• 의료법학
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• 제15권2호
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• pp.345-366
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• 2014

Because the health care or medical sector has such characteristics as publicity, professionality, and exclusivity, it cannot be left to the free market system. As a consequence, the state has restricted the establishment of medical institutions in order to protect the life and health of people. Also, the medical law has regulated to permit the establishment of medical institutions by only medical personnel and a few corporate bodies and to ban the establishment of medical institutions under disguised ownership as well as double opening of medical institutions by medical personnel. Nevertheless, there are still many cases that non-medical personnel have dominantly established medical institutions under disguised ownership of other medical personnel or nonprofit corporation. Because they are willing to recover their investment costs as soon as possible, these illegally established medical institutions are likely to make patients undergo unnecessary tests or to perform the excessive treatments and, as a result, are likely to cause infringement on the health and lives of the people. In addition, even if the misconduct is uncovered, the rate at which the costs already paid is very low and, as a result, the damages are straightly connected to the people's loss. On the other hand, there are also increasing number of cases that medical personnel or nonprofit corporations are establishing medical institutions against the medical law regulations. The examples of this illegality are also the double opening of medical institutions and the establishment of medical institutions under disguised ownership by medical personnel or nonprofit corporations. And the damages in these cases may not differ from those in the above cases. In this study, regarding medical law regulations restricting opening a medical institution, I will review the intent of those regulations, the type of violations and criminal punishments, and the possibility of recovery from unlawful profit by the National Health Insurance Act. And then, I would like to find a way for rational improvement of each.

• 보건행정학회지
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• 제32권1호
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• pp.3-13
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• 2022

Health centers provided intensive health care services for local residents according to changes in the times and environment. Public health centers were given various roles such as medical treatment, administration, and service, and the demand for functional reorganization has emerged. We analyzed the literature on the functional restructuring of public health care institutions. In addition, the current status of medical services, which is the main function of institutions, will be analyzed through health insurance statistical data, and detailed contents will be analyzed according to regional types and income levels. As a result of the analysis of medical services at institutions, the total number of patients was 2,238,000, and the number of visits was 11,806 times. Total medical expenses were 169.6 billion won, of which 132 billion won was found to be benefit. When analyzing the number of patients per institution, public health centers had the largest number of 4,326, and the share of benefit was also the highest at public health centers. It should focus on the function of providing local health and medical services related to health promotion and disease prevention in the community. This functional reorganization of public health centers can contribute to forming cooperative relationships with private medical institutions in the local community. For this, first, to establish the role, essential functions for public health centers for preventive health management are established. Secondly, regular manpower expansion and flexible manpower management are required in the human resources sector. Finally, in the organizational sector, it is necessary to establish a step-by-step organizational system according to environmental changes.

• 보건행정학회지
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• 제30권1호
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• pp.62-71
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• 2020

Background: The purpose of this study is to analyze the current status and factors of elderly patients' hospitalization for hip replacement, knee replacement, and general spine surgery. Methods: National health insurance data in 2018 was provided by the National Health Insurance Service. We used multiple regression to analyze factors associated with the medical utilization of hip replacement, knee replacement, and general spine surgery in elderly patients over 65 years old. The dependent variables are the length of stay and total health expenditure. The independent variables are the demographic-social factors (sex, age, region, insurance type, income level) and surgery-related factors (institution type, location of the hospital, surgery classification). Results: The most common factor affecting surgery was the location of medical institutions. Compared with the medical institutions located in metropolitan, the length of stay in rural medical institutions was higher and total health expenditure was lower. The lower quartile of income, the higher the length of stay and total health expenditure. In addition, the variables of age, type of health insurance, and type of medical institution were statistically significant. Conclusion: In this study, we confirmed the effect of sociodemographic factors and medical institution factors on the Healthcare Utilization of spinal and joint surgery.

• 디지털융복합연구
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• 제11권10호
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• pp.619-627
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• 2013

본 연구는 응급의료기관을 내원 한 행려환자들의 내원, 진료, 발생특성에 따라 체류시간을 살펴본 후 영향을 미치는 관련요인을 파악하여 향후 의료서비스 개선방안을 위한 기초자료를 제공하고자 하는데 그 의의가 있다. 조사대상은 2012년 1월 1일부터 동년 12월 31일까지 1년 동안 충남소재의 응급의료기관을 내원한 행려환자 691명으로 하였으며, 분석방법은 빈도분석, ANOVA, 상관관계분석 후 독립변수를 더 미화하여 다중회귀분석을 실시하였다. 결론을 보면 첫째, 의료기관은 행려환자에 대한 부정적인 인식에서 벗어날 필요가 있으며, 질 좋은 의료서비스 제공 및 응급진료지원체계를 갖추고 있어야 한다. 둘째, 행려환자의 대부분이 남자이고, 40,50대가 절반이상을 차지하고 있어, 이들이 사회적으로 아직까지는 생산성이 높은 연령층이라고 할 수 있으며, 향후 의료적지원 뿐만 아니라 사회복귀프로그램이 포함된 정부 정책의 관리구축 방안이 필요하다.

• International Journal of Internet, Broadcasting and Communication
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• 제12권4호
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• pp.122-127
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• 2020

After the THAAD crisis, Goyang city's Global Medical Service performance is showing a sharp decline compared to other cities and provinces. In particular, the contraction of participants who can create policy outcomes such as Medical Institutions and Attracting companies has emerged as the biggest problem. Therefore, Goyang City wanted to derive effective marketing policies and establish marketing policies according to their priorities in order to prevent the deaths of the future patient visitor market as well as performance. In order to examine such policy needs more closely, this paper reviewed the Global Medical Service policies of Goyang City based on AHP analysis, and derived a ranking of 28 major policies and preferred policies for each participant. In the future, Goyang City is expected to derive major policy effects by applying the results of this study to the establishment of marketing policies through customized policies for each medical institution type and Patient attraction company.

• 의료법학
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• 제17권2호
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• pp.281-313
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• 2016

우리 헌법은, 국가로 하여금 국민의 건강을 보호할 의무를 지우고 있고, 그 구체화된 규범인 의료법은 의료기관 개설 등에 관한 사항을 상세히 규정하고 있는데, 그 내용 중 하나가 의료인의 의료기관 복수개설 운영 금지 제도이다. 이에 대하여, 종래의 판례는 '다른 의사 명의로 추가 개설하는 의료기관에서 직접 의료행위 등을 하지 않는다면 여러 개의 의료기관을 개설 운영할 수 있다'고 해석함으로써, 사실상 복수의 의료기관을 개설 운영할 수 있었다. 하지만 일부 의료인들이 다른 의사의 면허로 의료기관을 여러 장소에 개설하고 이익을 극대화하기 위하여, 환자유인행위를 하거나 과잉진료 및 위임치료를 하는 등의 불법의료행위를 조장할 뿐만 아니라 국민의 건강권 등을 침해하는 현실적 문제가 발생하게 되었다. 이에 입법자는 의료법의 개정을 통해 의료인은 어떠한 명목으로도 둘 이상의 의료기관을 개설하거나 운영할 수 없도록 의료기관 개설제도를 정비하게 된 것이다. 이에 따라 개정 의료법 하에서 1인의 의료인이 더 이상 복수의 의료기관을 개설 내지 운영할 수 없게 되자, 일부 의료인들은 새로이 개정된 규정 하에서는 네트워크병원의 장점을 살릴 수 없다며, 개정 의료법의 규정이 위헌이라고 주장하고 있다. 그러나 사무소의 복수개설을 금지하는 규정은 의료인에게만 특별한 제한을 두고 있는 것이 아니며, 변호사, 약사 등 수많은 다른 전문자격사들에 대해서도 하나의 사무소만을 개설하도록 규정하고 있으며, 이는 자신이 직접 그 본연의 업무를 수행하기 위하여 필요한 장소적 범위 내에서만 사무소를 책임지고 개설 운영토록 하기 위함이다. 또한 동 규정이 위헌적 소지가 있어 폐지된다면, 어렵사리 의료법인 또는 비영리법인을 설립하여 여러 개의 의료기관을 개설 운영하는 절차를 따를 이유도 없게 된다. 나아가 무엇보다 중요한 것은 의료인의 복수 의료기관 개설을 허용할 경우 사실상 영리병원을 허용하는 결과를 초래하게 된다는 점을 유념해야 한다. 요컨대 공공의료가 차지하는 비율이 절대적으로 적은 우리나라의 보건 의료 현실에서 일부 소수의 자본력 있는 의료인이 수많은 의료기관들을 독점하여 소유하고 사실상 영리병원으로 운영한다면, 이는 의료서비스의 질 저하를 초래하고, 궁극적으로 국민의 건강권 내지 생명권을 침해할 수 있다는 점을 깊이 고려해야 한다.

• 한국융합학회논문지
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• 제8권10호
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• pp.239-248
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• 2017

최근 의료기관의 사회적 책임(CSR)은 선택적으로 수용하여 적용하는 것이 아니라 병원과 의료기관의 지속 성장 발전을 위한 기본 역량이자 책임으로 인식되고 있다. 그러나 사회적 책임활동 분야 선행연구의 대부분이 기업의 사회적 책임에서 태동되어 일반기업과 조직을 대상으로 하고 있으며 의료기관이나 병원에 대한 CSR 연구는 아주 미미한 수준에 머물러 있는 것이 현실이다. 본 연구는 의료기관의 사회적 책임이 조직성과와 경영성과에 미치는 영향을 분석하고, 의료기관의 사회적 책임활동과 경영성과 사이에서 조직성과가 매개역할을 하는지 실증분석한다. 본 연구의 결과는 의료기관의 효과적인 사회적 책임활동의 전략적 접근 방향을 제공하고, 아직은 척박한 의료기관 CSR활동과 관련한 연구에 단초가 되고 의료기관이 CSR활동을 통한 전략방향을 제시하는데 기여한다.

• 의료법학
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• 제24권2호
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• pp.79-117
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• 2023

2002년 의료 관련 선고된 판결들 중에는 , 환자의 자기결정권 행사를 보장하기 위하여 구체적인 상황에서 환자에게 의료행위의 위험성과 부작용 등에 관하여 충분히 숙고한 후 결정할 수 있는 시간적 여유가 주어져야 한다는 점을 명시하면서 설명의무의 이행시기와 관련된 의미 있는 판결이 있었다. 또한 보험회사가 실손보험상품 가입자들을 대위하여 의료기관에 대해 부당이득반환을 청구한 사례에서 채권자대위권의 보전의 필요성 관련 적극적 요건과 소극적 요건을 분설하여 명확한 기준을 제시한 판결이 있었다. 의료행정 영역에서는, 국민건강보험법에 따른 요양기관 업무정지처분의 성격을 대물적처분으로 명확히 한 판결, 코로나 백신투여 부작용에 대한 보상 인정 사례에서 인과관계를 폭 넓게 인정한 판결 및 한의사의 초음파 의료기기 사용 등 의료인의 면허범위 관련 판결이 있었다. 환자에 대한 의료기관의 퇴거 청구 사례에서 의료법 제15조 제1항과 관련하여 입원진료계약의 해지에 관한 정당한 사유에 대한 판결을 검토하였다.

• 한국한의학연구원논문집
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• 제18권2호
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• pp.101-116
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• 2012

Objectives : This study aims to analyze the papers of the east-west medical combined treatment and suggest the research direction. Methods : 183 research papers were collected by using 25 keywords including combination(in korean words, 병용), collaborative practice(in korean words, 협진) in Korean Medical Database(KMbase) and Oriental Medicine Advanced Searching Integrated System(OASIS). We analysed the type of studies, the kind of diseases, the treatment method, the kind of herbs and drugs in frequent use, and the result of research. Results : Among the analysed 183 papers, clinical studies are 89 cases and experimental studies are 94. 5 cases of clinical studies are Randomized Controlled Trial(RCT). The cancer(50 papers) and diseases of the circulatory system(25 papers) occupied mostly in treatment studies. Because Combined treatment was actively progressed in oriental medicine, treatment was mainly applied the combined oriental medical treatment with herbs and western drugs. In herbal medicine, Mahwangyounpae-tang(麻黃潤肺湯) and Eunkyo-San(銀翹散) were frequently used in the papers. In western drugs, Cyclophosphamide, Cisplatin, and Mitomycin C were frequently used in the papers. 154 papers introduced the treatment effect, 14 papers announced the safety, and 4 papers mentioned the side effect. Conclusions : We suggested several future research direction as follows. Clinical studies based on experiment studies must be more activated and many RCT shoud be shown. Experimental group in clinical studies should be clearly separated to confirm the treatment method is effective or isn't effective. Studies about the side effect must be expanded, and every study should be confirmed both the treatment effect and safety.

• 한국보건간호학회지
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• 제3권2호
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• pp.47-76
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• 1989

The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.