• 보건행정학회지
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• 제15권2호
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• pp.16-36
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• 2005

Due to the existence of asymmetry of information between doctor and patient, it has been believed that doctor might affect patient's decision making process of purchasing medical care. Based on this notion, doctor's reimbursement method has been suggested as an effective policy device of improving efficiency of patient's medical care use by way of its affecting doctor's practice pattern. By using the Community Tracking Study (CTS) household and physician data set, which includes not only various information on patient's medical care use, but doctor's practice arrangements and sources of practice revenue, this paper investigates the effect of community doctor's characteristics of reimbursement method on community patient's medical care use under the control of patient's socio-demographic characteristics and community doctor's practice type. In the process of estimating econometric model, the endogeneity problem of individual health insurance purchase was corrected by using 2818. And due to the existence of sample selection problem, Heckman's two-step estimation method was used for strengthen the robustness of estimation which was adversely affected by sample selection problem The empirical results show that as the average value of community doctor's portion of practice revenue determined by prospective method out of total revenue increases, the community patient's total out-of-pocket medical cost decreases. This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would be more conscious about practice cost, which might affect doctor's practice pattern and by which his/her patient's use of medical care would decrease.

• 의료법학
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• 제24권3호
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• pp.125-153
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• 2023

대법원 2022. 12. 22. 선고 2016도21314 전원합의체 판결은 한의사의 진단용 의료기기 사용이 면허된 것 이외의 의료행위에 해당하는지를 판단하는 새로운 기준을 제시하고, 이 기준에 따라 한의사의 초음파 사용을 무면허 의료행위가 아니라고 판단하였다. 대법원 2023. 8. 18. 선고 2016두51405 판결은 새로운 판단기준을 적용하여 뇌파계를 파킨슨병과 치매 진단에 사용한 행위가 한의사로서 면허된 것 이외의 의료행위에 해당하지 않는다고 판단한 첫 번째 사안이다. 대법원은 판례변경을 통해 의료기기 사용에 서양 의학적 지식과 기술이 필요하지 않아야 한다는 종전 기준을 폐기하였지만, 진단용 의료기기를 사용한 한의사의 서양 의학적 진단행위를 진단의 보조수단으로 볼 것인지는 불투명한 상태였다. 이에 대법원은 뇌파계를 활용하여 파킨슨병과 치매, 즉 서양 의학적 진단을 한 한의사의 행위를 면허된 것 이외의 의료행위가 아니라고 판단함으로써 진단의 보조수단이 가지는 의미를 명확히 정리하였다. 이외에도 대상 판결은 뇌파계의 개발, 제작 원리와 뇌파계 검사 결과의 자동 추출 및 자동 판독 여부 또한 판단기준에서 배제함으로써 한방의료행위의 의미가 수범자인 한의사의 관점에서 명확하고 엄격하게 해석되어야 한다는 죄형법정주의 관점을 더욱 투철하게 적용하고 진단용 의료기기가 한의학적 의료행위 원리와 관련 없음이 명백한 경우가 아닌 한 형사처벌 대상에서 제외됨을 분명히 하였다.

• 보건행정학회지
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• 제19권2호
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• pp.21-35
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• 2009

Limited studies examined Medical Aid recipients' perception for amount of medical use. This study aimed to identify self-perception(optimal, under and overutilization) for amount, and real amount of medical use, and to determine factors associated with the perception. Subjects were 2,489 Medical Aid recipients among top 2% overusers in 2005. 200 case managers(CM) managing them conducted survey. CM interviewed them using 2005 medical claiming data from the Health Insurance Review & Assessment Service and structured questionnaire. Despite of overusers, perception of overutilization was only 26.9% and 23.6% in Class I and Class II, and that of underutilization was 21.4% and 18.7% respectively. In Class I, monthly total outpatient cost per capita of overutilization perception in 2006 was 206 thousand won higher than 150 thousand won of optimal utilization. Amounts of outpatient visit-days and prescribed cases of overutilization perception were higher than those of optimal and underutilization(p <0.0001). In Class II, overutilization perception had more prescribed cases(p 0.004). After adjustment of confounding factors including age and sex, the associated factors(odds ratio) with overutilization perception were hypertension(1.25), arthritis(1.32), depression(1.66), visit of multi medical institutions(3.09), and those of the underutilization were female(1.34), disabled(1.27), no family support(1.49), living in medium and small city(1.48), experience of unabled-visit to medical institution(2.54), frequent visit-recommendation from physician (1.36). In conclusion, education and consult are needed for subjects to improve the reasonable decision of medical use, and the self-care ability to manage diseases and symptoms. We suggest reinforcing the alternative service in community instead of costly medical institution.

• Journal of Preventive Medicine and Public Health
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• 제50권3호
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• pp.177-187
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• 2017

Objectives: Medical students represent a primary target for tobacco cessation training. This study assessed the prevalence of medical students' tobacco use, attitudes, clinical skills, and tobacco-related curricula in two countries, the US and Italy, with known baseline disparities in hopes of identifying potential corrective interventions. Methods: From September to December 2013, medical students enrolled at the University of Bologna and at Brown University were recruited via email to answer survey questions assessing the prevalence of medical students' tobacco use, attitudes and clinical skills related to patients' smoking, and elements of medical school curricula related to tobacco use. Results: Of the 449 medical students enrolled at Brown and the 1426 enrolled at Bologna, 174 Brown students (38.7%) and 527 Bologna students (36.9%) participated in this study. Italian students were more likely to smoke (29.5% vs. 6.1%; p<0.001) and less likely to receive smoking cessation training (9.4% vs. 80.3%; p<0.001) than their American counterparts, even though the majority of students in both countries desired smoking cessation training (98.6% at Brown, 85.4% at Bologna; p<0.001). Additionally, negative beliefs regarding tobacco usage, the absence of formal training in smoking cessation counseling, and a negative interest in receiving specific training on smoking cessation were associated with a higher risk of not investigating a patient's smoking status during a routine history and not offering tobacco cessation treatment to patients. Conclusions: Medical curricula on tobacco-related health hazards and on smoking cessation should be mandatory in order to reduce smoking among medical students, physicians, and patients, thereby improving tobacco-related global health.

• 대한한의학회지
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• 제31권1호
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• pp.69-80
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• 2010

Objectives: This study aimed to find determinants of customers' use of and satisfaction with oriental medical services in Korea. Methods: A total of 33 articles which consist of 9 articles published in academic journals, 20 master's theses, and 4 doctoral dissertations were included in the systematic review. Among the articles used in the study, 29 used primary survey data, while 4 used secondary data produced by the Korean National Health and Nutrition Evaluation Survey. Results: First, it was found that people who prefer to use oriental medical services usually have one or more of the following diseases: musculoskeletal disorders, paralysis, or diseases or injuries without clear diagnosis. Other variables of gender, age, expectation of treatment outcome, and kindness of doctor and other staff were found to be significant determinants of using the oriental medical services. Second, the determinants of customers' satisfaction with oriental medical services were found to be age, gender, level of education, chronic disease with long length of stay, kindness of staff, medical cost, clinical environment, doctor's reputation, and public image of the institutions. Conclusion: The results of this study can be used to develop marketing strategies for oriental medical institutions in Korea.

• 한국주거학회:학술대회논문집
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• 한국주거학회 2008년도 춘계학술발표대회 논문집
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• pp.187-192
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• 2008

This purpose of this study is to figure out the inter-relationship between the residence stories in high-rise mixed-use apartments and their residents' disease patterns throughout the dweller's medical reports in high-rise mixed-use apartments. Research basic data are obtained from medical fee request of National Health Insurance Corportion. Data are limited a housing complex to 'A' high-rise mixed-use apartment and a medical treatment time to 3 years(2004-2006). Analysis data of total 346,286 medical records, 43,159 disease records, and 8,999 persons are collected. By analyzing those data, findings are as follows: 1) Women is more medical treatments than men, 40-50 age group is more treated, and the residents of 6-25 stories are more received medical treatments. Diseases of the respiratory system and diseases of the eye and adnexa are relatively treated higher than other diseases. 2) The diseases of the respiratory system, the eye and adnexa, the skin and subcutaneous tissue, the ear and mastoid process), and the asthma have not relation to the high-storied residence through the data of disease records and personal records. But the analysis on the data of children, 7 ages and less, is showed a significant relation. And to conclude, there is no relationship between the residence of high-stories in that apartment and dwellers' disease patterns, but there is a little probable to the relationship in the pre-school child.

• 한국응급구조학회지
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• 제12권1호
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• pp.5-15
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• 2008

Purpose : Centering on users(patients) who are offered the patient transport service by the emergency medical service system in our country, the use and satisfaction are analyzed with the transport service in 119 Emergency Medical Service System and Private transport agent. Results : 1. As for personnel in ambulance cars, 119 emergency staff showed a higher boarding rate of the first-class emergency medical technicians than private transportation centers : 48.4% and 17.7%, respectively. 2. Private transportation centers showed higher user satisfaction with transportation service than 119 emergency staff, which was not statistically significant. 3. As for the case that needs to receive the transport service in the future, the ratio with the will to use 119 Emergency Medical Service System(70.9%) was indicated to be much higher than the ratio of the private transport agent(29.1%). Suggestions : First, Centers transporting first-aid patients should essentially secure a sufficient number of first-class emergency medical technicians as professional emergency medical staff to reinforce qualitative improvement in emergency medical service. Second, It is necessary to establish a systematic monitoring system and develop educational programs in order to enhance satisfaction with the use of 119 emergency staff. Third, the government or the local government needs to positively support and guide the private transport agent, which is in charge of the public medical service.

• International Journal of Knowledge Content Development & Technology
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• 제9권2호
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• pp.45-64
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• 2019

This study examined the perception and use of web 2.0 applications for academic purposes by medical students of Ambrose Alli University, Ekpoma. The objective was to investigate the medical students' perceptions of web 2.0 applications, web 2.0 tools use, extent of use, perception and purpose for using web 2.0 applications. Descriptive survey method was used for this study. The total population of this study was 3670 and the sample size was 367 representing 10% of the study. The purposive sampling technique was adopted, and the instrument used for this study was questionnaire, a total of 367 copies were administered and 321 were found useful for the study. Percentage means and standard deviation on table and chart were used to analyze the data collected using Statistical Package for the Social Sciences (SPSS) software. Findings showed that the perception of web 2.0 applications of medical students AAU was positive and few of web 2.0 applications were used for academic purposes. It was recommended in the study that medical students should be provided with the facilities in a format more familiar to them and used by most of them and institutions need to equip the learning process with the needed facilities which will be of utmost benefit even for future purposes.

• 한국병원경영학회지
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• 제24권1호
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• pp.11-20
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• 2019

The purpose of this study was to identify the factors affecting the use of superior general hospitals on public holidays by using the medical use model (Dutton's medical use model) with the medical panel data. The study found that 34.2% of superior general hospital emergency rooms were used on public holidays and the factors which made statistically significant influences on the use of superior general hospital emergency rooms on public holidays were whether patients were operated or emergency care and inspection etc. Also, there was a difference depending on whether the type of establishment of the medical insititution is national or private. In other words, patients who received emergency care and examinations were found to make more frequent visit to hospital emergency room on pubic holiday, compared to patients who underwent surgery and those who visited emergency rooms in the private superior general hospital did so, compared to those who visited emergency room in the national general hospital(OR, 4.4, 3.386, respectively). Therefore, it is necessary to consider the introduction of integrated care of health and social care medical service that focuses on primary care in Denmark, which focuses on patients, and pre-The Canadian Triage and Acuity Scale(pre-CTAS) in the UK.

• 한국사회복지학
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• 제62권3호
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• pp.83-108
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• 2010

본 연구는 고령사회 준비를 위한 현황이해 차원에서 앤더슨 모형을 이용하여 노년기 외래의료 서비스 이용궤적 및 예측요인을 살펴보고, 초기노년기와 후기노년기 간에 궤적이나 예측요인이 차이가 있는지를 살펴보는 것을 목적으로 한다. 한국복지패널의 1, 2, 3차년도 자료를 사용하여, 궤적 및 예측 요인은 잠재성장모형을 이용해서 분석하였고 연령 차이는 다중집단분석을 이용하여 분석하였다. 60세 이상 노인들은 해가 지남에 따라서 외래이용 횟수를 증가시키는 경향을 보였는데, 75세 미만의 초기 노년기의 노인들이 75세 이상의 후기노년기의 노인들 보다가 이용 횟수를 상대적으로 빨리 증가시켰다. 예측요인에 있어서는 선행요인, 자원요인, 욕구요인들의 상당수가 궤적과 유의미한 관계가 있었는데, 자원요인 보다는 욕구요인들이 의료서비스 이용궤적에 크게 영향을 주는 것으로 나타났다. 하지만 예측요인에 있어서 초기 및 후기 노년기 사이에 큰 차이는 없었다. 결과를 토대로 연구의 의의 및 함의를 논의하였다.