• 보건행정학회지
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• 제6권2호
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• pp.58-90
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• 1996

This study provides an empirical analysis of location competition for demand maximization by central place theory among physicians in nonmetropolitan areas of Korea. The results show that the primary care physicians distribute themselves evenly from urban communities to rural communities. The subspecialists, however, cluster together in major cities rather than decentralize themselves in rural counties. This study establishes the three statistical models : Primary care physicians, subspecialist physicians, and total physicians. Two models of primary care physicians and total physicians have a strong significance in multiple regression analysis (p=-.0001). The primary care model explains approximately 45% of the variation and the total physicians model explains approximately 70% of the variation in physician/1,000 population ratios across national counties. The subspecialist physicians model analysze the tobit regreassion because of the left consored and truncated values(57 cases = 0). In all three models, analysis of the coefficiencts for physician centralization degrees in the 0- to 5- and 5- to 10-km rings around the core county reveals each a positive and negative association betwee these degrees and the physician/1,000 population ratios in the core county. Also, the results provide moderate evidence that the relationship between clinic physicians and community hospitals is competitive, and the relationship between clinic physicians and pharmaceutists is synergistic. This suggests that public policy makers and local self-governing bodies must take an active role to ensure procider availability and the regional health planning in all nonmetropolitan areas of Korea.

• 보건행정학회지
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• 제13권3호
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• pp.21-34
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• 2003

Patient revisit to used hospital is a key factor in determining a health care organization's competitive advantage and survival. This article examines the relationship between customer's satisfaction and his/her revisit associated with three different methods which are the Chi Square Automatic Interaction Detection(CHAID) for segmenting the outpatient group, logistic regression and neural networks for addressing the outpatient's revisit. The main findings indicate that the important factors on outpatient's revisit are physician's kindness, nurse's skill, overall level of satisfaction, hospital reputation, recommendation, level of diagnoses and outpatient's age. Among these ones, physician's kindness is the most important factor as guidelines for decision of their revisit. The decision maker of hospital should select the strategy containing the variable amount of the level of revisit and size of outpatient's group under the constraint on the hospital's time, budget and manpower given. Finally, this study shows that neural networks, as non-parametric technique, appear to more correctly predict revisit than does logistic regression as a parametric estimation technique.

• 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.

• Journal of Preventive Medicine and Public Health
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• 제29권3호
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• pp.429-437
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• 1996

The geographical distribution of active physicians who graduated from medical schools before 1985 were studied. Those who had emigrated, hold non-medical jobs, are in the military service, or work as public health physicians and resident staff were excluded from the study. A total of 27,728 physicians were analyzed. Our studies have shown a relationship between the location of the medical schools from the which the physicians have graduated and the geographical regions in which they practice. A statistically significant number of physicians are working near the medical colleges from which they have graduated. That is, those who had graduated from medical schools located in the southern area of the country are presently working in the same region. This relationship was shown to be especially significant for older physicians and female doctors, who work around the area of the medical colleges from which they graduated.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권4호
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• pp.334-347
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• 2006

The aim of this study is to evaluate the reasonableness of the medical fee on oral and maxillofacial surgery field according to surgeon's opinions and actual conditions. The medical fee has significant influence on hospital income, the supply and distribution of medical manpower, quality and facilities of medical services. Questionnaire survey was sent to 86 oral and maxillofacial surgeons who worked more than 3 years in general hospital. Among them, 25 doctors replied the 109 answers survey and the average of treatment time and physician work relative value on each category was calculated. And the health insurance cost (that has been applied since 2003) was compared with the questionnaire results. And finally we investigated items that health insurance system did not include in oral and maxillofacial field but actually performed in oral and maxillofacial surgery clinic. The result was that the medical fee did not properly reflect physician work relative value of actual treatments. In case of complicated extraction, work relative value needed 3.5 times enhancement of present value. For simple impacted tooth extraction 1.8 times, for impacted tooth extraction including odontomy 1.7 times, and for fully impacted tooth more than 2/3 of it located into the alveolar bone, 1.8 times enhancement needed. In respect of the present physician work relative value, hemimandibulectomy with neck lymph node dissection for the malignancy is appropriated as 3.3 times of open reduction and internal fixation for the mandibular fracture, but the questionnaire result showed 25 times discrepancy. In conclusion, this research shows the need for intervention that health insurance included items and legal relative medical value must act in union with treatment in clinic to reduce the imbalance between them.

• 농촌의학ㆍ지역보건
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• 제17권1호
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• pp.5-16
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• 1992

The maternal and child health is a basis of national health, and indicates the level of social welfare and health of the country, because it is related with community welfare status, general cultural conditions, and medical and health sciences. This is a study carried out to identify the present practices of maternal and child health care programs implemented by the private clinics located in Guns(counties ; rural area) in Kyungsangnam Province and to propose alternatives to improve their current programs through a self-administrative questionnaire. The subjects were 90 private physicians who operated their own clinics since 1990 and were general practitioners, Obstertrician/Gynecologists or pediatricians: This survey was conducted by mail from 15 January to 25 February 1992. The response rate was 94.4 percent. 1) The major manpower for MCH programs of the studied clinics was physicians and nurseaids. 70.3% of physicians were general practitioners, 81.1% of nursing manpower were nurseaids. 31.1% of the studied clinics employed lab-technicians. 89.2% of them had MCH room whatever the size and the setting, and 84.4% of Ob/Gyn clinics installed laboratory equipments. 2) 55.4% and 63.5% of the studied clinics provided 151 or above consulting services and curative services of MCH per physician a month respectively and 33.8% and 25.7% of them provided 10 or less consulting services and curative services per physician a month. 91.9% of lab-technicians had 10 or less laboratory tests per technician a month. 3) There was a difference between Ob/Gyn and pediatric clinics in terms of services delivered : for example, 80% of Ob/Gyn clinics provided pre- and post- natal care services, while 84.6% of pediatric clinics provided vaccinations for children. It was also found that only a few of general practitioners involved pre-and post- natal care services. 4) There were no clinics which had opened regular health education session but 24.3% of them had opened the sessions irregularly. Ob/Gyn clinics put emphasis on maternity and pediatric clinics did on child health, but general practitioners touched with both maternal and child health. 21.6% of the studied clinics had some kind of educational materials for MCH programs. Most of the materials were pamphlets or small booklets. 5) Proteinuria/glucosuria, blood pressure and blood type were tested in 48.6~69% of the studied clinics ; tests for blood sugar and hepatitis B were provided in 39.2~41.9% of them, most of them were done in Ob/Gyn clinics. 6) 41.9% of physicians, 29.7% of nurses and 45.9% of nurses-aids wanted to receive on-job-training for MCH programs.

• 농촌의학ㆍ지역보건
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• 제49권3호
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• pp.235-256
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• 2024

Background: The adequate provision of medical care relies on the availability of a suitable number of healthcare professionals. To ensure stability in healthcare delivery, it is crucial for a country to accurately estimate and address the supply of doctors. This study aims to contribute to the formulation of effective policies for securing and distributing doctor manpower, with a focus on medically underserved areas at both the national and local government levels. Methods: Employing the system dynamics methodology, this research utilizes stock and flow diagrams, including level and rate diagrams, to quantitatively analyze the cumulative structure of the doctor supply and demand system. Results: The analysis reveals a substantial shortage of clinical doctors in Gyeongsangnam-do, amounting to 15,477 as of 2021. Projections indicate a need for an additional 7,570 doctors by the year 2050 to maintain the current healthcare service level. Examination of medical treatment rights and distribution across cities and counties indicates an insufficiency in doctor supply relative to demand in the majority of regions. Alternative scenarios, such as increasing medical school enrollments and adjusting retirement ages, were explored, yet none provided a sufficient resolution to the shortage. Conclusion: The findings underscore an impending exacerbation of the doctor shortage in Gyeongsangnam-do if the existing system is perpetuated. Addressing this issue necessitates not only augmenting the number of medical school students and adapting retirement age policies but also implementing diverse strategies employed successfully in other countries. This study serves as a foundational step in informing evidence-based policies aimed at securing an ample and appropriately distributed doctor workforce for sustainable healthcare delivery.

• 보건행정학회지
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• 제5권2호
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• pp.70-103
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• 1995

The aim of this study sets out to discover a desirable form of public centers among the alternative ones and make a health center model. Especially, this study attempts; (i) to investigate factors that affect the performance of health centers; (ii) carry out cost-effectiveness analysis (CEA) for the various type of health centers; (iii) identify innovative strategies to increase the use of health center. Cost-effectiveness analysis is used to compare the performance of all the centers. The following is taken to create the index. Wi = Ti x Mi x Eij (Wi: weight for service item I, Ti : time spent for service I, Mi ; number of health personnel involved in service I, Eij : years of schooling for personnel j in providing service I). As a result of these analyses, policy options as follows are recommended; (i) proper manpower, especially public health physician (oriental medical doctor), should be enough to provide health care adequately; (ii) facilities ad equipments in the health center should be provided sufficiently. (iii) the utilization of health centers should be raised by active operation of mobil service, community participation and health education program. Ultimately health centers in public sector are to be fostered for the promotion of health care by enhancing the financial and quality, continuity and efficiency of health services.

• 대한방사선기술학회지:방사선기술과학
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• 제43권1호
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• pp.35-43
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• 2020

The purpose of this study was to study on radiologic technologist's license system and primary pathway education curriculum in the United States American (USA), focused on one case of college in Texas. We were collected and analyzed through class participation at a community college in Tarrant, interviews with professors of radiologic science and clinical radiographers, field trips, an internet search, and literature reviews. As a result, first, the American radiologic technologists license system is composed of fifteen chapters, and the professional education courses for each field are being carried out through three courses of a primary pathway, a post primary pathway and a physician extender. Second, the primary pathway courses consisted the radiography, the radiation therapy, the nuclear medicine, the magnetic resonance imaging, the sonography. Third, the USA had about 30 times more clinical practice time than Korea. In clinical practice, students had done actually examination through X-ray exposure on patients. Last radiographers in the USA was able to perform intravenous injection of radiopharmaceutical agents on patient, so that he could perform rapid examination and efficient manpower operation. This study could be used as basic data for the globalization of radiologic technologists license system in Korea.

• 대한임상검사과학회지
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• 제52권3호
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• pp.261-270
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• 2020

본 연구는 질 가산율 산출 및 적용기준을 검토하여 우수검사실 신임인증 및 전문인력영역에 있어 임상병리사를 추가 가능성을 알아보았다. 연구에 참여한 6개 기관은 1,000병상 이상의 대형병원 규모이며, 상근 진단검사의학과 전문의 평균 5명, 임상병리사는 평균 53명으로 전문의 1명당 10.6명으로 나타났다. 임상병리사의 행위분류별 소요시간에 대한 분석결과, 분석 중 행위는 낮아지고 있는 반면 검사실 운영, 정도관리 등의 강화로 포괄적 분석 전 행위의 비율이 높게 나타났다. 분석 중 행위는 생화학 검사수행 등의 비중이 높았고, 분석 후 행위는 결과분석 등이 대부분을 차지하였다. 이와 같이 검체검사 질 향상을 위해 많은 시간이 소요되며, 그에 맞는 인력이 요구된다. 결론적으로 검체검사 질 향상을 위해 임상병리사의 채용 역시 중요하며, 그에 따른 인원 규정이 필요하다 할 수 있다.