• 제목/요약/키워드: future death burden

검색결과 26건 처리시간 0.019초

사학연금의 재정안정화와 적정성 유지 방안 (How to Maintain the Financial Stability and Adequacy of Teachers Pension)

  • 박유성;정민열;전새봄
    • 응용통계연구
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    • 제28권4호
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    • pp.643-661
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    • 2015
  • 사학연금은 사립학교 교직원이 의무 가입하는 연금으로, 가입자들이 퇴직, 사망 등으로 경제적 위험에 처한 경우 연금을 수급하여 안정을 보장하기 위한 사회보장제도이다. 따라서 사학연금이 공적연금의 기능을 위해서는 기금의 안정성 및 지속가능성이 확보되어야 하며, 적절한 급여소득을 보장해야 할 것이다. 그러나 가장 대표적 공적연금인 공무원연금은 이미 2001년 재정수지 적자를 기록하였으며, 누적적자폭은 앞으로 더욱 커질 것으로 예상되어 최근 이에 대한 여러 개혁안이 활발히 논의되고 있다. 사학연금 제도는 기본적으로 공무원연금제도를 기초로 하는바, 이러한 국민연금 및 공무원연금 개혁 논의에서 자유롭지 못하다. 뿐만 아니라 한국의 고령화 및 인구구조 추세로 볼 때, 현행제도 하에서는 사학연금 기금 역시 향후 30년 내 기금 고갈이 예상되는 바, 현재의 사학연금 제도가 개선될 필요가 있음을 시사한다. 본 연구는 기존의 사학연금 제도의 문제점을 짚어보고, 이를 개선하기 위한 추계방법 및 개정방안을 제안한다. 이를 위해 사학연금의 장기재정추계를 통한 기금고갈시점 및 재정적자액의 규모를 예측하고, 현재 및 미래의 인구구조를 반영한 수급부담 구조를 비교 분석함으로써, 사학연금의 안정성과 적정성을 유지하기 위한 연금개혁 방안을 논의하고자 한다.

뇌졸중환자의 희망 (The Hope of the Stroke Patients)

  • 김이순
    • 대한간호학회지
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    • 제27권1호
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    • pp.212-227
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    • 1997
  • Cerebrovascular diseases in Korea is an important health problem since mortality and mobidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The stroke causes physical function disorder due to hemiparalysis and emotional disorder, and stroke patients experience helplessness, powerlessness. sense of alienation and loss of hope. These feelings make the rehabilitation difficult because they lose the will of life. The subjects of the study were seven citizens who live in Pusan, are over 50 years old and belong to low income-level. The data were collected from Jan. to Sep. 1995. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi, which is as follows ; as an unit of description which include the subject' expressions and the researcher's observation, it is examined the theme that express the hope experience with the subject's language(underlining), and the focal meanings are identified. The focal meaning is the crystalization of the theme, which is written in the language of the researcher. After intergrating the focal meaning and make the situated structural description as the meaning of the hope experience identified on each subject's point. After intergrating the situated structural description and make the general structural description as the meaning of the hope experience identified on total subject's point then the systemizing of the structure of the hope experienced phenomena and the flowing of the conciousness was researched. The conclusions of this study was as follows : The ten sources of hope which the subjects experienced were sorted as under 〈mutual relations to others : spouse, children, relatives, fellow believer. health professioner. associate patient group〉, 〈spiritual dependence〉. 〈recovery of physical function〉. 〈rumination of the past life〉, 〈expectation of the future〉. 〈economic power〉, 〈belief〉, 〈ability〉. 〈spontaneous participation〉 and 〈recovery of roles〉. Their hope was spoken out by the following two kinds of linguistics. First. the hope was expressed in the affirmative expression as follows : 〈 to be dependable〉, 〈to make efforts〉, 〈to keep under control〉, 〈to desire〉, 〈to be pleasant〉, 〈to be peaceful〉, 〈to be grateful〉, 〈to give help〉, 〈self-confidence. Courage〉, 〈to be happy〉, 〈to satisfy oneself〉, 〈to share with others〉, 〈to understand〉 and 〈to be affected, be impressed〉 Second, the hope was expressed in the negative on pression as under : 〈to be distressed〉, 〈to be uneasy〉, 〈to be sorry, be unsatisfied〉 〈despair〉, 〈to abandon〉, 〈to be fearful〉, 〈to suffer〉, 〈to bear a burden〉 〈to be confused〉, 〈to be solitary〉, 〈chest trouble〉, 〈to feel heavy〉 〈grief〉, 〈to be daunted〉, 〈to get angry〉, 〈to be uncomfortable〉, 〈to have something regretable〉 and 〈to feel guilty〉. And their hope was expressed by the following four behavioral expressions : 〈physical sphere〉, 〈psychological sphere〉, 〈social support sphere〉 and 〈spiritual sphere〉. The reaction patterns of their hope experience appeared in the following 4 coping method : 〈conquest type〉, 〈dependence type〉, 〈adaptation type〉 and 〈fate type〉. Finally, in the hope structure the sense of certainty don't always coexict with the sense of uncertainty, When the stroke patients try to search for the best quality of life, the senses of certainty and uncertainty make a continual cyclic system in the hope structure.

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Requirements for Cerebrovascular Surgery in Comprehensive Stroke Centers in South Korea

  • Kim, Tackeun;Oh, Chang Wan;Park, Hyeon Seon;Lee, Kunsei;Lee, Won Kyung;Lee, Heeyoung
    • Journal of Korean Neurosurgical Society
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    • 제61권4호
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    • pp.478-484
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    • 2018
  • Objective : Cerebrovascular disease (CVD) was the third most common cause of death in South Korea in 2014. Evidence from abroad suggests that comprehensive stroke centers play an important role in improving the mortality rate of stroke. However, surgical treatment for CVD is currently slightly neglected by national policy, and there is still regional imbalance in this regard. For this reason, we conducted a survey on the necessity of, and the requirements for, establishing regional comprehensive cerebrovascular surgery centers (CCVSCs). Methods : This investigation was performed using the questionnaire survey method. The questionnaire was consisted with two sections. The first concerned the respondent's opinion regarding the current status of demand and the regional imbalance of cerebrovascular surgery in South Korea. The second section asked about the requirements for establishing regional CCVSCs. We sent the questionnaire to 100 board members of the Korean Society of Cerebrovascular Surgeons. Results : Most experts agreed that cerebrovascular surgery patients were concentrated in large hospitals in the capital area, and 83.6% of respondents agreed that it was necessary to alleviate the regional imbalance of cerebrovascular surgery. With regards to personnel, over 90% of respondents answered that at least two neuro-vascular surgeons and two neuro-interventionists are necessary to establish a CCVSC. Regarding facilities, almost all respondents stated that each CCVSC would require a neuro-intensive care unit and hybrid operating room. The survey asked the respondents about 13 specific neurovascular surgical procedures and whether they were necessary for a regional CCVSC. In the questions about the necessity of cerebrovascular surgical equipment, all seven pieces of equipment were considered essential by all respondents. A further five pieces of equipment were considered necessary on site: computed tomographic angiography, magnetic resonance angiography, conventional angiography, surgical microscope, and surgical navigation. Our results may provide a basis for future policy regarding treatment of cerebrovascular disease, including surgery. Conclusion : Raising the comprehensiveness of treatment at a regional level would lower the national disease burden. Policies should be drafted regarding comprehensive treatment including surgery for cerebrovascular disease, and related support plans should be implemented.

2011년 주요 의료 판결 분석 (Review of 2011 Major Medical Decisions)

  • 유현정;서영현;이정선;이동필
    • 의료법학
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    • 제13권1호
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    • pp.199-247
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    • 2012
  • According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.

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저작권법에 준한 도서관봉사에 관한 연구 -미국과 한국의 저자재산권의 제한규정을 중시으로- (Limitations on Exclusive Rights of Authors for Library Reprography : A Comparative Examination of the Draft Revision of Korean Copyright Law with the New American Copyright Act of 1976)

  • 김향신
    • 한국도서관정보학회지
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    • 제11권
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    • pp.69-99
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    • 1984
  • A dramatic development in the new technology of copying materials has presented us with massive problems on reconciling the conflicts between copyright owners and potential users of copyrighted materials. The adaptation to this changing condition led some countries to revise their copyright laws such as in the U. S. in 1976 and in Korea in 1984 for merging with the international or universal copyright conventions in the future. Copyright defined as exclusive rights given to copyright owners aims to secure a fair return for an author's creative labor and to stimulate artistic creativity for the general public good. The exclusive rights on copyrightable matters, generally for reproduction, preparation of derivative works, public distribution, public performance, and public display, are limited by fair use for scholarship and criticism and by library reproduction for its preservation and interlibrary loan. These limitations on the exclusive rights are concerned with all aspects of library services and cause a great burden on librarian's daily duty to provide balance between the rights of creators and the needs of library patrons. The fair use as one of the limitations on it has been coupled with enormous growth of a new technology and extended from xerography to online database systems. The implementation of the fair use and library reprography in Korean law to the local practices is examined on the basis of the new American copyright act of 1976. Under the draft revision of Korean law, librarians will face many potential problems as summarized below. 1. Because the new provision of 'life time plus 50 years' will tie up substantial bodies of material longer than the old law, until that date librarians would need permissions from the owners and should pay attention to the author's death date. 2. Because the copyright can be sold, distributed, given to the heirs, donated, as a whole or a part, librarians should chase down the heirs and other second owners. In case of a derivative work, this is a real problem. 3. Since a work has its protection from the moment of its creation, the coverage of copyrightable matter would be extended to the published or the unpublished works and librarian's work load would be heavier. Without copyright registration, no one can be certain that a work is in the public domain. Therefore, librarians will need to check with an authority. 4. For implementation of limitations on exclusive rights, fair use and library reproduction for interlibrary loan, there can be no substantial aggregate use and there can be no systematic distribution of multicopies. Therefore, librarians should not substitute reproductions for subscriptions or purchases. 5. For the interlibrary loan by photocopying, librarians should understand the procedure of royalty payment. 6. Compulsory licenses should be understood by librarians. 7. Because the draft revision of Korean law is a reciprocal treaty, librarians should take care of other countries' copyright law to protect foreign authors from Korean law. In order to solve the above problems, some suggestions are presented below. 1. That copyright clearinghouse or central agency as a centralized royalty payment mechanism be established. 2. That the Korean Library Association establish a committee on copyright. 3. That the Korean Library Association propose guidelines for each occasion, e.g. for interlibrary loan, books and periodicals and music, etc. 4. That the Korean government establish a copyright office or an official organization for copyright control other than the copyright committee already organized by the government. 5. That the Korean Library Association establish educational programs on copyright for librarians through seminars or articles written in its magazines. 6. That individual libraries provide librarian's copyright kits. 7. That school libraries distribute subject bibliographies on copyright law to teachers. However, librarians should keep in mind that limitations on exclusive rights are not for an exemption from library reprography but as a convenient access to library resources.

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웰다잉 국가 전략에 대한 일반 국민들의 인식 및 수용도 (Public Perception and Acceptance of the National Strategy for Well-Dying)

  • 이서현;신동은;심진아;윤영호
    • Journal of Hospice and Palliative Care
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    • 제16권2호
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    • pp.90-97
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    • 2013
  • 목적: 본 연구는 정부가 호스피스완화의료를 제도적으로 지원하겠다고 발표한 2002년 이후 10년이 지난 현시점에서 일반 대중들의 웰다잉에 대한 인식과 수용도가 어떤 방향성을 띄는지 알아보고자 하였다. 이를 통해 향후 한국 호스피스 완화의료 정책이 나아갈 길을 제시하는 것을 목표로 하였다. 방법: 2012년 6월 1일부터 6월 11일까지 전국 만 20~69세 성인 남녀 1,000명을 대상으로 Computer-Assisted Telephone Interviewing (CATI)를 이용하여 웰다잉에 대한 인식 및 수용도에 관한 설문을 실시하였다. 조사 항목은 인구학적 특성 전반과 신체적, 정신적, 사회적, 영적 건강상태 등 건강에 대한 인식, 그리고 아름다운 삶의 마무리에 대한 정책적 선호도로 구성하였다. 결과: 아름다운 삶의 마무리를 위한 제1 중요 요소로는 다른 사람에게 부담을 주지 않음이 36.7%로 가장 많았다. 제2 중요 요소로는 가족이나 의미 있는 사람과 함께 있는 것이 19.1%로 가장 높은 비율을 차지하였다. 죽음과 관련하여 삶의 아름다운 마무리를 위한 9가지 전략의 선호도를 조사한 결과, 간병 품앗이 활성화에 대해 찬성하는 의견이 88.3%로 가장 많았으며 의료인의 임종환자 관리 교육 실시(83.7%), 장례식장 대신 가족들을 편하게 해주고 의료진이 환자를 돌볼 수 있는 시설을 병원/집에서 가까운 곳에 마련(81.7%)이 그 뒤를 이었다. 삶의 아름다운 마무리를 위한 5개년 국가 전략을 수립하는 것에 찬성한 비율은 전체의 91%로 매우 높은 수준이었으며 그 수행 주체로는 정부(47.5%), 국회(20.2%), 시민 단체(10%)순인 것으로 조사되었다. 결론: 일반 국민 1,000명을 대상으로 조사한 본 연구결과는 국가적 차원의 웰다잉 정책과 완화의료의 제도적 지원책을 마련하는데 초석이 될 수 있을 것이다.