• 한국사회정책
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• 제25권2호
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• pp.31-55
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• 2018

돌봄의 경제적 불이익과 성불평등은 서로를 강화한다. 성불평등의 기저에 돌봄의 불평등한 분배와 대우가 자리하고 있다. 돌봄은 성불평등을 심화시키는 경제적 불이익을 초래한다. 돌봄을 수행하는 자는 사회경제적 권력 관계에서 보통 약자의 위치를 점하고 있으며, 사회경제적 약자가 수행하는 돌봄은 그 수행에 대한 공정한 대우와 보상의 목소리를 내기가 어렵다. 그 결과 낮은 경제적 가치를 갖게 된 돌봄을 수행하는 자는 더욱 취약한 사회경제적 지위와 권력 관계에 놓여 불평등한 성별 관계를 지속시킨다. 기본소득 제도는 성불평등을 완화할 수 있는 잠재적 가능성을 지니고 있지만, 돌봄 노동의 특수한 성격이 야기하는 경제적 불이익은 그러한 잠재적 가능성을 희석시킬 수 있다. 기본소득 제도가 여성의 실질적 자유를 실현하기 위해서는 돌봄의 경제적 불이익에 대한 천착과 적극적 개입이 필요하다. 본 논문은 기본소득 지지론자들의 돌봄 노동에 대한 관점을 검토하고, 돌봄노동의 고유한 특성으로 인한 돌봄불이익이 완화 혹은 해소되지 않는다면 기본소득이 도입되어도 돌봄 노동 선택의 성별화를 변화시키는 데 한계가 있다고 주장한다.

• 한국사회복지학
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• 제66권3호
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• pp.133-158
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• 2014

경제적, 사회적, 인구학적 변화에 따라 전세계적으로 돌봄노동의 규모와 중요성은 상당히 커졌다. 그에 따라 한국을 포함한 많은 나라들에서 돌봄노동자는 노동력을 구성하는 의미있는 부분으로 자리잡게 되었다. 그러나 여전히 돌봄노동은 다른 노동에 비해 임금수준이 낮고 열악한 노동으로 평가되고 있다. 이 연구는 한국 돌봄노동의 실태를 조망하고, 성향점수매칭법을 통해 임금불이익을 실증적으로 추정하는 것을 목적으로 한다. 돌봄노동에 대한 실태분석을 통해 돌봄직업이 학력, 연령, 근속기간과 관련하여 위계화되어 있음을 알 수 있었다. 또한 성향점수 매칭법을 활용하여 돌봄노동의 임금불이익을 추정한 결과, 돌봄직업 근로자는 다른 직업 근로자보다 시간당 임금수준이 9.2% 낮음을 확인할 수 있었다. 돌봄노동조건의 열악함과 임금불이익은 사회서비스 확대와 관련하여 우선적으로 해결해야할 과제이다. 적절한 보상체계 없는 돌봄노동의 안정적 재생산은 어려우며, 사회서비스의 원활한 공급과 적절한 질 유지 또한 불가능하기 때문이다.

• 품질경영학회지
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• 제27권2호
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• pp.1-19
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• 1999

It is truism to say that today's customers demand high quality products and services; nevertheless, nowhere is this more prevalent than in the medical industry. Korea's globalization has increased it's citizen's awareness of greater life expectancies and medical improvements in other regions of the globe. Therefore, it is universally essential that in order to be successful in the medical industry, vendors must meet the ever increasing demands of better educated customers. The purpose of this study was twofold: 1) The first objective was discover what health care services are in demand and the quality factors related to these services. 2) The second objective was to determine a strategy for improving health care service through quality function deployment(QFD). One hundred and ninety-five respondents were randomly selected and asked to fill out a questionnaire after having undergone treatment at a medical clinic, located in Daejon, South Korea. The questionnaire was designed to obtain information about both he clients' satisfaction with, and their sense of the value of the medical treatment they received. Penalty-reward analysis and QFD were used to interpret the survey results and to deploy the collective voices of the customers. The results of the penalty-reward analysis illustrated that the 'communication' service quality factor was classified into an excitement factor that incurs no penalty if not achieved but adds value if the requirement is exceeded. As a result of the QFD analysis on the 'communication' service quality factor, eleven strategic alternatives were prioritized, and isolated a vital service quality characteristic. This characteristic can be implemented to bring value-added changes for the improvement of health care services.

• 의료법학
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• 제8권1호
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• pp.215-234
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• 2007

The mission of the doctors is to take care of human life, body and health through the medical behaviors such as diagnosis and treatment. Under this job propensity, the doctors have care duty to take the best actions required to prevent the risk according to the patients' specific disease status. Such care duty of the doctor may be evaluated based on the medical behavior level at the medical institution and clinical medical study field. Such medical level should be understood in the normative level, considering the treatment environment, condition and specialty of the behavior, because it means the medical common sense known and acknowledged to the normal doctors. While the criminal suit requires the evidence for no doubt conviction, the civil suit requires more eased different standard. The results between the criminal and civil sentence may be different, because the confirmed former case may lead to long-term imprisonment and even death penalty, while the latter case puts only monetary penalty on the defeated party.

• 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.

• Child Health Nursing Research
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• 제28권2호
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• pp.91-102
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• 2022

Purpose: This study systematically analyzed cases in South Korea wherein nurses were prosecuted for involuntary manslaughter or injury due to professional negligence in pediatric care. Methods: We analyzed the precedents using the methodology of Hall and Wright (2008) and Austin (2010). Of the 618 cases retrieved from the Supreme Court Decisions Retrieval System in South Korea, we selected the 12 cases in which children were the victims and nurses were the defendants, using a case screening methodology. Results: The most frequent penalty was a fine, and newborns were the most frequent victims. The distribution of cases according to Austin's violation categories was: improper administration of medications (n=5), failure to monitor for and report deterioration (n=4), ineffective communication (n=4), failure to delegate responsibly (n=4), failure to know and follow facility policies and procedures (n=1), and improper use of equipment (n=1). Conclusion: To ensure the safety of children, nurses are required to teach and practice a high standard of care. Nursing education programs must improve nurses' awareness of their legal obligations. Nursing organizations and leaders should also work towards enacting effective nursing laws and ensuring that nurses are aware of their legal rights and responsibilities.

• 보건행정학회지
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• 제27권2호
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• pp.121-127
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• 2017

The effort to measure and improve the quality of healthcare is a common health policy issue worldwide. Korean Value Incentive Programme is one of that effort, but some concerns exist. Compared to pay for performance program in other countries, it measures healthcare quality with relatively narrow performance domain using a small number of clinical indicators. It was designed without involving hospitals and other key stakeholder, and program participation was mandated. Highest and lowest performers get bonus and penalty using relative ranking. As a suggestion for development, the direction for quality management at the national level should be given first. Therefore the philosophy or strategy for quality improvement should be reflected to the program. And various domains and indicators of healthcare quality should be developed with active communication with healthcare providers. The evaluation method is necessary to be changed to provide achievable goal to the healthcare providers and attract quality improvement.

• Korean Journal of Radiology
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• 제25권7호
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• pp.662-672
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• 2024

Since the emergence of the first photon-counting computed tomography (PCCT) system in late 2021, its advantages and a wide range of applications in all fields of radiology have been demonstrated. Compared to standard energy-integrating detector-CT, PCCT allows for superior geometric dose efficiency in every examination. While this aspect by itself is groundbreaking, the advantages do not stop there. PCCT facilitates an unprecedented combination of ultra-high-resolution imaging without dose penalty or field-of-view restrictions, detector-based elimination of electronic noise, and ubiquitous multi-energy spectral information. Considering the high demands of orthopedic imaging for the visualization of minuscule details while simultaneously covering large portions of skeletal and soft tissue anatomy, no subspecialty may benefit more from this novel detector technology than musculoskeletal radiology. Deeply rooted in experimental and clinical research, this review article aims to provide an introduction to the cosmos of PCCT, explain its technical basics, and highlight the most promising applications for patient care, while also mentioning current limitations that need to be overcome.

• 한국의료질향상학회지
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• 제3권2호
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• pp.26-35
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• 1997

Background : Glycopeptide antibiotics are the only drugs for treatment of infections due to beta-lactam-resistant Gram-positive bacteria. As the incidence of infection and colonization with vancomycin-resistant enterococci(VRE) rapidly increases, the hospital infection control practices advisory committee(HICPAC) recommends prudent vancomycin use to detect, prevent and control infection and colonization with VRE. Methods : The inpatients admitted from September to December, 1996 in Pusan National University Hospital, with Gram-positive bacterial infections were evaluated retrospectively to see whether the administrations of glycopeptide antibiotics were appropriate or not, upon comparison with the recommendations for preventing the spread of vancomycin resistance by HICPAC. Results : Teicoplanin has been chosen more frequently than vancomycin of the glycopeptide antibiotics. The indications of administration of glycopeptides in patients with pneumonia, wound infections, sepsis, and in febrile or neutropenic patients with malignancies were appropriate, but the use of glycopeptides for elimination of merely colonized bacteria in the oral cavity could not be excluded. Inappropriate use of glycopeptides was 10.6%, and inappropriately long-term use without positive culture for beta-lactam-resistant Gram-positive organisms was about 40% of total days of drug use. Conclusion : It seems essential for the quality assurance committee to make a plan in teaching the HICPAC recommendations to the medical practitioners who prescribed the glycopeptides inappropriately or used for irrelevantly long to his patient, monitor and survey their use of glycopeptides prospectively and periodically, and if there are repeated inappropriate prescriptions, a certain penalty would be given to the practitioners.

• 의료법학
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• 제21권1호
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• pp.33-67
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• 2020

사무장병원은 경제력을 지니고 있으나 의료기관을 개설·운영할 수 없는 비의료인이 의료업계에 첫발을 내딛는 의료인이 경제적으로 자립하기 어려운 상황에서 의료기관 개설 초기에 소요되는 막대한 자본을 감당할 수 없다는 점을 악용하여, 의료인과 공모하여 외형상 요건을 구비한 의료기관을 난립시켜 의료인이 중심이 되어야 하는 의료시장질서를 교란시키고 있다. 또한 사무장병원은 정부로부터 요양급여나 보조금 등 다양한 혜택을 부정하게 수급하여 감으로써 국민건강보험의 막대한 재정 누수를 가져오고 있어 사회적으로 큰 문제를 야기하고 있다. 사무장병원의 개설상의 불법성은 그 개설에 관한 약정을 민사상 무효화하고 의료법상 개설에 관여하는 자 전체에 대하여 형사벌을 가함과 동시에 의료인에게 행정처분을 부과할 정도로 높다. 또한 사무장병원이 개설상의 위법을 인지하고 있음에도 불구하고 이를 묵비한 채 국민건강보험공단에 대하여 요양급여비용을 청구하여 수급하는 행위에 대하여, 국민건강보험법과 의료급여법상의 환수에 더하여 형법상 사기죄, 나아가 이득액에 따라 특정경제범죄 가중처벌등에 관한 법률위반(사기)죄의 처벌, 그리고 민사상 불법행위책임까지 적용하고 있다. 본고에서는 사무장병원에 대한 현행법상 법적 규제와 현재까지의 판례의 태도를 살펴봄으로써, 사무장병원에 대한 규제가 어떻게 이루어지고 있는지 그 현황을 고찰하고, 향후 입법 방향의 토대를 제시하고자 한다.