Kim, Hyun Ji;Kim, So Youn;Ji, Young Seung;Nam, Seung Kyu;Kim, Jeong Ho;Kim, Young Il
Journal of Acupuncture Research
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v.31
no.1
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pp.75-93
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2014
Objectives : This study was designed to establish medical trust realization system by finding factors influential to it using questionnaire. Methods : 277 subjects were participated in this study. After a treatment, we conducted a survey from April 1st to October 31th about medical service perception index, medical trust index, patient satisfaction index, patient reliability index, patient flow degree index, recall intension index, and hospital image index. To evaluate the influence of medical service perception with other 6 indexes, we statistically made regression analysis of the results through the survey. Results : By the results of the analysis, evaluation of hospital image influenced all 6 indexes. The systemicity of treatment process had an effect on 5 indexes except for the flow degree of patients. The humanity of medical team brought out the estimation of 4 indexes except for the patient flow degree and hospital image. The empathic ability of doctor and appropriacy of medical costs hold the next rank influencing 3 indexes. It reached the conclusion that the systemicity of medical team tend to determine the medical trust and patient reliability. The expertise, professional skill of doctor, the fault, commercial application, fame of medical team, the speed of treatment process, the newest and clean medical facility affected each one index. Conclusions : Korean medicine should find a way to consider the mind of patients for improving the medical quality through trust realization system, keeping up with times. As a result of this research, we can find out important causes which influence the trustful medical system. From now on, we should apply this result to actual treatment of psychology customized system. Also, more simple and clear questionnaire was organized through this research, it can be used to forward research to apprehend patient mentality more conveniently.
Purpose: Many doctors have difficulty in deciding the treatment duration in trauma patients to write in the casualty medical certificate. We tried to find a solution for this problem by using abbreviated injury scale (AIS). Methods: A total of 39 patients treated in our regional trauma center who requested an author to write treatment duration on casualty medical certificate from January 2014 to April 2017 were included. And the treatment duration was decided based on the PARK Formula (AIS). PARK Formula $(AIS)=(AIS{\times}2){\sim}([AIS{\times}2]+2)$ Results: Among 39 patients included and 36 (92.3%) had treatment duration on casualty medical certificate within the range of treatment duration calculated by PARK Formula (AIS). Compared to the PARK Formula (AIS), the mean value was 0.13 week (0.90 day) smaller. Comparing the treatment duration between Korean Medical Association (KMA) guideline and PARK Formula (AIS), only 22 patients (56.4%) showed agreement. The mean value was 1.02 week (7.18 days) smaller in KMA guideline. Conclusions: For the decision of the treatment duration in trauma patients, utilizing worldwide used AIS scoring system is very efficient. Using PARK Formula (AIS), doctors can document the treatment duration in the casualty medical certificate with ease. KMA should provide more practical 'treatment duration of each diagnosis in writing casualty medial certificate' for the doctors. We recommend PARK Formula (AIS) as a good alternative for KMA guide.
The medical system of the Central Military Command in the late Joseon Dynasty was practiced by military yakbang (clinicians 藥房), acupuncturists, and horse veterinarians. By analyzing and verifying various literatures, the following conclusions were obtained: 1) In the late Joseon Dynasty, military yakbang prioritized internal medical treatment over surgical treatment. Military yakbang were recognized before military acupuncturists were and had more medicinal gardens. This can be associated with the characteristics of the Military Medical Specialized Book that focuses on drug prescription. 2) The positions of military yakbang and military acupuncturists were not preferred by the Western Medical Offices (洋醫司). For example, in the latter days of King Sukjong's reign, positions were appointed from the Western Medical Offices but, on appeal, outside doctors were included as well. This is understood in terms of salary levels and guarantees of career opportunities. 3) The military acupuncturist was not selected based on ability as per the rules. If that was the case, more military acupuncturists would have been selected as royal acupuncturists (內鍼醫) under the system that continued until the late 19th century. In the future, it is expected that comparative studies will be conducted between local military medicine and the early Joseon's military medicine, thereby intensifying research on military medicine in the Joseon Dynasty.
Park, Eunkyoung;Lee, Jae-Woong;Kang, Minhee;Cho, Kyeongwon;Cho, Baek Hwan;Lee, Kyu-Sung
International Neurourology Journal
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v.22
no.4
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pp.228-236
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2018
Neuromodulation was introduced for patients with poor outcomes from the existing traditional treatment approaches. It is well-established as an alternative, novel treatment option for voiding dysfunction. The current system of neuromodulation uses an open-loop system that only delivers continuous stimulation without considering the patient's state changes. Though the conventional open-loop system has shown positive clinical results, it can cause problems such as decreased efficacy over time due to neural habituation, higher risk of tissue damage, and lower battery life. Therefore, there is a need for a closed-loop system to overcome the disadvantages of existing systems. The closed-loop neuromodulation includes a system to monitor and stimulate micturition reflex pathways from the lower urinary tract, as well as the central nervous system. In this paper, we reviewed the current technological status to measure biomarker for closed-loop neuromodulation systems for voiding dysfunction.
Journal of Physiology & Pathology in Korean Medicine
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v.19
no.4
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pp.897-902
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2005
Internal deficiency of vital Qi is origination of cancer and root cause of its development from the viewpoint of traditional Chinese medicine(TCM). For about 40 years, China has developed a combined system of TCM and Western medical system in treatment of cancers, laying stress on the therapeutic principle of strengthening the body resistance and restoring normal functioning of the body to consolidate the constitution (Fu Zheng Pei Ben). According to the results of the latest clinical and experimental studies, Chinese medicine not only increases curative effectiveness, but also reduces the side effect caused by the toxic, radio and chemical treatment of cancer cases in the western medical system as well as various complications. Long-term taking Chinese herbal medicine prevents recurrence and metastasis of tumor, and heightens long-term curative effectiveness after western medical treatments. It also helps to relieve symptoms, improve the quality of life, and prolong life of terminal cancer patients who have already lost opportunities of western medical treatments. In addition, it can prevent and cure premonitory symptoms of cancer.
Traditionally, the Supreme Court has held that medical treatment agreements covered by national health insurance should be distinguished from other medical treatment agreements which are viewed as a consummation of the autonomous free will between doctor and patient. Namely, the Supreme Court views medical treatment agreements covered by national health insurance to be bound by the National Health Insurance Law with the intent to promote the applicability and comprehensiveness of the national health insurance scheme. Yet, issues of voluntary non-reimbursable treatments are triggered not only by the mistakes or moral hazard of medical care institutions but also by systemic limitations of national health insurance coverage criteria. Thus, there is a need for legislative measures that allow certain medical treatments to be included or reflected in the national health insurance coverage system so that patients may receive prompt and flexible medical treatments. To reflect such concerns, the Supreme Court made an exception for voluntary non-reimbursable treatments and developed a strict test to be applied in such cases in Supreme Court Judgment 2010 Doo 27639, 27646 (ruled on June 8, 2012 by the Grand Bench). Such judgment, however, is not a fundamental overturn of the Supreme Court's prior rulings that voluntary non-reimbursable treatments are not allowed under the law. It is only a slight revision of its previous stance for cases in which there is a lack of legislative measures to make coverage of a new yet valid medical treatment possible under the current national health insurance coverage system.
The aim of this study is to suggest theoretical foundations on which hospital employees could estimate medical care services not in the position of providers but consumers. For this purpose this study compares satisfaction of providers but consumers. For this purpose this study compares satisfaction of patients with medical care service with that of hospital employees. 287 patients and 261 employees in three university hospitals in Daegu were selected as samples of investigation and asked questions. Statistical analysis was taken using SAS package. The result of this study are as follows. 1) Among the five fields of medical services patients and hospital employees have different views in doctor hospital staff(except doctor) treatment system availability service but parking service 2) Hospital employees overestimate the level of medical care services compared with patients 3) Demographical variables make a difference in medical satisfaction 4) In satisfaction-evaluation after r ceiving treatment medical system service is influential variables in both patients and hospital employees. And in patient group doctor service is following variables while availability and parking service is influential variables in employees.
This thesis shows about the meaning of treatment rate increasing, the current treated level and the reason of low treatment rate and increasing methods. 1. Treatment rate incresing means high treat level within short time, keeping treatment effect for a long time as well as raising treatment rate. 2. The current by diseases each others completed treatment rate of oriental medicine is 14.0% to 89.7%$(mean:\;{\pm}40.0%)$. Therefore the rate is show too low. 3. The reasons of low treatment rate; low academic level of oriental, academic limitation, clinic and prevention problem of oriental medicine, lack of medical approch suitable for current diseases and symptoms, mostly incurrable diseases using oriental medicine, lack of preventive education, disappropriate medical service and nonspecialty of the treatment, etc. 4. The next methods for incresing the treatment rate must be improved; such as accurate establishment of process that diagnosis symptoms and treats them, system research of microdiagnosis, positive treatment with medicine and nonmedicine method at the same time, appropriate subdivision and actualization of clinical basic research, research of dose and response, diversity of treatment methods and forms, development of treatment service and prevention based on health level, enormous change as cure medicine and opening-up of new disease field, specialization of medical examination, reinforcement of public medical part and herbal drugs use with same origin, mental and pysical stability of patients, accurate extract and oral drinking ways, etc.
Emergency Medical Service(EMS) requires a system that supports the communication between emergency medical technicians (EMT)s and the doctor in the emergency department. Because the rapid triage and on-site treatment of patients need doctor's medical advice. However, a system to assist the doctor assign for medical advice does not exist in Korea. This paper suggests a medical advice support system that focuses on appropriate doctor assign and real-time communication among the ambulance, the Emergency Medical Information Center (EMIC), and the doctor using an agent system. We expect that the system can help to solve the problems affecting prehospital EMS and improve its general quality.
This study is to suggest some developmental policies by analyzing the activities of first aid party in Kwangju and Chonnam regions for two years from Jan. 1, 1991 to the end of December, 1995. First, the residents in Kwangju and Chonnam regions have the sufficient benefits of emergency medical center, but it will be desirable that general hospital should be established and managed in Kohung peninsula which forms the wide island area far away from big cities. Second, the classification of the degree of severe case in the field by rescue members should be strengthened as the means which can reduce the number of patients transferred to the emergency room and the legal method which rescue members can select the medical agency. Third, children less than 10 are most frequent emergent patients and it is due to parent's indifference and children's in sensibility to safety. So the safely education in the course of infant and elementary education should be strengthened and the method which can keep the self safety through the legal system. Fourth, to increase the rate of emergency measure by rescue members, the reasons of fail of emergency treatment are suggested, the treatment results of each rescue member are analyzed every year and it is desirable that the system which can evaluate the personal ability should be introduced. Fifth, the medical accidents occurred in the case of medical act, by rescue members must lake the legal responsibility, but such a problem can he solved with the compensation of insurance system by government. Sixth, to reduce the time required for transfer, traveling service system for the fixed period in beach should be complemented and extended more and service system at ordinary times should be examined at mountains, the area of traffic jams and large special industrial park. Seventh, since service system with one team of two members of 119 rescue party in expressway cannot be mobilized when multiple accidents occur at the same time, it is considered that service system of two teams of four members should be extended. Eighth, first-aid service in expressway is conducted with rescue and emergency treatment by the rescue party at the same time, but the professional rescue lacks and it may result in the injury of patients. Therefore the creation of rescue party in expressway is the urgent problem.
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