 CRM 도입을 하고자 하는 병원에게 지식정보를 제공하고자 하였다.