• Safety and Health at Work
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• 제13권3호
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• pp.279-285
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• 2022

Background; In the event of an industrial accident, the appropriate choice of hospital is important for worker health and prognosis. This study investigates whether the choice of hospital by the employer in the case of industrial accidents affects the prognosis of injured employees. Methods; Data from the 2018 Panel Study of Workers' Compensation Insurance in Korea were used in an unmatched case-controlled study. The exposure variable is "hospital selection by an employer," and the outcome variable is 'worker's disability." Odds ratios (ORs) were estimated by modified Poisson regression and adjusted for age, gender, underlying disease, injury severity, and workplace size and stratified by industrial classification. The group at increased risk was analyzed and stratified by age, gender, and area. Results; In the construction industry, hospital selection by the employer was significantly associated with increased risk of disability (adjusted OR 1.26; 95% confidence interval [CI]; 1.20-1.32) and severe disability (adjusted OR 1.38; 95% CI; 1.08-1.76) among the injured. Female and younger workers not living in the Seoul capital area were more at risk of disability and severe disability than those living in the Seoul capital area. Conclusions; Hospital selection by employers affects the prognosis of workers injured in an industrial accident. For protecting workers' health and safety, workplace emergency medical systems should be improved, and the selection of appropriate hospitals to supply treatment should be reviewed.

• 보건행정학회지
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• 제16권4호
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• pp.128-146
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• 2006

The objective of this paper is to examine the proportion and characteristics of non-emergent patients at emergency departments. The observational survey was conducted using a structured form used by emergency medicine specialists or senior residents on June 7-20, 2005. 1,526 patients at ten emergency centers took part in this study. The structural form contained type of insurance, route and means of emergency department (ED) visit, triage based on the Manchester Triage Scale(MTS)-modified criteria, emergency level based on the government defined rule, type of emergency centers (Regional Emergency Medical Center; REMC, Local Emergency Medical Center; LEMC, Local Emergency Agency; LEA), as well as patient's general information. Data were analyzed using SAS statistical program(V.8.2). Descriptive analysis was performed to describe the magnitude of non-emergent patients. ${\chi}^2-analysis$ and logistic regression analysis was performed to identify the nonurgent patients' characteristics. In the MTS-modified criteria, we found a 15.3% rate of non-emergent patients. This rate differed from that of non-emergent patients obtained using government's rule. In particular, there were inaccuracies in the definition of government rule on non-emergent patients, so it is necessary to apply the new government rule regarding classification of non-emergent patients. There were significant differences in the rate of non-emergent patients according to type of ED, means of ED visit, time to visit, and insurance. Non-emergent patients are more likely to visit a D-type ED(LEA having less than 20,000 patients annually), not to use ambulance, to have 'Automobile Insurance, Industrial Accident Compensation Insurance, or pay out-of-pocket'. Non-emergent patients tend to visit ED due to illness rather than injury. Further studies on the development' of triage scale and reexamination of the government's rule on emergency visits are required for future policy in this area.

• 의료법학
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• 제11권1호
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• pp.397-445
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• 2010

This thesis introduces the trends of korean courts' ruling on damages in medical malpractice cases for past 10 years. First of all, Korean courts' ruling have had a tendency to pay only non-economic damages for not taking the informed consent. If a doctor cannot get the informed consent from a patient, he compensate only non-economic damages for the infringement of self-determination rights of patient. It's enough for the plaintiff to prove the infringement of self-determination rights, if the plaintiff just want to get non-economic damages. The Korean Supreme court have ruled that if plaintiffs want to get economic damages for the infringement of self-determination rights or informed consent, plaintiffs must prove that the infringement of self-determination rights is the proximate cause of the economic damages of patient. There is another tendency for the Korean Supreme court to limit the damages in medical malpractice cases on the ground of patient's diseases' dangerousness or patient's idiosyncrasy. In the past courts often limit the damages only to 70~80% of total damages, but now a days courts mostly limit the damages to 20~30%. This thesis also introduce the Korean courts' trends about Valuing damages in personal injury actions awarded for gratuitously rendered nursing and medical care.

• Journal of Korean Neurosurgical Society
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• 제57권1호
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• pp.19-22
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• 2015

Objective : Posttraumatic cerebral infarction (CI) is a well-known complication of traumatic brain injury (TBI). However, the causation and apportionment of trauma in patients with CI after TBI is not easy. There is a scoring method, so-called trauma apportionment score (TAS) for CI, consisted with the age, the interval, and the severity of the TBI. We evaluated the reliability of this score. Methods : We selected two typical cases of traumatic CI. We also selected consecutive 50 patients due to spontaneous CI. We calculated TAS in both patients with traumatic and spontaneous CI. To enhance the reliability, we revised TAS (rTAS) adding three more items, such as systemic illness, bad health habits, and doctor's opinion. We also calculated rTAS in the same patients. Results : Even in 50 patients with spontaneous CI, the TAS was 4 in 44 patients, and 5 in 6 patients. TAS could not assess the apportionment of trauma efficiently. We recalculated the rTAS in the same patients. The rTAS was not more than 11 in more than 70% of the spontaneous CI. Compared to TAS, rTAS definitely enhanced the discriminating ability. However, there were still significant overlapping areas. Conclusion : TAS alone is insufficient to differentiate the cause or apportionment of trauma in some obscure cases of CI. Although the rTAS may enhance the reliability, it also should be used with cautions.

• 한국환경보건학회지
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• 제38권2호
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• pp.166-174
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• 2012

Introduction: After 17 years since the first production of humidifier disinfectants in Korea, Korea Centers for Disease Control and Prevention (KCDC) announced that the odds ratio of lung injury related with humidifier disinfectant usage was 47.3 (95% confidence interval 6.0-369.7) according to a case-control study with 18 adult cases, including 8 pregnant women at a university hospital in Seoul. Results: From September 2011 to April 2012, one-hundred and seventy four victim cases have been reported to an environmental non-governmental group (NGO). We summarized timetable of humidifier disinfectants accidents, analyzed health outcomes (death, lung or lung and heart transplantation, pulmonary disease) of reported victims, and classified some information for humidifier disinfectants with health outcomes, and government action for this accident. Among the victims, number of death cases are 52 (30.0%), including 26 babies less than 3 years old. Sixty-nine victims come from twenty-seven family with 2 to 4 members per family. About twenty types of humidifier disinfectant products and about 600,000 product items a year have been sold. Fifty-two death cases used 7 different types of disinfectant products, including imported goods and some private brands of well-known supermarkets. KCDC confirmed inhalation toxicity of 6 products through an animal experimental test, and based on this observation recalled disinfectants containing PHMG (polyhexamethylene guanidine) and PGH (Oligo(2-(2-ethoxy)ethoxyethyl guanidinium chloride). Discussions: The use of these biocides involved highly fatal consequences among biologically vulnerable victims, such as pregnant women, several family member victims after semi-acute exposure. This is the first biocide disaster in Korea with non-specific targets, and unknown scale of victims, warranting concerns on use of biocides in the living environment. Conclusions: Special administrative agency for chemical safety and compensation act for environmental health victims are needed to prevent similar problems.

• 한국병원경영학회지
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• 제17권2호
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• pp.21-33
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• 2012

Purpose : This study aims to suggest application of patients DB to hospital marketing by performing market segmentation and selecting target market. Consequently help to establish suited strategy of marketing. Method : 14,072 patients hospitalized in a University Medical Center were recruited into this study. In order to classify the customer groups, cluster analysis was used with RFM(Recency, Frequency, Monetary) model, and 1-way ANOVA verified the differences among groups. And then, sociodemographical status, healthcare utilization and diagnosis(ICD-10) of each group were compared to draw a marketing strategy. Results : Four groups were classified through clustering analysis, and'high use and high profit' and'low use and high profit' groups were selected as a target market. The features of target market were as follows, the female proportion was high; used a private room; hospitalized through the emergency room; had operation; length of stay was long; had many comorbidity and cooperative treatment. There was difference in each feature of target market: as for the'high use and high profit' group, many patients were diagnosed with 'certain infectious and parasitic diseases'; and as for the'low use and high profit'group, the proportion of patients who purchased'industrial accident compensation insurance'and'auto insurance'was relatively high; many patients were diagnosed with'Injury, poisoning and certain other consequences of external causes'. Conclusion : It is needed to establish'positioning' strategy by monitoring and communicating with'high use and high profit' group. And for the case of'low use and high profit' group, it is necessary to make a follow-up management and lead them to have a medical check-up.

• 한국환경보건학회지
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• 제42권6호
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• pp.375-384
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• 2016

Objectives: This paper analyzes the intersection of tort law and environmental health in a recent court decision. Methods: This paper analyzes Supreme Court Decision 2011Da7437, Decided on September 4, 2014 and related lower court decisions. Results: The plaintiffs sought financial compensation from the defendants, arguing that air pollutants in gases emitted by vehicles produced by the defendants had caused them to acquire respiratory diseases. The district court highlighted the need to mitigate the burden of proof for the plaintiffs, but proceeded to review whether the plaintiffs proved the actual toxicity levels of the air pollutants, whether the defendant's vehicles were the main source of the emissions, the plaintiff's level of exposure to the pollutants, and causation between the emissions and the injury. By doing so, the district court required the plaintiffs to prove both indirect and direct facts of causation, increasing burden of proof for plaintiffs. The appellate court upheld the district court's decision, adding that the defendant's conduct did not constitute an illegal act because it did not violate the emissions standards set by environmental law. The Supreme Court upheld the appellate court's decision, reasoning that the epidemiological evidence cannot establish a direct causation for diseases that lack specificity. Conclusion: This case demonstrates that discussions in environmental health have significance in tort lawsuits. For each fact that the plaintiffs and defendants attempted to prove, environmental health research studies were offered as evidence. In addition, the courts decided the legality of the defendant's conduct based on emission standards set by environmental law.

• 항공우주정책ㆍ법학회지
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• 제22권2호
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• pp.155-175
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• 2007

As intellectual terror threats increase, we feel the limit in coping with those threats and the things we do are placing traditional X-ray machines & ETD and increasing aviation security staffs. In fact, even if air transportation system is the fast and most efficient transportation methods, it is true that there are many inconveniences to endure due to terror threats. In the name of security, even if we make a lot of efforts and time to screen both good-natured passengers, baggage, cargo and suspicious passengers, it is impossible to screen perfectly and it is not an efficient methods. Therefore, we introduce profiling system that reduce the effort to screen good-natured passengers but focus on screening dangerous passengers and baggages. Profiling system strengthens aviation security, using the concept "Selection & Concentration". Israel started to introduce manual profiling system in aviation security, which is interviewing suspicious passengers and it has been used in crime investigation since 1960. And it has been upgraded and diversified to CAPPS(Computer Assisted Passenger Screening Program) and SPOT(Screening Passenger by Observation). So, this theses is to study on the concept & kind of profiling and profiling methods adopted in airlines. Also it presents the method of introduction of profiling system in Korea and the necessity of making law on it.

• 항공우주정책ㆍ법학회지
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• 제30권2호
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• pp.279-310
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• 2015

몬트리올협약은 국제항공운송에서 발생한 사고에 따른 여객의 사망이나 상해에 관하여 항공운송인의 책임을 배타적으로 규율하고 있다. 국제항공산업의 재정적인 안정과 항공사를 파산으로 이끌 수도 있는 과도한 배상책임으로부터 항공산업을 보호할 목적으로 몬트리올협약은 금전배상에 있어서 책임제한제도를 운영하고 있다. 하지만 여객의 사망이나 상해가 항공사 혹은 그 대리인의 직접적인 과실이나 불법적인 작위 혹은 부작위의 결과라는 점이 인정될 경우에 그러한 책임제한원칙은 유지될 수 없고, 손해배상을 청구하는 자는 협약이 정하는 제한책임액 이상의 배상을 받을 수도 있다. 한편, 몬트리올협약은 손해배상을 청구하는 원고가 소송을 제기할 수 있는 법정지에 관해서도 관할권 관련 조항에서 일정한 제한을 두고 있다. 이러한 관할권은 특히 피고 항공운송인의 영업소나 원고의 주소지가 주요 결정요인이 된다. 지난 2015년 3월, Germanwings 항공사 9525편에 발생한 사고는 당시 심한 우울증을 앓고 있었던 부기장의 의도적인 행동이 원인이었고, 해당 항공기가 프랑스령 알프스산맥에 추락하면서 대부분의 탑승 여객과 승무원의 사망이라는 결과로 이어졌다. 보도 자료에 따르면 사고 직후, 항공사는 사망승객의 국적에 따라 금액의 차이는 있지만 미화 8,300불에서 4백5십만불에 이르는 손해배상액을 합의금으로 제시하였다고 한다. 이러한 합의제안에 대해 몇몇 유가족들은 보다 많은 배상액을 얻기 위하여 미국과 같이 피해자에게 관대한 법정지에서 소송제기를 계획하고 있다고 한다. 본 논문은 위 사고와 관련하여 두 가지 쟁점에 관하여 기술하고 있다. 첫째, 본 논문은 몬트리올협약상 관할권 조항과 관련하여 미국 시민이 아닌 피해자가 미국 법정지에서 소송을 제기할 가능성에 대해 살펴보았다. 둘째, 본 사고의 직접적인 원인이 부기장의 의도된 사고유발 행동이었던 점에서 사안의 항공사는 몬트리올협약이 규정하고 있는 책임제한원칙이 부정될 가능성이 있다. 이에 관하여 본 논문은 해당 항공사가 그럼에도 불구하고 협약상 책임제한규정을 원용할 수 있는 가능성이 있는지 여부를 중점적으로 살펴보았다.

• 한국항해학회지
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• 제17권3호
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• pp.57-68
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• 1993

The economy of Korea has grown up significantly in its scale. It has, therefore, become imperative to develop countermeasures to prevent work related injuries and occupational illnesses resultining from haza-rdous working conditions and handling harmful substances. A lot of cargo handling accident in port have occurred due to the characteristics of poor working environment, diversity of working place and method, fluctuation of the amount of cargo and handling of heavy, long, harmful and dangerous cargo, etc. According to '91 industrial accident analysis carried out by the ministry of labour, the number of the stevedores injured by cargo handling accident in port were 1, 432 persons (the death accident : 22 per-sons), the amount of industrial accident compensation in port was 6.7 billion won (the amount of economic loss : 33.6 billion won), and the injury occurance rate of the stevedoring industry was higher than that of the whole industry. This paper, therefore, aims to the actual status of the stevedoring industry and to extract the main cau-ses of the accidents related to cargo handling in port through factor analysis using the data of the accide-nts in the whole habour from 1990 to 1992, and to suggest the countermeasures to prevent such accident. The main causes of the accident and countermeasures are found to be as follows through the factor analy-sis : Factor1, factor2, and factor3 related to a defect of human being and management, a defect of state and environment, and an insufficiency of education and law are extracted. The short-term countermeasures to prevent these accidents are 1) to consolidate the safety and health organization in the working spot, 2) to secure a safe condition in working spot before dock work, 3) to strengthen a dock worker's safety educa-tion. The long-term countermeasures are 1) to promote a decasualisation of dock workers, 2) to modernize the cargo working methods through constructing exclusive pier and introducing exclusive cargo handling equipment, 3) to establish a exclusive dock accident prevention organization and the dock workers law. Factor 4, factor5, factor6, and factor7 related to an unfitness, a deficiency of technical knowledge, a nonfu-lfilment of safety measures, and a bad arrangement are extracted. The countermeasures to prevent these accidents are 1) to perform a complete safety inspection of cargo handling equipments and tools and to carry out the dock work according to a working plan, 2) to publish and supply technical safety books, safety instruction book, safety check list, etc., 3) to strengthen the safety patrol at the working spot in habour and to activate a safety fund, 4) to maintain always a clean workshop with the safety consciousness in which the good arragement of the working spot is considered to be the beginning of safety.