• 디지털융복합연구
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• 제12권3호
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• pp.289-297
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• 2014

본 연구는 선택병의원제도 이후 변수들을 이용하여 의료급여수급권자의 의료이용 만족에 대하여 살펴보면서 지속적으로 수급권자의 의료이용 만족 및 건강증진을 향상시킬 수 있는 기초자료를 제공하는 데 그 의의가 있다. 조사기간은 2013년 8월 16일부터 8월23일까지이며, 결론적으로 선택병의원제도 실시 후 의료급여 수급권자의 의료이용 만족을 향상 시킬 수 있도록 하기 위해서는 의료수급권자의 의료서비스의 효과 및 미 충족 의료 욕구에 대한 보다 충분하고 정밀한 파악하는 것이 무엇보다 중요하며, 적정한 의료이용 도모를 위해 효과적인 의료접근성 파악, 행정절차의 비효율성 극복, 적정진료 보장으로 인한 합리적인 의료전달체계 확립 및 건강관리의 향상을 위해 의료기관의 적극적인 협조 및 정부의 다양한 정책 대안이 필요하다.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제10권1호
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• pp.221-237
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• 2016

The wireless body area networks (WBANs) consist of wearable computing devices and can support various healthcare-related applications. There exist two crucial issues when WBANs are utilized for healthcare applications. One is the protection of the sensitive biometric data transmitted over the insecure wireless channels. The other is the design of effective medical management mechanisms. In this paper, a secure medical information management system is proposed and implemented on a TinyOS-based WBAN test bed to simultaneously address these two issues. In this system, the electronic medical record (EMR) is bound to the biometric data with a novel fragile zero-watermarking scheme based on the modified visual secret sharing (MVSS). In this manner, the EMR can be utilized not only for medical management but also for data integrity checking. Additionally, both the biometric data and the EMR are encrypted, and the EMR is further protected by the MVSS. Our analysis and experimental results demonstrate that the proposed system not only protects the confidentialities of both the biometric data and the EMR but also offers reliable patient information authentication, explicit healthcare operation verification and undeniable doctor liability identification for WBANs.

• 한국병원경영학회지
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• 제18권3호
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• pp.106-125
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• 2013

Medical litigation, as a method of resolving medical disputes, has been a huge burden on both the patient and medical institution as it is both costly and time-consuming. The Korea Medical Dispute Mediation and Arbitration Agency has created a dispute mediation process as a method of alternative dispute resolution(ADR). Being in its early stage of implementation, there are still areas requiring improvement as some functions overlap with the Korea Consumer Agency's damage redress and mediation process. This study examines the problems of existing practices in medical litigation while reviewing the mediation process of the two agencies from legal/administrative aspects, and provides an in-depth analysis of the situation through case studies and interviews. While the Korea Medical Dispute Mediation and Arbitration Agency offers many advantages in resolving medical disputes, there must be a distinct division of roles and mutual cooperation with the Korea Consumer Agency. Considering the increasing amount of compensation in medical disputes, medical professionals are being requested to carry medical malpractice insurance. However, this has yet to become a general trend in the medical field despite the growing social demand. As such, the coverage of medical malpractice insurance should be expanded to prevent medical accidents from escalating into medical disputes, thus acting as a social safety net. This study seeks to examine the methods of medical dispute resolution and to allow institutional provisions to reduce the social costs arising from such disputes.

• 한국병원경영학회지
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• 제11권1호
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• pp.54-90
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• 2006

Medical clinics are core institutes that cover the primary medical care in Korea. Financial viability of the clinics is essential for them to conduct their roles and functions, and can be improved by increasing their operating profitability. On this ground, this study aimed at finding important factors that affect the operating profitability, and thereby at suggesting strategic alternatives that can contribute to the improvement of the profitability. Operating margin was set as a dependent variable, and such factors as general management conditions, number of visits, medical revenue, marketing activities, input resources, medical cost as independent variables. Nineteen hypotheses related to the variables were established and tested using data collected from 138 sample clinics for the year 2003. The results of the study are as follows : Firstly, such variables as percent ratio of the depreciation plus rent costs to total administration costs, type of clinical department manifested whether medical, surgical, or quasi-surgical, percent ratio of the interior facility investment to total fixed assets, and total number of outpatient visit are important factors that affect, positively or negatively, the medical profitability of the clinics. Secondly, following measures are needed to be established and implemented to improve the medical profitability. (1) Administration costs share 53.2% of the total medical costs, and depreciation plus rent costs 16.3% of the total administration costs. This implies that such measures as reinforcement of marketing activities, establishment of the cooperative utilizing system of the facility and equipment, or group practice are needed to increase cost-effectiveness. (2) Occupancy rate of the clinics with inpatient bed is as low as 45.5%, causing high fixed costs and low medical profitability. For its improvement, the resource input structure should be reorganized. Thirdly, in the future, a study that can increase sample representativeness of the study and explanation power of the variables should be performed for each type of clinical department to find more specific determinant factors and to contribute to the improvement of the medical profitability of the clinics.

• 보건의료산업학회지
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• 제10권4호
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• pp.51-59
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• 2016

Objectives : The purpose of this study was to examine the health service utilization of elderly patients who visited an emergency medical center in the Gyeongbuk region and to provide basic information for the effective management of emergency medical centers. Methods : This study analyzed the characteristics of the hospital visits and the actual situation for the use of emergency medical care of 10,264 elderly patients that visited an emergency medical center in the Gyeongbuk region from January, 2014 to December, 2014. Frequency analysis and chi-square test were done in this study. Results : This study showed that there is a difference in the characteristics of health service utilization which included hospital visits, duration of hospital visits and mode of arrival to the emergency medical center according to age, gender and other characteristics. Conclusions : Providing efficient emergency services is necessary as well as establishing an emergency medical center management plan that takes into consideration the difference in health service utilization of elderly patients.

• 한국의료질향상학회지
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• 제9권1호
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• pp.6-17
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• 2002

Background : This study was conducted to investigate the current situation of medical supply purchasing and stock management at general hospitals having more than 150 beds in Korea and to find methods of effective purchasing and optimal stock management. Methods : Survey was done from staff at the purchasing departments of 229 general hospitals throughout Korea. Data collection was done using a structured questionnaire between January 3 to March 15, 2001. The survey form was returned from 88 hospitals (rate of return: 38.4%). Results : Firstly, 13.6% of the hospitals did not carry the optimal stock of medical supplies, the lead time optimal stock was 3 weeks or longer in 64.4% of the hospitals. Secondly, since 69.8% of the hospitals showed passive attitude toward training on purchasing management and stock management techniques. Thirdly, as for the question on the presence or absence of a deliberation committee for purchasing of new medical supplies, 60% of the hospitals with less than 300 beds did not have one, and 9.4% of the hospitals opened the deliberation committee less than twice a year. Conclusion : At the time of purchasing new medical supplies, purchasing should be done according to the decision by the deliberation committee so that no deduction is made at the time of claiming insurance, and by setting a certain period of time, purchasing of those medical supplies that were not purchased during this period needs to be done according to the decision by the deliberation committee.

• 보건의료산업학회지
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• 제12권1호
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• pp.1-11
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• 2018

Objectives : The purpose of this study was to identify the relationship between decision-making types, public entrepreneurship, and performance management of local public hospital directors. Methods : A questionnaire survey was carried out to assess the dependent variables of directors' decision-making types and public entrepreneurship. The analysis of management performance was carried out through a comparison between 2016 results of, data of variation rate on medical revenue and change rate on medical profit and results in 2015. Results : Results indicated that local public hospital directors who used rational decision-making showed better performance management. The analysis showed that enterprise had a greater positive effect (+) on variation rate of medical revenue than that of innovation. However, innovation had a higher positive effect (+) on change rate of medical profit than that of enterprise. These results suggest that innovation and enterprise have a major influence on performance management. Conclusions : The survey used for this study suggests that an education and training program is needed to improve public hospital directors' ability for rational decision-making, public entrepreneurship and performance management. Additionally, the policy change guaranteeing autonomy within the proper range is demanded that Local Public Hospital Director having spirit of innovation and enterprise achieves peak capacity and have responsibility for management.

• 대한의용생체공학회:의공학회지
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• 제44권1호
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• pp.1-10
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• 2023

With the announcement of MEDICAL DEVICE REGULATION 2017/745 (MDR) on April 5 2017, medical device manufacturers shall apply ISO 14971:2019 (3^rd) revised in December 2019. However, there is not much related information and guidance available to medical device manufacturers, especially single use medical device. Risk management process basically follow 5 steps which are Risk Analysis, Risk Evaluation, Risk Control, Evaluation of overall residual risk and post-production activities. The purpose of this study is to provide a guidance of from risk analysis with Failure Mode and Effects Analysis (FMEA) table to overall residual risk evaluation for the single use medical device and to reflect it in a Periodic Safety Update Reports (PSUR) to satisfy with MDR requirements with single use medical device which are widely used and manufactured FDA class 2 or CE class IIb as examples. For this study, single use medical device manufacturer can adopt ISO 14971:2019 in accordance with MDR requirements and it can be extended to the PSUR. But there are still limitations to adopt to the all-single use medical device especially high class, private device and implantable device. So, Competent Authority (CA) shall publish more guidance for the single use medical device.

• 디지털융복합연구
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• 제10권11호
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• pp.493-502
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• 2012

본 연구는 진료비 삭감율에 영향을 미치는 의료기관의 운영요인과 환경요인이 무엇인지 알아보기 위한 연구로 삭감율을 최초 삭감율과 최종 삭감율로 구분하고, 진료비는 입원과 외래로 구분하여 조사 연구 하였다. 연구의 자료는 전국 병원급 이상 독립된 보험심사부서의 부서장을 대상으로 직접 설문조사를 통해 얻어진 205부의 설문지를 최종 분석 자료로 이용하였다. 본 연구의 결과는 다음과 같다. 진료비 최초 삭감율과 최종 삭감율에 대한 집단 간의 차이를 분석한 결과 입원의 의료기관 운영요인은 보유 병상, 총 진료과, 보험심사 인력, 총 직원수에 유의한 결과를 보였으며, 외래는 의무기록 운영형태, 보유병상, 총 진료과, 보험심사인력, 총 직원수에 유의한 결과를 보였다. 진료비 삭감율에 영향을 미치는 의료기관의 운영요인은 최초 삭감과 최종 삭감이 동일하게 입원은 병상수가 높을수록, 외래는 전자의무기록을 시행할수록 유의한 결과를 보였다. 진료비 삭감율에 영향을 미치는 의료기관의 환경요인은 최초 삭감과 최종 삭감이 동일하게 입원은 업무협조가 잘 될수록, 지표관리를 시행할수록, 시간외 수당이 지급될수록 유의한 결과를 보였다. 외래의 경우 진료비 최초 삭감은 지표관리를 시행할수록, 진료비 관련 위원회를 구성하여 운영할수록 유의한 결과를 보였으며, 최종 삭감은 업무협조가 잘 될수록, 지표관리를 시행할수록, 시간외수당이 지급될수록 유의한 결과를 보였다.

• 보건행정학회지
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• 제27권1호
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• pp.30-38
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• 2017

Background: This study aims to analyze the behavioral changes of healthcare providers and influencing factors after the reviewer unification of auto insurance medical benefit claims by an independent review agency. Methods: The comparison data were collected from the second half of 2013 and the same period of 2014. The key indicators are the number of admission days, the number of outpatient visits, inpatient ratio, inpatient medical expenses, and outpatient medical expenses. Results: Four indicators (number of admission days, number of outpatient visits, inpatient ratio, and outpatient medical expenses) showed statistically significant drops, while one indicator (inpatient medical expenses) showed no significant change. Conclusion: The reviewer unification of auto insurance medical benefit claims by an independent review agency showed significant reduction in cost and patient days.