• 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.

• 한국응급구조학회지
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• 제25권1호
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• pp.147-158
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• 2021

Purpose: This study was conducted as a direct investigation of the data in the dispatch logbooks and status of patient transportation provided by private emergency transport companies in Busan. Methods: This study was conducted using SPSS 23.0 version for a total of 1,000 processed records of private emergency ambulance services in Busan from September 23, 2017 to November 5, 2019. Results: First, 100% of the emergency patient transfers by private emergency ambulances were carried out between medical institutions; 76.4% of all transfer patients had emergency conditions, and 86.0% had serious diseases. Second, 59.3% of the emergency patients were located at distances less than 10 km and 43.2%, at more than 10 km from the medical institutions. Third, 63.5% of the passengers were accompanied by first-class emergency rescuers according to the severity of the condition. Fourth, 92.7% of the reasons for the selection of medical institutions were transferred to places where professional care was available, accounting for most of the reasons for the selection. Finally, the medical institutions were selected according to the severity of the patient's condition; 76.5% patients were transported to institutions with a large number of doctors, and 42.9% of those were transported to specialized care institutions. Conclusion: This study collected data from 1,000 dispatch records of private emergency transport companies in Busan; these records reflect the government's policies to improve the emergency patient transfer system. The current status of emergency patient transfer offered by private transport companies was analyzed. All of the emergency patient transfers were carried out between medical institutions, and 76% of the transferred patients had emergency conditions.

• 대한의생명과학회지
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• 제16권4호
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• pp.311-316
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• 2010

We studied a comparison of the concentration of biochemical markers in sera of patients hospitalized with high fever (n=296) in Jeonbuk province during the last 2 years (2008 to 2009). The patients were divided into three patient groups of viral hemorrhagic fever (VHF) patient group tested positive for Hantavirus (n=53), leptospirosis (LEP) patient group tested positive for Leptospira interrogans (n=137) and scrub typhus (TSU) patient group tested positive for Orientia tsutsugamushi (n=106). We analyzed the concentration of ALP, AST, ALT, blood urea nitrogen, creatinine and glucose and compared the mean levels of them to normal range, the first sample and last sample. The frequencies of abnormal patient elevated above the upper limit of normal for ALP, AST and ALT were 18~43.4%, 78~97% and 62.3~92.7% in patient groups, and 24.5~47.4% (total protein) and 13.2~50.0% (albumin) of patients in patient groups had decreased below the lower limit of normal. The patients showed higher abnormal levels of glucose in patient groups were 58.5% (viral hemorrhagic fever patient group), 66.4% (leptospirosis patient group), 71.7% (scrub typhus patient group) and 66.9% (total patient group). There were significant difference between the first sample and the last sample in the mean levels of AST (decreased 22.2% in viral hemorrhagic fever patient group, 30.2% in leptospirosis patient group, 20.4% in scrub typhus patient group and 24.1% in total patient group), BUN (43.0% in viral hemorrhagic fever patient group, 41.6% in leptospirosis patient group, 47.4% in scrub typhus patient group and 43.0% in total patient group) and glucose (20.2% viral hemorrhagic fever patient group, 17.9% in leptospirosis patient group, 18.6% in scrub typhus patient group and 18.9% in total patient group) in the first sample and the last sample. According to these results, those diseases may cause liver damage and have high concentration of ALP, AST, ALT and glucose in blood even though the patients get out of the hospital.

• 간호행정학회지
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• 제17권4호
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• pp.413-422
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• 2011

Purpose: This descriptive correlation study was done to identify how perception of patient safety culture of general hospital nurses affects safety during nursing activities. Data from this study should provide information on management of patient safety as well as improvement in patient safety. Method: Participants in this study were 357 clinical nurses working in a general hospital in M city which had two medical evaluations. A survey was conducted to gather the data. Results: The score for perception of patient safety culture of the general hospital nurses was 3.42, out of a possible 5 points, and the score for safety care activities was 3.90. There was a statistically significant positive relationship between the nurses' perception of patient safety culture and their safety care activities, Perception of patient safety culture, Supervisor/manager, communication and procedures, and frequency of accident reporting were factors that impacted significantly on safety nursing activity. Conclusion: The results of the study indicate that patient safety cultural perception significantly affects the safety of nursing activities and thus systematic educational strategies to increase perception should be provided to increase the level of patient safety culture. Also, other specific methods that increase the level of patient safety culture should be considered.

• 사상체질의학회지
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• 제20권1호
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• pp.24-33
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• 2008

1. Objectives We analyze Doctor-Patient Relationship in anthropological medicine, medical sociology Oriental Medicine and find out solutions about problems of Modern Medicine which are dehumanized through the meaning of Doctor-Patient Relationship in Sasang Constitutional Medicine. 2. Methods We consider various studies which are related with doctor-patient relationship from models of the Doctor-Patient Relationship, anthropological medicine, medical sociology and Oriental Medicine. And we compare and analyze Sasang Constitutional Medicine's meaning of doctor and patient through Sasang Constitutional Medicine's view of treatment and philosophy. 3. Results and Conclusions 1) In various studies, Doctor-Patient Relationship have been dualistic perspective which is divided into doctor and patient, and lay emphasis on relationship between them. 2) In Sasang Constitutional Medicine, anyone might be a patient because they are human being, anyone might be a doctor as cure their own disease. In other words, doctor and patient are not separated but united. A point of regarding human is the core of illness and cure can present new direction that solves problems of dualistic perspective Modern Medicine.

• 한국의료질향상학회지
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• 제2권2호
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• pp.20-30
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• 1996

Background : Theoretically as the waiting-time of patient is estimated in queueing, many men and much money are needed. But being the estimation of patient s waiting-time very important in hospital service, so the continuous monitoring of waiting-time is inevitable. To verify that the estimation of waiting-time using parking time is economical, effective and continuous monitoring method and to develop utilizing the method, this study was done. Method : In parking confirmation office, the personnel of parking office wrote parking confirm time, chart number and whether medical examination and treatment finish or not in parking ticket. The next day the parking tickets were gathered and the above data were input. The input parking data were connected with the hospital outpatient file indexing chart number. Then the patient' s data for department, new patient or not, reservation or not, receipt time and payment time were retrieved. The group for finishing medical treatment were compared with that for not finishing in average time lag between confirmation and out-time for hospital. And In-time for hospital, receipt time, payment and out-time for hospital were also analyzed. Result : Confirming parking ticket, the group for finished medical treatment left hospital after 7 minutes. This result showed that the patient for finished medical treatment left hospital immediately. So parking time was reasonable to estimation of hospital-time was concluded. The time for medical treatment, diagnosis and test was constant for all patients and short for waiting time, Then I concluded that the parking time was reasonable for estimation patient's waiting time. Overall patient's waiting time was 113 minutes and new patient's time was 149 minutes, old patient's times was 109 minutes. Waiting time for reservation patient was 98 minutes and for non reservation patient was 122 minutes. The time from hospital arrival to payment was 50 minutes for the group of reservation patient and 69 minutes for non-reservation group. The time from payment to hospital leaving was 51 minutes and 56 minutes for non reservation group. The short time difference between reserved group and not reserved group from payment to hospital leaving time was due to bottle neck effect. Conclusion : The estimation of patient's waiting time using parking time was reasonable because the possession of car was common and the time for medical treatment was equal and the patient after treatment left hospital immediately. Using this method, timely, fast evaluation and continuous monitoring of the intervention effect were possible.

• 대한간호학회지
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• 제16권3호
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• pp.97-107
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• 1986

This study was about nurse's helping behaviors and the purpose of the study was to find out the nurse's helping behaviors, to identify the nurse's helping behavior level by the nurses personal back-ground and to find out the relationship between the nurse's helping behavior and patient's self-exploration. The subjects, consisting of 192 adults in-patients who had less acute physical problem and 192 registered nurses working on these ward in 3 hospitals in Seoul and 1 hospital in Kang Won province of Korea. The data were collected from Jan. to rob. 1986 through the descriptive responds and self-reported questionaires. The instruments used for this study were Carkhuff's index of communication. Henderson's Irritating Listening Behavior, revised by the Kim(1984) and patient problem understanding scale, patients trust scale on nurse, developed by the Kim(1984). Analysis of the Data was done by use of mean, t-test, F-test and Pearson correlation coefficients. The results of study are summerized as follows; 1. Mean of nurse's helping behavior was 1.84 out of 4. These point were less than 3.0 which means the minimum points as the facilitative helper. 3. There was no significant differences of nurses helping behaviors to the nurse's personal back-ground (p<.05). 3. There were positive rotation between the nurse's helping behaviors and patient's self-exploration behavior (P<0001). In conclusion, 1 may can give some suggestion, according to the study results: 1. The systematic study about nurse's helping behavior is need all over the Korea. 2. Educational program for the facilitative relationship between nurses and patient must be developed, 3. Further detailed analysis methods are need on the independent variables of patient's self-explorations behavior.

• 대한한방부인과학회지
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• 제31권3호
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• pp.152-163
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• 2018

Objectives: In recent studies, increased AMH level has been suggested as objective surrogate marker for diagnosis PCOS, one of the major causes of oligomenorrhea. The purpose of this study is to report the clinical effect of Korean medicine treatment on oligomenorrhea patient with increased Anti-mullerian hormone level, who can be diagnosed who can be ruled out PCOS. Methods: A 27 year old woman with oligomenorrhea was enrolled in this study. We measured serum hormone levels and ruled out PCOS. The patient received Korean medicine treatment for 3 months, we assessed the result of treatment through observation of the menstrual cycle and follow-up measurements of serum hormone levels. Results: 1. The patient had menstrual cycle regularly. 2. Increased serum AMH level of the patient decreased from 12.16 ng/ml to 8.51 ng/ml. 3. The other serum hormone levels such as testosterone, LH/FSH ratio decreased Conclusion: This case shows that Korean medicine treatment could have a beneficial effect on menstrual cycle and decrease the increased serum hormone levels of ruled out PCOS patient.

• Archives of Plastic Surgery
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• 제34권2호
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• pp.222-228
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• 2007

Purpose: Report of the good results of breast reconstruction using Becker permanent tissue expander that showed a short operation time and a quick post-operation recovery time, little side effects and usually superb aesthetic results without the need for additional incisions or donor site morbidity. The authors, after carrying out breast reconstruction operations using Becker permanent tissue expander on patients with appropriate indications, attempted to analyze several factors such as complication rates and patient satisfaction measurements. Methods: 11 cases of breast reconstruction using Becker expander implants were carried out on a total of 10 patients between March 2000 and February 2003. The patients were followed up at outpatient visit for an average of 6 months. Results: The most common post-operation complication was pain resulting from saline injection into the expanders, complained by 5 patients(50%). rib fractures, skin necrosis, implant removal due to infection, and breast cancer recurrence each occurred in 1 patient (9.9%). There was no occurrence of skin contracture complications which occurs frequently in case of silicone implant insertion. Patient complacency was surveyed by patient interviews made right after the operations and during outpatient follow-up periods: 5(50%) patients out of 10 showed excellent, 3(30%) good, and 2(20%) showed fair, leaving no patients who were disappointed with operation results. On routine follow-up, 80% of patients expressed satisfaction with the cosmetic outcome of their post-mastectomy beast reconstruction. Conclusion: Breast reconstruction using the Becker expander is a reliable alternative to other reconstructive methods but good patient selection is essential for satisfactory results.

• 성인간호학회지
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• 제13권2호
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• pp.262-276
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• 2001

The purpose of this study is to investigate the correlation among the stroke patient family's health, burden and quality of life which is based upon the comparative appreciation of the adult stroke patient's family and elderly stroke patient's family. For this purpose, data were collected from the family care-givers for two groups of stroke patients under sixty years old and over sixty years of age, admitted at K Hospital and H Hospital in Seoul. The instruments for this research are based on the tool for measuring physical health and psychological health developed by Yang, Young-hee(1992), the tool for measuring the sense of burden by Seo, Mee-hae and Oh, Ga-sil(1993), and the tool for the quality of life by Noh, Yoo-ja(1988). The sampling for this study was done from December, 2000 until February, 2001. Questionnaire data were drawn up by personal interviews aided by the staff nurses. The analysis of collected data are based on general characteristics calculated at the rate of 100 percent of the average, t-test, ANOVA(some difference on a level with p<.05 being subsquently confirmed by DMR) for Health Status, Burden, Quality of Life and Pearson Correlation to verify the hypothetical correlation among the subjects. The results of this study are as follows: 1. In the adult stroke patient family, the factors influencing the physical health proved to be age, present occupation and family-formation. Here, the factors influencing psychological health turned out to be age, matrimonial status, present occupation and family-formation. In the elderly stroke patient family, the factors influencing physical health proved to be age, gender, final academic status, matrimonial status, present occupation, and relation with the patient. Here, the factors influencing the psychological health were age, final academic status, matrimonial status, present occupation, relation with the patient and family-formation. In the former case, the influencing factors upon the burden were shown to be age, final academic status, matrimonial status, relation with the patient and family-formation. In the latter case, the influences upon the burden were age, gender, final academic status, matrimonial status, present occupation and relation with the patient. In the former case, the influences on the quality of life were gender, and economic situation. In the later case, the influencing factors on the quality of life were age, final academic status, matrimonial status, present occupation, and relation with the patient. 2. The rate of the physical condition in the former case turned out to be 2.83, and the psychological condition 2.37. The physical condition of the latter case was 2.76, and the psychological condition 2.46. The rate of the burden in the former case was 3.14, and that of the latter case was 3.04. The rate of quality of life in the former case proved to be 2.46, and that of the latter case 2.55. 3. The rate of correlation between the burden and the quality of life appeared to be the high counter-correlation (r= -.573). The rate of correlation between the psychological health and the burden of a simialr (r= -.565). The rate of correlation between the physical health and the psychological health proved to be a moderate correlation (r= .372), The rate of correlation between physical health and the burden turned out to be a low counter-correlation (r= -.276). According to this study, there proved to be a very close correlation among the stroke patient family's health, the burden and quality of life. Thus, it would be necessary to find out various nursing interventions in order to mitigate the stroke patient family's burden in the process of caring for the patients.