• 보건행정학회지
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• 제30권4호
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• pp.451-459
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• 2020

Background: Although Korean government have been adopting several policies to expand coverage of National Health Insurance (NHI) program, the coverage rate is still below average across Organization for Economic Cooperation and Development countries. This study was to identify public perception on appropriateness of coinsurance rate and factors associated with coinsurance rate in National Health Insurance. Methods: For this cross-sectional study, 507 participants over aged 20 years were recruited from telephone surveys. Respondents experienced at least one and more visiting medical facilities due to medical problems in last 12 months. Demographic factors, socioeconomic positions, and experiences on medical utilization were measured in order to identify factors associated with perception appropriateness of coinsurance rate. Results: The 49.9% (n=209) of the public responded that the coinsurance rate of NHI program was appropriate. There were no differences in positive perception according to socio-demographic factors and experiences on medical utilization except for gender, residential area, and felt expensive when using medical services. People who felt burden of medical expenditure were more likely to perceive coinsurance rate inappropriate (odds ratio, 2.33; 95% confidence interval, 1.52-3.58) Conclusion: In spite of the relatively low coverage rate of NHI, this study identified that 49.9% of the public perceived the current coinsurance rate was adequate. However, people who felt the burden of medical expenditure were still had a negative perception of the coinsurance rate needed to decrease the coinsurance rate.

• Genomics & Informatics
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• 제9권3호
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• pp.114-120
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• 2011

Chronic inflammation has been implicated as one of the important etiological factors in insulin resistance and type 2 diabetes mellitus (T2DM). To investigate the role of anti-inflammatory cytokines in the development of T2DM, we conducted a case-control study to assess the association between IL4/IL4R polymorphisms and disease risk. We firstly identified single nucleotide poly-morphisms (SNP) at IL4 and IL4RA loci by sequencing the loci in Korean participants. Case-control studies were conducted by genotyping the SNPs in 474 T2DM cases and 470 non-diabetic controls recruited from community-based cohorts. Replication of the associated signals was performed in 1,216 cases and 1,352 controls. We assessed effect of IL4 -IL4RA interaction on T2DM using logistic regression method. The functional relevance of the SNP associated with disease risk was determined using a reporter expression assay. We identified a strong association between the IL4 promoter variant rs2243250 and T2DM risk (OR=0.77; 95% CI, 0.67~0.88; p=$1.65{\times}10^{－4}$ in the meta-analysis). The reporter gene expression assay demonstrated that the presence of rs2243250 might affect the gene expression level with ~1.5-fold allele difference. Our findings contribute to the identification of IL4 as a T2D susceptibility locus, further supporting the role of anti-inflammatory cytokines in T2DM disease development.

• 한국병원경영학회지
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• 제4권1호
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• pp.190-207
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• 1999

The objectives of this research are to examine the factors influencing the employees' satisfaction and to investigate that the employees' satisfaction effects the organizational commitment on seven National University's hospitals. The data for this analysis were collected by questionnaire survey. 657 usable questionnaires were returned, a 78.2%, response rate. The major statistical methods used for the analysis are factor analysis, t-test and hierarchical multiple regression. The findings suggest that four components of job satisfaction are selected: these are "task", "organizational operation system", "opportunity of development", "interpersonnel". Highly satisfied employees turn to organizational commitment such as responsibility of organization and retention. Futhermore the findings suggest that responsibility is affected by work period, task satisfaction, opportunity of development. And retention is affected by work period, role as teaching hospital, and task satisfation. This study concludes with a discussion of the managerial relevance of the findings and future research directions.

• 한국병원경영학회지
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• 제11권1호
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• pp.1-30
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• 2006

According to the available data, in these days, the number of medical accidents and disputes have significantly increased since 1990 in Korea. From this aspect, a variety of approaches and efforts to solve these problems is needed before it is too late. This study intended to identify the thoughts of patients who are directly connected with medical accidents and disputes and then to consider reasonable settlement methods of the increasing disputes. For achieving the purpose of this study, the self-administerd questionnaire was conducted with 450 out-patients who visited three university hospitals, five small and medium-sized hospitals, and ten clinics in Seoul from June 13 to 17, 2005. Incomplete questionnaires were omitted and 410 respondents(91%) were included for the analysis of this study. Each section of the survey was composed of six categories such as the recognition of malpractice, a compensation system about no-fault medical accidents, the recognition of the judgement of medical accidents in court, reasonable settlement of medical accidents, reasons of lawsuit, and the need of the medical dispute settlement organization. The major results of this study were as follows. First, more than half of the respondents, 51.9 percent, worry about malpractice. And many respondents think malpractice causes their symptoms to persist or become worse, and also some respondents think that the doctor's prescription changed too frequently. Second, as for a compensation system about no-fault medical accident, 55.7 percent of the respondents insist that a proper compensation for suffering patients or their families should be provided. And also as for the responsibility of compensation, respondents think joint compensation of both the medical institution and the government is needed foremost, followed by the medical insurance company and finally by the medical institution. The government as well as the related institutions should take responsibility for malpractice accidents for which the doctor is not responsible. Third, as for the acknowledgment of medical accident judgements by the court, 32.8 percent of respondents think that it is best to compromise with a medical institution, followed by lawsuit(26.2%), the assistance of civil organization(23.2%), and a powerful physical protest(7.6%). Fourth, as for the lawsuit of medical accidents, 62.9 percent of respondents think that patients and their families would be in a disadvantageous position in relation to medical institutions and doctors mentioning the lack of professional medical and lawful knowledge, experience and know-how as the reason. So many people have given up appeals owing to the difficulties involved in defending themselves through evidence. Fifth, about a half share of the respondents indicated that the medical institution's neglect of the responsibility of medical accidents is one of the most important reasons of lawsuit. And next respondents mentioned the lack of the medical dispute settlement organization and a general distrust of medical institutions and doctors. Sixth, a majority of respondents consented to the introduction of the need of the medical dispute settlement organization, And about a half of the respondents mentioned a readiness to accept the mediation of the organization, but the rest did not express a clear opinion. It seems that conflict among the parties concerned have existed in relation to the medical dispute settlement organization and related legislation for many years. But as this study has shown, the needs of the medical dispute settlement organization is in desperate demand. Therefore, more negotiation efforts from all interest groups should be considered for the birth of the medical dispute settlement organization and related legislation.

• 한국보건간호학회지
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• 제15권1호
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• pp.13-26
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• 2001

Today's health care environment is rapidly changing and nurse administrators' transformational leadership needs to practice in nursing organization to achieve organizational objectives. Transformational leadership is related to the job satisfaction, productivity, and organizational commitment. This study investigated the effect of transformational leadership and carreer characterics on nurses' organizational commitment. The sample for this study consisted of 594 nurse from 8 large Korean hospitals. The factor analysis Cronbach's alpha analysis, Pearson correlation analysis, multiple regression analysis and hierarchical multiple regression analysis were used for the statistical method. The results of this study were found that (1) charisma dimension of transformational leadership has positive influence on nurses' organizational commitment; but another two dimensions (intellectual stimulation and individualized consideration) did not showed significant effect on organizational commitment (2) nurses' career characteristic(age, marital status, education level. work duration, status) moderated the effect of transformational leadership on organizational commitment.

• 간호행정학회지
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• 제22권1호
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• pp.99-108
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• 2016

Purpose: The purpose of this study was to develop a nursing workplace spirituality instrument. Methods: Using 44 preliminary items which were developed in a former study, a survey was done with 469 nurses working in 2 city general hospitals. Data were collected from September 19 to October 10, 2014 and were analyzed using statistical packages SPSS 18.0 and AMOS 18.0. Results: The finalized Nursing Workplace Spirituality instrument consisted of 32 items and 6 sub factors: meaning of nursing, relationship with colleagues, transcendency through nursing service, inner self, interaction between the workplace environments, and harmony between individual and organization. A seven-point Likert scale was employed, and achieving a higher score in a particular factor and sum of all scores indicated high factor and Nursing Workplace Spirituality. Conclusion: Findings indicate that with this instrument, it is possible to understand nursing organization's workplace spirituality. Therefore this instrument is recommended for use in hospitals.

• Genomics & Informatics
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• 제9권3호
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• pp.127-133
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• 2011

The Epstein-Barr virus-transformed lymphoblastoid cell line (LCL) is one of the major genomic resources for human genetics and immunological studies. Use of LCLs is currently extended to pharmacogenetic studies to investigate variations in human gene expression as well as drug responses between individuals. We evaluated four common internal controls for gene expression analysis of selected hematopoietic transcriptional regulatory genes between B cells and LCLs. In this study, the expression pattern analyses showed that TBP (TATA box-binding protein) is a suitable internal control for normalization, whereas GAPDH (glyceraldehyde-3-phosphate dehydrogenase) is not a good internal control for gene expression analyses of hematopoiesis-related genes between B cells and LCLs at different subculture passages. Using the TBP normalizer, we found significant gene expression changes in selected hematopoietic transcriptional regulatory genes (downregulation of RUNX1, RUNX3, CBFB, TLE1, and NOTCH2 ; upregulation of MSC and PLAGL2) between B cells and LCLs at different passage numbers. These results suggest that these hematopoietic transcriptional regulatory genes are potential cellular targets of EBV infection, contributing to EBV-mediated B-cell transformation and LCL immortalization.

• 한국병원경영학회지
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• 제16권1호
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• pp.124-141
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• 2011

The purpose of this study was to analyze of hospital administrator based on the DACUM(Developing A Curriculum) method. The contents of this study were to extract the duties, tasks consisting of job of hospital administrator and to investigate levels of importance, difficulty, frequency and entry level on each task, and to make out a job model of hospital administrator. A DACUM committee was composed to analyze job of hospital administrator and the committee members were total 9, a facilitator, 7 hospital administrator and a recorder. The major findings of this study were as the followings; first, duties in job of hospital administrator were total 13, which were organization of hospital administration affairs, health insurance review & assessment, general affairs, personnel management, hospital planning & management, medical quality improvement, hospital financial affairs, logistics management, facilities management, computerized system management, education & study supports, medical staffs' perceptions of service quality both directly and indirectly through their perceptions of patient orientation. These findings implied that HPWS would be a way of survival in drastically changing hospital environments.

• 한국병원경영학회지
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• 제9권4호
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• pp.70-86
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• 2004

The purpose of this study is to find determinants for service mind and skills of hospital employees to seek ways to improve the service level of hospitals. The past studies focused on the perspectives of customers in finding the solutions for service improvement. However, the existing approach failed in delving into the whole picture of service system. The behind operation of service system(e.g., selection and training of employees, support system) needs to be examined to have a balanced solution of service improvement. The personal characteristics, organizational characteristics, and customer experience were considered as the independent variables in predicting service mind and skills. The data collected in this study was gathered through questionnaire survey with 291 employees in five hospitals - from Sept. 10 to Oct. 16 in 2004. The results are as follows. 1. The regression analysis showed that job satisfaction and service commitment of organization were statistically significant in predicting service mind and skills. 2. The hierarchical regression analysis showed that the effect of hospital type on service mind was explained by service commitment of organization.

• 간호행정학회지
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• 제23권1호
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• pp.1-7
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• 2017

Nursing research in the United States (US) spans several decades. Many of the priorities/trends have stayed through the years. Today, the goal of producing evidence to support nursing care interventions coupled with the drive for Magnet Recognition has encouraged academic nurses (faculty) to work with nurse clinicians to form research teams. Interdisciplinary research teams have also formed to address growing concerns over patient safety and quality care. These issues are not just US issues but global ones. This article addresses US trends with the link to global research trends. The role that organizations such as the International Council of Nurses (ICN), the World Health Organization (WHO), and the Council of International Neonatal Nurses, Inc. (COINN) pay in shaping research agendas and promoting nursing research is highlighted. It emphasizes the key role that nurses, especially nurse leaders/administrators play in changing health outcomes through support of nursing research.