• The Korean Journal of Pain
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• 제26권1호
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• pp.51-56
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• 2013

Background: The C-arm fluoroscope is an essential tool for the intervention of pain. The aim of this study was to investigate the radiation exposure experienced by the hand and chest of pain physicians during C-arm fluoroscopy-guided procedures. Methods: This is a prospective study about radiation exposure to physicians during transforaminal epidural steroid injection (TFESI) and medial branch block (MBB). Four pain physicians were involved in this study. Data about effective dose (ED) at each physician's right hand and left side of the chest, exposure time, radiation absorbed dose (RAD), and the distance from the center of the X-ray field to the physician during X-ray scanning were collected. Results: Three hundred and fifteen cases were included for this study. Demographic data showed no significant differences among the physicians in the TFESIs and MBBs. In the TFESI group, there was a significant difference between the ED at the hand and chest in all the physicians. In physician A, B and C, the ED at the chest was more than the ED at the hand. The distance from the center of the X-ray field to physician A was more than that of the other physicians, and for the exposure time, the ED and RAD in physician A was less than that of the other physicians. In the MBB group, there was no difference in the ED at the hand and chest, except for physician D. The distance from the center of the X-ray field to physician A was more than that of the other physicians and the exposure time in physician A was less than that of the other physicians. Conclusions: In conclusion, the distance from the radiation source, position of the hand, experience and technique can correlate with the radiation dose.

• Journal of Preventive Medicine and Public Health
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• 제21권1호
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• pp.61-69
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• 1988

In this study, the number of physicians presently living in Korea was thoroughly estimated by several means and, on this basis, their productivity and level of supply were estimated. The results were as follows First, the number of physicians who did not notify the Korea Medical Association in May 1987 were 10,110, including 4,093 emigrant physicians(40.5%) ,861 military medical officers,745 public health doctors, and 107 deceased physicians. A total of 1,330 physicians could not be identified by any effort. Second, among the 34,897 registered physicians as of May 1987, 29,933(85.8%) were residing in Korea, 4,115 physicians(11.8%) had emigrated to other countries, and 849 physicians(2.4%) were deceased. Practicing physicians difined as those in Korea who were not retired, serving in the military, or completing residencies or internships, comprised 78.6%(27,414 physicians) of the total number of registered physicians. Third, it is estimated that in the year 2000 the number of registered physicians, physicians residing in Korea, and practicing physician will be 75,040, 64,038, and 57,655, respectively and these are increases of 115.0%, 113.9%, and 110.3%, respectively, compared to 1987. Fourth, the population physician ratio will be 759 to one physician in the year 2000. Fifth, the productivity of physicians, as calculated by relative values defining the productivity of 35 to 44 year-old male physicians as 10, will increase 110.7% in the year 2000 compare to that of 1987, and this increment is almost the same level as that of physician supply. From the results of the present analysis of physician manpower and supply projection, it can be recognized that the development of a regular notification system is necessary in order to identify precisely the number of physicians. Also a policy of physician supply is essential in order to adjust in advance the number of physicians, otherwise there will be surplus to the medical demand.

• Journal of Preventive Medicine and Public Health
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• 제24권2호
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• pp.171-180
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• 1991

Productivity analysis of physician is one of essential factors for the optimal health manpower planning. Among 690 physicians operating clinic and registered on the Kyeongsangnamdo Medical Association, 623 physicians were studied with a structural questionaire from April 1 to May 31, 1990. This study covers the general characteristics and productivity of physicians and attempts to find relevant determinants of their productivity through stepwise multiple regression analysis based on collected data. The mar results were as follows. First, physicians were more prevalent $35{\sim}44$ group (30.2%) in age, male (95.8%) in sex, specialist (76.5%) in specialization,'city (78.0%) in geographical location. Age group of 35-54 and specialist were mere prevalent in cities than in counties, while age group of 25-44 and 55 over and general practitioner in counties (p<0.001). Second, daily outpatients load of all physician were 77.1 persons on average. Age group of $35{\sim}44$ had the most outpatient load (90.3 persons) among all age group, $6{\sim}10$ years group (94.2 persons) in years of duration of practice, 11 hours per day group (83.4 persons) in working hours per day. Specialists had more outpatient load (82.6 persons) than general practitioners (61.1 persons) and physicians in cities had more (80.2 persons) than physicians in counties (66.3 persons). Daily average outpatient load of physicians were significantly different by their age, speciality, number of assistants and years of practice (p<0.001) and working location (p<0.05), but not significantly different by working hours per day of physician (p>0.1). Third, the productivity of physicians operating clinic were significantly affected by the three factors-number of assistants of physician, age of physician and duration of practice at the current clinic. Age of physician had negative regression coefficient.

• 의료법학
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• 제15권1호
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• pp.123-164
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• 2014

Under the new system of 'Separation of pharmaceutical prescription and dispensing' in Korea, which was implemented in 2000, physician could not dispense a medicine, and outpatient should have a physician's prescription filled at a drugstore. After pharmacist makes up outpatient's prescription, National Health Insurance Service(NHIS) pay for outpatient's medicine to pharmacist, except an outpatient's own medicine charge. And NHIS only pay for outpatient's prescription fee to physician and, physician doesn't derive profit from dispensing medicine in itself. Nevertheless, if physician writes out a prescription with violation of 'Criteria for the Medical Care Benefits', NHIS clawed back the payment of outpatient's prescription and medicine from the physician or the medical institution which the physician belongs to. In the past, NHIS's confiscation was in accordance with 'the National Health Care Insurance Act, Article 52, Clause 1'. But, since 2006 when the Supreme Court declared that there was no legal basis on the NHIS's confiscation of outpatient's medicine payment, NHIS had put in a claim for illegal prescriptions on the basis 'the Korean Civil law, Article 750(tort)'. So, Many medical institutions filed civil actions against NHIS. The key point of this actions was whether the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits constitute of the law of tort. On this point, the first trial and the second trial took different position. Finally the Supreme Court acknowledged the constitution of the law of tort in 2013. In this paper, the author will review critically the decision of the Supreme Court, and consider the relativeness between the legal effect of Criteria for the Medical Care Benefits and the constitution of the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits as the law of tort.

• Journal of Preventive Medicine and Public Health
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• 제40권6호
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• pp.487-494
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• 2007

Objectives : Little is known about the physician-related factors that are associated with the management of Hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. Methods : We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do, Forty-one physicians completed the survey (response rates : 26.6%) and 31 physicians were finally included as the study subjects. Using the information obtained from the self-reported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center#s information system. We compared the physicians# perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25% of the median degree of hypertension control rate overestimation) among the physicians. The physicians# antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physician-related factors. Results : The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5% perceived vs. 57.8% actual). The percentage of physicians with high overestimation was 35.5% (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients# control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensin-converting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95% CI : 1.17-1.48). Conclusions : Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians# overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician# awareness regarding the management of patients with hypertension are needed.

• 한국병원경영학회지
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• 제27권4호
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• pp.22-35
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• 2022

Purpose: Physician's occupational burnout has been a very important issue that can cause negative consequences not only for individual's physical and mental health, but also for patient's health and the overall national healthcare system. For the reason, this study confirmed how consultation length and the number of outpatients affect physician's occupational burnout in the medical environment. Methodology: In the study, the data of '2020 Korean Physician Survey' conducted by Korean Medical Association(KMA) was used for the analysis, and a total of 4,215 physicians were selected as study samples. The differences in the degree of occupational burnout according to the physicians' general characteristics were confirmed through uni-variate analysis, and also a regression analysis was conducted to confirm the effects of consultation length and the number of outpatients on physician's occupational burnout. Findings: As a result. the overall degree of physician's occupational burnout decreased(𝛽=-0.051, p<0.01) as the consultation length increased. Specifically, the physician's emotional exhaustion increased(𝛽=0.051, p<0.01), while the reduction of accomplishment decreased(𝛽=-0.131, p<0.001). Furthermore, the overall occupational burnout decreased(𝛽=-0.047, p<0.01) as a proportion of advice and education during the consultation increased, and it had an effect on the decrease in depersonalization(𝛽=-0.045, p<0.01) and the reduction of accomplishment(𝛽=-0.065, p<0.001). At last, as the number of outpatients increased, the overall occupational burnout increased(𝛽=0.041, p<0.05) with more emotional exhaustion(𝛽=0.095, p<0.001), depersonalization(𝛽=0.065, p<0.001), and less reduction of personal achievement(𝛽=-0.081, p<0.001). Practical implication: Consequently, it is necessary to prevent physician's occupational burnout by ensuring sufficient consultation length and providing a medical environment to treat an appropriate number of patients. Therefore, national policies should expand health insurance coverage and compensate medical fees for sufficient consultation length that both patients and physicians can satisfy. It will ultimately contribute to ensuring the patients' health and improving the quality of national healthcare services.

• 기본간호학회지
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• 제23권2호
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• pp.126-135
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• 2016

Purpose: This study was done to identify the influence of clinical learning environment and attitude toward physician-nurse collaboration on professionalism in nursing students. Method: The sample consisted of 317 nursing students. Data were collected from October 10 to December 20, 2014 and were analyzed using t-test, ANOVA, Pearson correlation and multiple linear regression with IBM SPSS statistics version 19. Results: The mean score for clinical learning environment was 3.15 out of 5. The mean score on the Jefferson scale attitude toward physician-nurse collaboration (JSAPNC) was 3.31 out of 4. The mean score for professionalism was 3.70 out of 5. The predictors of professionalism were major satisfaction, 'care vs cure' for the JSAPNC and 'patient relationship', 'student satisfaction' for clinical learning environment. Conclusions: Based on these results, educational programs to improve attitude toward physician-nurse collaboration and clinical learning environment should be developed.

• 한국임상약학회지
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• 제23권2호
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• pp.123-128
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• 2013

Purpose: The aim of study was to investigate the racial or ethnic differences in FDA-approved medications. Methods: Data on racial-based differences of drugs in PDR (Physician's Desk Reference) were analyzed by searching with keywords, "ETHNIC" and "RACE". Results: There were descriptions related to "ETHNIC" in product directions of 53 cases and "RACE" in 266 cases in 2010 PDR. After excluding 30 cases of duplicates, 289 cases were shown of which 28 cases were verified to demonstrate racial or ethnic differences. Drug category showing the higher racial or ethnic differences was cardiovascular drugs (7), followed by alimentary tract and metabolism drugs (6), nervous system drugs (5), and antineoplastic and immunomodulating agents (3). Pharmacokinetic differences between race and ethnicity were observed most frequently; differences in AUC or Cmax showed in 15 drugs and clearance differences in 7 drugs. Conclusions: This study identified the racial differences in medication usage in PDR. Therefore, the results can contribute to safe use of medication in real clinical settings in regards to the racial or ethnic differences.

• 한국병원경영학회지
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• 제24권4호
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• pp.43-56
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• 2019

Purpose: Importance of patient satisfaction related to patient-centeredness has been emphasized, and it is known to have effect on various health outcomes including health resource utilization. However, the effect of patient satisfaction has been discussed mostly in terms of hospital marketing in Korea. This study aims to examine the effect of patient satisfaction in patient-physician communication on healthcare utilization in a nationally representative adult population of South Korea. Method: Patient satisfaction with physician communication is assessed using 4 items in the 2011 Korea Health Panel Survey. Generalized linear regression analysis is conducted using 9,325 adults' healthcare utilization in 2012. Findings: Adjusting for the socio-demographic, economic factors, individual health status, health behaviors and healthcare utilization in 2011, more satisfied individuals, more likely to utilize the outpatient service, especially in clinical setting. Practical Implications: The study findings suggests that in context of South Korea healthcare system such as insufficient medical consultation time and the absence of health delivery system, patient satisfaction as a subjective healthcare quality indicator would have effect on the individual's outpatient visit. This study contributes to stimulate patient satisfaction research and discussion in South Korea to further explore its relationship with potential and various health related outcomes. Further implications of the study are discussed.

• 보건행정학회지
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• 제4권2호
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• pp.58-76
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• 1994

In order to study factors affecting the use of the ambulatory physician services. Andersen's model for health utilization was modified by adding the health behavior component and examined with three different approaches. Three different approaches were the multiople regression model, logistic regression model, and LISREL model. For multiple regression, dependent variable was reported illness-related visits to a physician during past one year and independent variables are variaous variables measuring predisposing factor, enabling factor, need factor and health behavior. For the logistic regression, dependent variable was visit or no-visit to a physician during past one year and independent variables were same as the multiple regression analysis. For the LISREL, five endogenous variables of health utiliztion, predisposing factor, enabling factor, need factor, and health behavior and 20 exogeneous variables which measures five endogenous variables were used. According to the multiple regression analysis, chronic illness, health status, perceived health status of the need factor; residence, sex, age, marital status, education of the predisposing factor ; health insurance, usual source for medical care of enabling factor were the siginificant exploratory variables for the health utilization. Out of the logistic regression analysis, health status, chronic illness, residence, marital status, education, drinking, use of health aid were found to be significant exploratory variables. From LISREL, need factor affect utilization most following by predisposing factor, enabling factor and health behavior. For LISREL model, age, education, and residence for predisposing factor; health status, chronic illess, and perceived health status for need factor; medical insurance for enabling factor; and doing any kind of health behavior for the health behavior were found as the significant observed variables for each theoretical variables.