• 보건행정학회지
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• 제23권4호
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• pp.303-313
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• 2013

During last 65 years, Korea has achieved very rapid economic growth and social reformation including healthcare system. Many foreigners have praised that Korea healthcare system is very good in the respect of ease accessibility to healthcare under the lowest cost among the industrialized countries. Whole population are covered by the National Health Insurance. Also utilizations of healthcare among different income classes are even. However Korea healthcare system faced with several challenges, in terms of the an aging population and a rise in chronic disease problem, new threats of communicable disease due to globalization, the rapid increase of healthcare expenditure and high financial burden of patients even though they are insured. To cope with these challenges, we need reconsider the healthcare system as followings; to set up ideology of healthcare as normative public goods, to rebuild paradigm of healthcare for 21 century, to reform public health for strengthening health promotion, to develop new method for healthcare management including quality improvement and consumer responsiveness, to build new governance for health and to view new perspective on healthcare as a kind of industry.

• 디지털융복합연구
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• 제11권5호
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• pp.347-354
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• 2013

양질의 의료 서비스를 요구하는 환자들은 증가하는 반면 의사나 간호사와 같은 전문 의료 인력은 한정되어 있어 그들에게 가해지는 업무 부담이 과중하게 부여되고 있는 실정이다. 이러한 문제를 해결하기 위한 대안으로 USN(Ubiquitous Sensor Network)을 이용한 환자 모니터링 시스템이 대두되고 있다. 본 논문에서는 USN을 산부인과에 적용하여 간호사의 업무 부담을 줄이기 위해 산모 모니터링 시스템 모델을 설계하였다. 효율성 평가는 서울소재 대학병원(S, K 병원) 두 곳을 모델로 설정하여 의사의 처방에 따른 측정 주기를 산출하여 실시하였으며, 그 결과는 간호사 1인이 12명의 환자(자연분만 6명, 자연분만 외 출산 6명)를 케어하는 경우 입원기간(5일 기준) 동안에 1,260분이 경감되는 것으로 나타났다. 또한 간호사의 기존 업무량과 모니터링 시스템 적용 후 업무량을 비교해 보았을 때 자연분만 산모의 경우 산모 수가 1명씩 증가함에 따라 하루에 50분씩, 자연분만 외 수술 산모의 경우 산모 수가 1명씩 증가함에 따라 하루에 130분씩 업무량 감소 효과가 있는 것으로 나타났다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제13권1호
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• pp.37-44
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• 2007

With the rapid changes in healthcare system, the impact on healthcare design is significant and constantly changed. Because of emergence of new technology, far-advanced methods of healthcare delivery, and changing social and environmental issues, the healthcare planners and architects have to make sure that future expansion are taken into consideration when they design the hospitals. This thesis aims to investigate the hospital remodeling cases in Korea and USA and find the solutions for the vertical expansion of the hospitals in the metropolitan area where the buildings may be limited to be horizontally expanded. The M Cancer center in Manhattan, NY is selected to be carefully investigated and analyzed. Based on this analysis, the strategy for the vertical expansion of the hospital will be suggested.

• 보건행정학회지
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• 제33권1호
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• pp.1-2
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• 2023

As the industrial paradigm shift, often condensed as the "4th Industrial Revolution," gains momentum, there is a growing need to actively introduce digital healthcare into the medical field. The new administration announced its commitment to become a global leader in the biohealth and digital healthcare sector. To fulfill this pledge, preemptive policy leadership and attention from the government are required. The recent issue of legislating non-face-to-face medical care suggests that introducing digital healthcare goes beyond simply adopting new technologies. Incorporating digital healthcare involves changing the existing healthcare delivery process and coordinating the roles of stakeholders. To successfully change the structure of the medical industry, a mid- to long-term roadmap should be meticulously organized and promoted. Policy efforts are needed to resolve conflicts and lead to compromises through continuous communication with interest groups.

• 보건행정학회지
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• 제30권3호
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• pp.277-285
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• 2020

Chronic diseases as well as a growing population of older adults are currently the leading cause of ill health and economic burden worldwide. Managing those diseases in one-on-one medical consultations poses substantial challenges due to limited time and resources in the current health care system. Various approaches have been taken to manage these conditions, most with limited success. Shared medical appointments (SMAs) are an innovative care delivery option to make the testing of alternative care modalities a prime concern. SMAs are individual medical consultations carried out in a group of patients with similar diseases by providing education, medication management, and disease monitoring. SMAs, since their initial conceptualization in 1998, have gained much popularity and adopted as one of the standard processes in many countries. Accumulated evidence-based studies show outcomes for increasing access to care, behavioral change facilitated through self-management education, maintained/better outcomes, physician productivity, and enhanced resource management. This review summarizes current evidence regarding the existing status of SMAs abroad. An extensive literature search was conducted on major electronic databases including PubMed and Google Scholar. This study suggests to explore and exploit the SMAs which have unique potential as a healthcare delivery innovation in Korea.

• 한국산학기술학회논문지
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• 제17권4호
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• pp.340-350
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• 2016

의료법에서는 의원은 외래환자를, 상급종합병원은 중증의 입원환자를 전문적으로 치료하는 의료기관으로 규정하고 있다. 그러나 일차의료를 제공하는 의원의 외래환자수는 위축되는 반면 상급종합병원의 외래진료비 비중은 지속적으로 증가하고 있다. 이 연구에서는 우리나라 의료전달체계를 정상화하기 위한 보다 근원적인 방안으로 두 가지 정책안을 제시하고 이 정책을 정착시키고 성공시키기 위한 보건의료정책 거버넌스에 관한 제안을 담고 있다. 상급종합병원의 중증 환자 진료기능을 강화하기 위하여 현행 종별가산율을 외래와 입원 종별가산율로 분리하고 외래진료비 목표관리제 도입이라는 두 가지 방안을 제시하였다. 그리고 이들 정책안을 큰 부작용없이 성공시키기 위한 보건의료 정책 거버넌스를 제안하였다. 보건의료 정책 거버넌스는 의료공급자, 환자의 참여와 동기부여가 전제되어야 하며 장기적인 관점에서는 향후 의료 질을 반영할 수 있도록 설계되어야 한다.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2013년도 춘계학술대회
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• pp.256-259
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• 2013

Data and network security for e-Healthcare Systems are a primary concern due to the easiest deployment area accessibility of the sensor devices. Furthermore, they are often interacting closely in cooperation with the physical environment and the surrounding people, where such exposure increases security vulnerabilities in cases of improperly managed security of the information sharing among different healthcare organizations. Hence, healthcare-specific security standards such as authentication, data integrity, system security and internet security are used to ensure security and privacy of patients' information. This paper discusses security threats on e-Healthcare Systems where an attacker can access both data and network using masquerade attack. Moreover, an efficient and cost effective approach for countermeasures is discussed for the delivery of secure services.

• Clinical and Experimental Reproductive Medicine
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• 제37권4호
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• pp.329-338
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• 2010

목적: 본 연구에서는 10개 이하의 2PN 접합자를 얻은 환자군에서 전핵 단계 배아의 동결보관이 누적 분만율을 증가시키는 지를 살펴보고자 하였다. 연구방법: 2003년 1월부터 2007년 12월까지 제일병원 아이소망센터를 내원하여 과배란 유도에 의해 체외수정 및 배아이식술을 시행한 주기를 후향적으로 비교 분석하였다. 본 연구에서는 일반적 체외수정법 또는 세포질내 정자주입술을 이용하여 수정을 시도한 후 20~22시간에 8개의 수정란을 확인하거나, 또는 전핵이 1개만 보이는 접합자와 발달지연 배아를 포함하여 수정란이 10개 미만인 138주기의 체외수정 및 배아이식 주기를 대상으로 분석하였다. 분석대상을 두 군으로 나누었으며 그룹 I (n=86)은 배아의 동결 없이 모든 수정란을 배양하여 3일째 이식한 군으로 하였으며, 그룹 II (n=52)는 전핵 시기에 일부 수정란을 동결하고 나머지를 배양하여 3일째 이식한 군으로 분류하였다. 두 군간 신선배아 이식주기와 그 다음 동결-해동 이식주기 후의 임상적 임신율과 누적 임신율을 각각 비교하였다. 결과: 비교 대상군 사이에 여성의 평균 나이, 획득 난자의 수 및 수정란의 수에서는 통계적 차이를 보이지 않았다. 배양된 배아의 수는 그룹 II ($5.2{\pm}0.5$)가 그룹 I $8.4{\pm}0.7$)에 비하여 유의하게 적었다 (p<0.01). 또한 이식한 배아의 수 역시 그룹 II ($3.3{\pm}0.6$)가 그룹 I ($3.6{\pm}0.6$)에 비하여 통계적으로 유의하게 적었다 (p<0.01). 신선주기 배아이식에서 ${\beta}$-hCG 양성을 보인 환자 수와 분만을 한 환자의 수는 그룹 I이 그룹 II에 비하여 약간 높은 양상을 보였다 (51.2 vs. 46.2% and 41.9 vs. 34.6%). 동결-해동 배아이식 후 누적 분만율을 비교하였을 때 그룹 I (48.8%)과 그룹 II (50.0%)에서 통계적으로 유의한 차이를 관찰할 수 없었다. 결론: 적은 수의 수정란을 얻은 환자군에서 일부 전핵 단계에서의 동결보관이 누적 분만율을 향상 시키는 효과를 확인할 수 없었다. 그러나 일부 수정란의 동결보관은 해당 신선주기에서 임신에 실패하였을 경우 환자에게 추가적인 배아이식 기회를 제공해 줄 수 있는 장점을 가지고 있는 것으로 생각된다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권3호
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• pp.47-54
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• 2022

Purpose: This study presents the analysis on space usage of delivery departments in regional public hospitals. The results intention is to achieve improvement of the delivery environment for the mothers and newborns regarding exposure prevention and efficient infection control. The purpose of this study is to provide fundamental data for architectural plans and guidelines for the delivery department. Method: The investigation and analysis were based on research papers, legal systems, public medical statistical data, and the architectural floor plan drawing. For research, 20 regional public hospitals with an operating delivery room were excluded. Regarding data accessibility, 15 regional public hospitals were selected. Results: To overcome the increased vulnerability of the delivery department, the research results of basic data is provided for the establishment to address urgent needs and rapid response. Thus, the research results are as follows: Firstly, the delivery department needs to respond promptly according to the type of patients. For example, in a case of emergency surgery, a connected circulation plan with the related departments is needed. Secondly, for the environment of the delivery area, alleviating anxiety is imperative for pregnant patients and guardians, labor, childbirth, and recovery. Therefore, these needs must be addressed for treatment space and circulation. Lastly, the delivery department is classified into three areas for analysis: access area, treatment area, and support area. In most of the delivery departments of the 15 selected hospitals, there is no space for the access and support area except for the labor and delivery rooms in the treatment area. For the access area, a waiting area, changing room for pregnant women and guardians, and a storage space for contaminated linens are required for infection prevention, safety, and efficiency. For the treatment area, childbirth processes and circulation should have space reserved for labor, delivery, recovery, examination, and treatment. In preparation for an emergency during childbirth, emergency response measures and supporting space needs to be established. For the support area, circulation and rooms are to be designed for medical staff support, activity space, storage and transportation of equipment, and urgent medical treatment. Implications: Along with the low fertility rate and the decrease of medical institutions that operate delivery departments, for the purpose of establishing a public medical service system and a healthy medical environment for mothers and newborns, the researched information demonstrates basic data on space plan of delivery departments in regional public hospitals.

• 한국병원경영학회지
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• 제19권3호
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• pp.11-28
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• 2014

This study, targeting Korean tertiary hospitals and general hospitals, aims to analyze how value chain model in health and medical institution suggested by Duncan and else influences on hospital management. A survey was conducted to verify the actual proof analysis of this study model. 880 questionnaires were distributed to entire 88 hospitals and 739 copies were returned from 76 hospitals. This study mainly consists of three steps to analyze the effect value chain activity has on management performance of general hospitals. For the first step, we analyzed the effects service delivery activity has on management performance. For the second step, we analyzed the effects service support activity has on management performance and for the third, we analyzed the effects interaction between service delivery activity and service support activity has on management performance. The main results of this study are as follows. First, in terms of the management performance of scale, the factors which influenced on daily charge of outpatient were service activity before treatment, at the moment of treatment and value chain activity, while more important factors in daily charge of inpatient were organizational culture, organizational structure and value chain activity. In terms of management performance of quality, the factors which influenced on the first medical examination rate of outpatient were service activity before, at the moment of and after treatment, while activity at the moment of treatment, organizational structure, and value chain activity which is interaction were more important factors in average length of stay. In terms of non-financial performance, the management performance factors which influenced on job satisfaction were service activity at the moment of, after the treatment and value chain activity, while organizational culture, strategy resources and value chain activity which is interaction were more important factors in job commitment. Secondly, all the service support activity, service delivery activity and value chain activity had statistically significant effect on management performance. Among the three factors, service support activity had relatively high effect than others.