• 보건행정학회지
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• 제9권2호
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• pp.21-39
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• 1999

An increasing number of hospitals are seeking for new or mixed compensation strategies to improve the productivity of their medical staff in the struggle to provide high quality medical services at low costs amid the economic hardship. To motivate physicians toward the right direction, it is necessary to effectively evaluate their performance that provides a basis for compensation. However, productivity has been historically difficult to measure, particularly for physicians in academic medical centers who are expected to engage in research, education, and patient care simultaneously. The objectives of this study were to define performance measures of physicians and clinical departments in academic medical centers. to examine correlations between the measures. and to investigate factors affecting the measures. The performance data of 212 faculty physicians in 17 clinical departments in two university teaching hospitals affiliated to one medical school during the fiscal year 1994 was used for analyses. Patient care revenue, net profit. and adjusted number of patients were defined to measure the performance in patient care. and number of articles published in academic journals and research grant were defined for research activities. Both individual physicians' performance measures and per physician measures of clinical departments were analyzed. All measures defined to evaluate individual physicians' performance were positively related to each other. Clinical department and rank of faculty position were statistically significant predictors of revenue. and hospital. clinical department. and rank were significant predictors of net profit. journal publication. and research grant. Patient care measures defined to evaluate clinical departments were related to each other. so were research measures. and no significant correlations were found between patient care measures and research measures. Also found were large differences in department. ranks when clinical departments were evaluated by absolute per physician performance measures and evaluated by annual rate of changes in performance measures. These findings suggest that departmental performance measures opposed to individual performance measures are relatively free from problems of factors affecting the performance measures that are not in control of clinical departments or individual physicians. Results from the correlation analysis of departmental performance measures indicates that measures of research performance should be included in the evaluation to promote research activities in academic medical centers.

• 의학교육논단
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• 제21권2호
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• pp.80-91
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• 2019

The tripartite mission of 'academic medicine' is education, research, and patient care. Academic medical centers (AMCs) are carrying out the mission and ultimately aiming to improve the health of people and communities. Globally, AMCs are facing a tremendous financial risk stemming from the changes in health insurance reimbursement plans and a shortage of human resources. Innovative AMCs in the United States are trying to transform their physician-centered, and siloed structure into a patient-centered, and integrated structure. They are also building integrated systems with primary healthcare groups to provide continuous patient care from primary to tertiary levels and making strategic networks based on value-based payment and the patient-centered model. These changes have been proven to improve outcomes of patient care and increase fiscal revenues, which are both crucial in supporting education and research. To address the shortage of human resources, programs are being built to develop newly appointed faculty for the future. AMCs have different approaches to bringing changes into their organizations; however, there is a common emphasis on 'a patient-centered approach,' which helps them set more explicit organizational values and make strategic decisions based on their values. Korean AMCs are facing similar challenges to AMCs in the United States in spite of many differences between the countries' healthcare systems. The innovative efforts of AMCs in the United States to address the challenges will be helpful, well-worked examples for Korean AMCs with similar challenges.

• 가정∙방문간호학회지
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• 제26권3호
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• pp.253-264
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• 2019

The aim of this review is to present a German system of an outpatient care center under the German Health Insurance Act and home care (integration of medical care, basic care, bathing) under the Long-Term Care Insurance Act. This idea of a German integrated home care system should contribute to the development of a Korean home care model. Prior the introduction of long-term care insurance (1995), and with the of the health insurance law (1989), German outpatient care centers already provided medical and basic care services for patients with acute and chronic symptoms. Since 1995, patients with acute symptoms and rehabilitation periods under the Health Insurance Act have been eligible for home care. The Long-Term Care Insurance Act is intended for all citizens who are unable to carry out their daily activities for more than six months. In 2017, 13,657 (97%) of 14,050 outpatient care centers provided home care services after long-term care and health insurance. In other words, patients in Germany can use home care in both the acute and chronic phase at the same home care center, or 'integrated home-care center'.

• The Korean Journal of Pain
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• 제27권1호
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• pp.35-42
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• 2014

Background: Epidural steroid injection (ESI) is one of the most common procedures for patients presenting low back pain and radiculopathy. However, there is no clear consensus on what constitutes appropriate steroid use for ESIs. To investigate optimal steroid injection methods for ESIs, surveys were sent to all academic pain centers and selected private practices in Korea via e-mail. Methods: Among 173 pain centers which requested the public health insurance reimbursements for their ESIs and were enrolled in the Korean Pain Society, 122 completed questionnaires were returned, for a rate of 70.5%; also returned were surveys from 39 academic programs and 85 private practices with response rates of 83.0% and 65.9%, respectively. Results: More than half (55%) of Korean pain physicians used dexamethasone for ESIs. The minimum interval of subsequent ESIs at the academic institutions (3.1 weeks) and the private practices (2.1 weeks) were statistically different (P = 0.01). Conclusions: Although there was a wide range of variation, there were no significant differences between the academic institutions and the private practices in terms of the types and single doses of steroids for ESIs, the annual dose of steroids, or the limitations of doses in the event of diabetes, with the exception of the minimum interval before the subsequent ESI.

• 한국간호교육학회지
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• 제22권2호
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• pp.240-249
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• 2016

Purpose: The purpose of this study was to identify the factors influencing personal disaster preparation and disaster nursing core competency among visiting nurses in public health centers. Methods: A descriptive survey study was adopted. A convenience sample was taken from 277 subjects in three regions. Data were analyzed by descriptive statistics, t-test, ANOVA, correlation, Pearson correlation coefficient and multiple regression. Results: The mean personal disaster preparation and disaster nursing core competency scores were 11.13 and 76.87, respectively. Personal disaster preparation was statistically significant by experience of disaster victims and disaster management guideline. Disaster nursing core competency was statistically significant by participation in future disaster recovery. As a result of multiple regression analysis, personal disaster preparation accounted for 14.9 of the variance by experience of disaster victims and disaster management guidelines; disaster nursing core competency accounted for 8.9 of the variance by perception of disaster nursing. Conclusion: Although visiting nurses are ill-prepared for disaster, global natural and man-made disasters can occur regardless of time and place. Disaster education and training should therefore be included in nurses' fundamental education.

• 가정∙방문간호학회지
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• 제10권1호
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• pp.5-14
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• 2003

Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.

• 가정∙방문간호학회지
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• 제29권1호
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• pp.40-49
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• 2022

Purpose: This study aimed to analyze the effects of fatigue, resilience, and self-leadership on nursing service quality of local medical center nurses who nursed COVID-19 patients. Methods: The participants were 135 nurses who worked at regional public hospitals located in H-gun, G, and C-city in province C. The collected data were analyzed using descriptive statistics, t-test, analysis of variance (ANOVA), Pearson's correlation coefficients, and stepwise multiple regression using IBM SPSS Statistics version 25. Results: The participants' nursing service quality showed significant positive correlation with resilience (r=.53, p<.001), and self-leadership (r=.60, p<.001). The factors affecting participants' nursing service quality were commitment to self-leadership (β=.57, p<.001) and work position (chief nursing officer) (β=.26, p<.001), which explained 42% of the participants' nursing service quality. Conclusion: During a crisis such as the COVID-19 pandemic, it is necessary to help nurses enhance their self-leadership skills and build their career continuously by developing relevant policies, systems, and nursing intervention programs. Future studies could expand the knowledge base by including more participants to explore other ways to improve nursing service quality during the COVID-19 pandemic.

• Parasites, Hosts and Diseases
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• 제56권5호
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• pp.401-408
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• 2018

Korea is successfully controlled intestinal parasitic infections owing to economic development and high health consciousness. The Division of Vectors and Parasitic Diseases (formerly the Division of Malaria and Parasitology) is in the Center for Laboratory Control of Infectious Diseases of the Korea Centers for Disease Control and Prevention. It has been the governmental agency responsible for controlling and leading scientific research on parasitic diseases. The Division of Vectors and Parasitic Diseases has conducted and funded basic research and disseminated the research results to various medical fields, ultimately promoting public health in Korea. Among the noteworthy achievements of this division are the national surveillance of healthcare-associated parasitic infections, prevention and control for parasitic infections, and the elimination of lymphatic filariasis from Korea. On a broader scale, the division's research programs and academic supports were influential in preventing and treating infectious parasitic diseases through public policies and laws. In this review, we summarize the past and present role of the Division of Vectors and Parasitic Diseases in preventing and treating infectious parasitic diseases in Korea.

• Journal of Preventive Medicine and Public Health
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• 제53권5호
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• pp.362-370
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• 2020

Objectives: Despite greater access to training positions and the presence of more women in emergency medicine, it has remained a men-dominated field. This study aims to identify the key issues causing the gender gap in Korea and establish measures to overcome them. Methods: Using the annual statistical reports of the National Emergency Medical Center and data published on the Korean Society of Emergency Medicine website, cases that listed the current status and positions of members in its organization and its committees were analyzed. Secondary analysis was conducted using data from the 2015 Korean Society of Emergency Survey that included physicians' demographics, academic ranking, years of experience, clinical work hours, training and board certification, core faculty status, position, and salaries. Results: As of September 2019, women account for only 12.7% of the total number of emergency physicians (EP) in Korea; of 119 chair/vice-chair academic positions, women represented only 9.2%. Women EP were more often assistant professors and fellowship-trained, with fewer in core faculty. However, they worked the same numbers of clinical hours as their men counterparts. The median annual salary of women EP was less than that of men EP after adjusting for academic hospital rank, clinical hours, and core faculty status. Conclusions: A gender gap still exists among Korean EP, and women earn less than men regardless of their rank, clinical hours, or training. Future studies should evaluate more data and develop system-wide practices to eliminate gender disparities.

• Genomics & Informatics
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• 제16권4호
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• pp.36.1-36.3
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• 2018

Next generation sequencing (NGS), a high-throughput DNA sequencing technology, is widely used for molecular biological studies. In NGS, RNA-sequencing (RNA-Seq), which is a short-read massively parallel sequencing, is a major quantitative transcriptome tool for different transcriptome studies. To utilize the RNA-Seq data, various quantification and analysis methods have been developed to solve specific research goals, including identification of differentially expressed genes and detection of novel transcripts. Because of the accumulation of RNA-Seq data in the public databases, there is a demand for integrative analysis. However, the available RNA-Seq data are stored in different formats such as read count, transcripts per million, and fragments per kilobase million. This hinders the integrative analysis of the RNA-Seq data. To solve this problem, we have developed a web-based application using Shiny, COEX-seq (Convert a Variety of Measurements of Gene Expression in RNA-Seq) that easily converts data in a variety of measurement formats of gene expression used in most bioinformatic tools for RNA-Seq. It provides a workflow that includes loading data set, selecting measurement formats of gene expression, and identifying gene names. COEX-seq is freely available for academic purposes and can be run on Windows, Mac OS, and Linux operating systems. Source code, sample data sets, and supplementary documentation are available as well.