• 의학교육논단
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• 제10권2호
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• pp.25-44
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• 2008

Objectives: Through using of the strong research method like a Randomized Controlled Trial: RCT, we have to heighten quality of Medical Education study. I'd like to introduce "CONSORT", which stands for Consolidated Standards of Reporting Trials. Contents: Preventive Service Task Force(200l) in USA proposed Levels of evidence for enlarging evidence-based Practice: EBP. And the CONSORT was introduced, which encompasses various initiatives developed by the CONSORT Group to alleviate the problems arising from inadequate reporting of randomized controlled trials (RCTs). the CONSORT has 13 guides like these: 1. How participants were allocated to interventions 2. Scientific background and explanation of rationale 3. Eligibility criteria for participants. The settings and locations where the data were collected. 4. Precise details of the interventions intended for each group and how and when they were actually administered 5. Specific objectives and hypotheses 6. Clearly defined primary and secondary outcome measures, When applicable. any methods to enhance the quality of measurements (e.g., multiple observations, training of assessors) 7. How sample size was determined. When applicable, explanation of any interim analyses and stopping rules 8. Method used to generate the random allocation sequence, Details of any restriction [of randomization] 9. Method used to implement the random allocation sequence 10. Who generated the allocation sequence, who enrolled participants. and who assigned participants to their groups 11. Whether or not participants, those administering the interventions, and those assessing the outcomes were blinded to group assignment. If done, how the success of blinding was evaluated 12. Statistical methods used to compare groups for primary outcome(s), Methods for additional analyses, such as subgroup analyses and adjusted analyses 13. Flow of participants through each stage (a diagram is strongly recommended) Specifically, for each group report the numbers of participants randomly assigned. receiving intended treatment, completing the study protocol. and analyzed for the primary outcome. Results and Conclusion: Randomized Controlled Trial: RCT guided of CONSORT will contribute to do stronger evidence-based medical studies.

• 약학회지
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• 제58권2호
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• pp.129-140
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• 2014

Background: As elderly population has been increasing, pharmacists need to possess special knowledge and skills to provide enhanced pharmaceutical care for senior patients. Purpose: This study aims to systematically review on (1) the certified geriatric pharmacists (CGP) system, (2) the curriculum related to geriatric pharmacy education, and (3) the CGP's performance in terms of clinical, economic and humanistic outcomes in the U.S. Method: The information related to CGP system and curriculum was obtained through the official websites of 'American Society of Consultant Pharmacists', 'Commission for Certification in Geriatric Pharmacy' and the selected pharmacy school samples. Articles about on the outcomes of pharmacist-provided cognitive services including Medication Therapy Management were searched through PubMed. Results: To gain the CGP credential, pharmacists need 2-year experience as pharmacist in advance and take the CGP examination. This certification must be renewed every 5 year. Most pharmacy schools provide geriatric-related curriculum through didactic or pharmacy practice classes for pharmacy students and certificate or dual degree in gerontology are given on completion. Most previous outcomes research reported that pharmacists have played a role in yielding favorable results regarding clinical, economic and humanistic outcomes for nursing facilities, hospitals and community pharmacy settings. Conclusion: Considering the organized CGP certification system and concrete educational courses established the basis for pharmacists to exert their ability for senior patients of the U.S., it is suggested to build a geriatric pharmacist credential model for pharmacists to provide the increasing elderly patients with the requisite safe and effective pharmacy care in Korea.

• 한국병원경영학회지
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• 제21권2호
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• pp.37-49
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• 2016

The purpose of this study is to investigate the level of competition between Public Health Centers (PHCs) and private clinics (PCs) by examining the number of patients that used PHCs vs. PCs, estimating the total amount of revenue generated from outpatient services at both PHCs and PCs, thereby analyzing the financial impacts on PCs derived from the PHCs. We utilized 2011 National Inpatient Sample data (NIS). Using the 20 table containing general information on each individual claims, we integrate it with the 40 table which contains all the diagnostic codes for each claim. Then, we disaggregate the bundled claims into the original individual claims. Overall, 3.1% of outpatient visits are made at PHCs while the rest was made at the PCs (96.9%). Among the total claim costs of 6.34 billion USD (as of 2011), PHCs occupy 2.0% (124 million USD), and 98.0% are contributed to PCs (6.21 billion USD). The estimated economic losses of PCs due to PHCs are summarized as follow; the maximum potential loss is estimated at 198 million USD in total and 7,099 USD per clinic when we include all patient types; the minimum loss is estimated at 71 million USD in total and 2,540 USD per clinic where Medical Aid recipients and the elderly (aged 65 and over) are excluded. Our results confirm the potential economic effect on PCs due to PHCs providing outpatient services. PCs and PHCs are the most important players providing primary care in Korea. Unnecessary competition between PCs and PHCs is not desirable. Health authorities should carefully examine the healthcare services currently provided by PHCs and their impacts on PCs.

• 한국병원경영학회지
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• 제22권4호
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• pp.74-86
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• 2017

Purposes: This study was performed to understand the recognition about accreditation motives, support within the hospital and accreditation survey process for the hospitals that participated in the accreditation program and to find out whether these factors are related to hospital management performances, so that the study can suggest plans for activation and development of the accreditation program. Methodology: This study was performed targeting 98 hospitals answered th the survey among 189 acute care hospitals that acquired accreditation from December 2010 to February 2014. For data analysis, frequency analysis, ${\chi}^2$-test, reliability analysis, ANOVA, Kruskal-Wallis H test and multiple regression analysis with SPSS 21.0 were used. Findings: The hospitals that had staff in charge of patient safety had bigger hospital culture change than those that didn't have(p<.05). In addition, the hospital culture change was bigger as internal motives were bigger, and as CEO's will was bigger(p<.05). Meanwhile, as maintenance rate of internal management after accreditation was higher, and as CEO's will was bigger, process improvement level was higher(p<.05). The quality improvement and patient satisfaction level were higher as CEO's will was bigger, and as suitability of survey process was recognized to be high(p<.05). As a result of analyzing the factors that affect hospital management performances with hospital culture change, process improvement and quality improvement combined, as internal management maintenance rate was higher, as CEO's will was bigger, and as suitability of survey process was higher, performances were higher(p<.05). Practical Implications: Hospitals need to reinforce internal motives to improve internal competences such as the whole system maintenance opportunity and staff training. In addition, the will of hospital director is most important, and if there is hospital director's interest in quality improvement and improvement intention definitely, employees voluntarily participate in and cooperate with the accreditation program, so that prompt medical service provision and high quality of medical services can be guaranteed, leading to hospitals' management performances.

• 한국의료질향상학회지
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• 제25권2호
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• pp.16-25
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• 2019

Purpose:The healthcare system of South Korea is at the extreme of the dispersed system. Few regulations limit patients from directly visiting higher-level medical institutions for primary care sensitive conditions. As a result, similar to local clinics, general and tertiary teaching hospitals also provide diverse primary care services. Our study aimed to examine the general public's perceptions of their primary care performance. Methods: Face-to-face surveys were conducted with 1000 adults who were living in South Korea with the aid of a questionnaire that included the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of five domains, which are the main indicators of primary care performance: first contact, comprehensiveness, coordination, personalized care, and family/community orientation. One-way analysis of variance and post hoc tests were used to compare the KPCAT scores across the three types of medical institutions. Results: Domain-wise analyses revealed two different patterns. With regard to first contact and its subdomains, the highest and lowest scores emerged for local clinics and tertiary teaching hospitals, respectively. However, the other four domain scores were significantly lower for local clinics than for the other two types of medical institutions. Conclusions: Local clinics were perceived to be medical institutions that are responsible for providing primary care. However, the general public perceived only one domain of their primary care to be superior to that of the other two types of medical institutions: first contact. National efforts should be taken to strengthen their other four domains of primary care by training their workforce and providing appropriate incentives.

• 한국의료질향상학회지
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• 제18권1호
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• pp.37-55
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• 2012

Objectives : This study was conducted to evaluate the effect of fixed critical pathway with emr (electronic medical record) on the length of hospital stay, the cost and quality of care provided to gastrectomy patients in a university hospital and to develop flexible critical pathway with emr which can be used excluded or drop-out patients. Methods : Thirty-eight patients with gastrectomy were included as case group and Thirty-four patients included as control group. The comparison between control and case with using fixed critical pathway were done. To develop and to evaluate usefulness of flexible critical pathway with flexible data base, simulation was done for flexible critical pathway with drop-out patients. Result : The major results of this study were as follows: There were no significant differences in patient clinical conditions and no sign of deterioration of quality from critical pathway. The length of hospital stay was 11 days in control group, 8 days in path group(P<0.01). The total costs during the hospital stay were reduced in path group. However the cost per day was significantly increased from reduction of hospital stay(554,352 won in control, 645,669 won in path group). One hundred percentage of drop out patients(60) in the simulation of flexible critical pathway was successful. Conclusion : Computerized critical pathway reduced the length of hospital stay, total hospital costs and resource utilization without harming quality of patient care. The flexible critical pathway program can be used as one of the powerful management tools for reducing the practice variations and increasing the efficiency of care process and decreasing the workload of doctors and nurses in Korean hospital settings.

• 한국산학기술학회논문지
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• 제15권10호
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• pp.6250-6257
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• 2014

본 연구의 목적은 중년여성의 건강관련 특성을 비교해 보고, 건강관련 노후준비에 영향을 미치는 요인을 규명하려는 것이다. 연구대상은 대구광역시 4개 지역의 문화센터를 이용하는 40세 이상부터 64세 미만 여성 중 391명을 대상으로, 2011년 3월 1일부터 3월 25일까지 설문조사하였다. 수집된 자료는 IBM SPSS Statistics 20을 이용하여, 기술통계와 로지스틱 회귀분석을 하였다. 연구결과, 노후건강을 대비해서 노력하고 있는 여성은 215명(55%)으로 건강관련 특성에서 전반적으로 분포의 차이가 있었다. 건강관련 노후준비에 미치는 변인들로 현재의 운동 여부(비차비: 4.990), 다양한 식품섭취(비차비: 3.563), 적정수면(비차비: 2.021) 등이었다. 중년여성을 위한 건강관리 교육프로그램과 환경조성이 연구결과처럼 다양하게 제공되어야 함을 시사한다.

• 한국산학기술학회:학술대회논문집
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• 한국산학기술학회 2011년도 추계학술논문집 1부
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• pp.166-169
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• 2011

체육전공에서 해부학을 통해 스포츠 상해, 운동역학적 적용, 인체의 병리나 생리적인 지식을 습득할 수 있는 바탕이 된다. 그러므로 해부학적 기초가 없이 운동생리학, 생체역학, 측정평가, 운동처방 등 여러 응용학문에 대한 이해가 불가능하다. 대부분 체육전공에서 해부학을 전공필수로 지정하여 그 중요성을 강조하고 있다. 체육전공학과는 학과특성 및 교육시설 등 여러 가지 문제로 인해 해부학 실습교육이 어렵고, 특히 체육 특기생 경우 잦은 시합으로 수업의 결손이 많다. 또한 체육학과 전공교수는 학과특성상 대부분이 체육전공자로서 최근 의과대학에서 해부학을 포함한 기초의학전공 교수들의 감소되는 현상으로 건강-의료-보건관련 학과의 기초의학강의의 수요를 충족시키는데 어려움이 존재하여 학과 내 해부학강의도 체육전공교수들이 직접하고 있는 실정이다. 기초의학전공자가 아닌 교원의 해부학강의는 깊이 있는 해부학지식을 전달하는데 제한적이며 교수의 강의에 대한 부담도 존재한다. 따라서 본 연구는 2007년부터 2009년 동안 강원대학교 스포츠과학부 학생들을 대상으로 자체 제작한 가상강의 컨텐츠와 해부실습, 그리고 면대면 강의를 병행한 혼합강의를 실시한 후 설문조사를 통해 체육전공학생들의 효과적인 해부학지식전달의 방식으로 그 도입을 제시하고자 한다.

• 한국산업보건학회지
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• 제29권3호
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• pp.383-393
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• 2019

Objectives: The proportion of those working beyond 53 hours a week in 2018 has reached 16.8% of the total number of workers in the Republic of Korea (Statistics Korea, 2018). Although there are many studies that have dealt with the correlation of long working hours and increasing risk of work-related health problems, studies dealing with the factors impacting work-related health problems of workers according to their working hours are few. This study aims to ascertain factors impacting work-related health problems of workers based on their working hours through thorough research on their work environment. Methods: Necessary factors for this study were extracted from 'the 4th Korean Working Conditions Survey to analyze details on normal characteristics and work environments used for the study analysis, work hours, and health problems related to work. Results: The results are as follows: First, men showed a greater probability of exposure to work-related health problems than did women, especially in the 50s age group, which showed the highest potential for health problems from work among age groups. Second, service providers and sales professionals showed a higher probability of work-related health problems. Third, for the work environment, health problems at work related to vibration, noise, chemical and poison exposure, exhaustion, pain, standing position, and repeated motion showed a higher probability if the work hours are long. Conclusions: This study suggests that the minimization of overtime labor would prevent work-related health problems and diseases, improve the well-being of workers, and decrease the negative impact on workers in the subject area.

• 융합정보논문지
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• 제8권4호
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• pp.9-14
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• 2018

본 연구의 목적은 국내 의료기관에서 외래진료 시 경구용 혈당강하제를 투약 받는 사람들의 특성과 복약순응도와의 연관성을 확인하기 위함이다. 연구방법은 2016년 한 해 동안 건강보험심사평가원 청구데이터에 주상병이나 부상병에 E11을 포함하는 제2형 당뇨병 환자표본자료를 이용한 단면연구로 당뇨약제 109개 주성분코드로 분석하였다. 연구결과 복약순응도는 성별에서 유의한 차이가 있었고, 남성이 여성에 비해 높았다. 복약순응도는 보험유형 간에 유의한 차이가 있었으며, 건강보험, 의료급여에 비해 보훈(무료)이 가장 높았다. 보훈(무료)이 타 보험유형에 비해 복약순응도가 높은 것은 자기부담이 적어 의료접근성이 높은 이유로 해석된다. 본 연구의 결과가 건강보험 외래 본인부담에 대한 정책적 기초자료로 활용될 것을 기대한다. 또한, 제2형 당뇨병 환자와 같은 만성질환자의 외래 본인부담률을 줄일 수 있는 적정방안을 추가연구로 제안한다.