• 한국병원경영학회지
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• 제18권4호
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• pp.54-77
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• 2013

This paper is a comparison study about leadership training transfer factors between physicians working in large scale hospitals and managers working in firms. To fulfill this purpose, this study conducted a regression analysis on 101 managers and 59 physicians who had attended similar leadership training programs more than 16 hours recently in order to identify the differences on the learning transfer factors. 6 factors such as Learner readiness, Performance self-efficacy, (so far as Trainee Characteristics group), Organization Culture, Supervisor's tangible incentives and Supervisor's intangible support, (so far as Work environment group), Content Validity & Transfer Design (so far Training Design group) were used as independent variables while the personal Managerial Capability Increase and Leadership Capability Increase were used as dependent variables. And also we used 5 factors as control variables ; Job style (Manager or Physician), Age, Gender, Working years and Organization size. Here are the summary of major findings ; first, there were statistically significant differences between the learning transfer factors in leadership training programs for managers and those of physicians. Second, there were also statistically significant differences among trainees' working years and their organization size factors while age and gender do not affect the learning transfer factors. Third, for the physician's leadership training the practitioners should focus on two factors ; Organization Culture and Learner readiness.

• The Korean Journal of Pain
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• 제25권1호
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• pp.16-21
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• 2012

Background: The C-arm fluoroscope is known as the most important equipment in pain interventions. This study was conducted to investigate the completion rate of education on radiation safety, the knowledge of radiation exposure, the use of radiation protection, and so on. Methods: Unsigned questionnaires were collected from the 27 pain physicians who applied for the final test to become an expert in pain medicine in 2011. The survey was composed of 12 questions about the position of the hospital, the kind of hospital, the use of C-arm fluoroscopy, radiation safety education, knowledge of annual permissible radiation dose, use of radiation protection, and efforts to reduce radiation exposure. Results: In this study, although most respondents (93%) had used C-arm fluoroscopy, only 33% of the physicians completed radiation safety education. Even though nine (33%) had received education on radiation safety, none of the physicians knew the annual permissible radiation dose. In comparing the radiation safety education group and the no-education group, the rate of wearing radiation-protective glasses or goggles and the use of radiation badges or dosimeters were significantly higher in the education group. However, in the use of other protective equipment, knowledge of radiation safety, and efforts to reduce radiation exposure, there were no statistical differences between the two groups. Conclusions: The respondents knew very little about radiation safety and had low interest in their radiation exposure. To make the use of fluoroscopy safer, additional education, as well as attention to and knowledge of practices of radiation safety are required for pain physicians.

• 한국병원경영학회지
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• 제10권2호
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• pp.1-25
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• 2005

This study purports to investigate the determinants of patient satisfaction and intent to revisit at national university hospitals in Korea. A total of 8 independent variables for outpatients, 9 independent variables for inpatients, and an intervening variable of overall patient satisfaction were selected through literature review. The independent variables for outpatients contain the level of satisfaction with physicians, nurses, ancillary staff, administrative procedure, medical cost, physical environment, facility convenience. and health recovery. With regard to the independent variables for inpatients, the quality of ward services was added to those of outpatients. Each variable contains 3 to 8 items measuring the level of satisfaction with various aspects of the variable. The sample used in this study consisted of 879 outpatients and 821 inpatients. Data were collected with interview survey and analyzed using path analysis. The major findings of the study are as follows: 1) The following variables have significantly positive effect on the intent to revisit of outpatients: health recovery, overall satisfaction, satisfaction with physicians, and ancillary staff. 2) The following variables have significantly positive effect on the intent to revisit of inpatients: health recovery, satisfaction with nurses and physicians, overall satisfaction, and administrative procedure. 3) The following variables of admission procedure, satisfaction with ancillary staff, facility convenience, quality of ward services were found to have significantly positive effect only on the level of overall satisfaction, even though they do not have significant total effect on the intent to revisit. The results of the study indicate that national university hospitals in Korea should make an effort to improve the satisfactory level of patients with clinical outcome, services provided by physicians, nurses, and ancillary staff, and the quality of administrative procedure for enhancing the intent to revisit of patients.

• 동의생리병리학회지
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• 제23권6호
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• pp.1460-1464
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• 2009

In spite of many studies on statistical model for pattern identifications (PIs), little attention has been paid to the complexity of pattern diagnosis processed by oriental physicians. The aim of this study is to develop a statistical diagnostic model which discriminates four PIs using multiple indicators in stroke. Clinical data were collected from 981 stroke patients and 516 data of which PIs were agreed by two independent physicians were included. Discriminant analysis was carried out using clinical indicators such as symptoms and signs which referred to pattern diagnosis, and applied to validation samples which contained all symptoms and signs manifested. Four Fischer's linear discriminant models were derived and their accuracy and prediction rates were 93.2% and 80.43%, respectively. It is important to consider the pattern diagnosis processed by oriental physicians in developing statistical model for PIs. The discriminant model developed in this study using multiple indicators is valid, and can be used in the clinical fields.

• The Korean Journal of Pain
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• 제33권1호
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• pp.73-80
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• 2020

Background: The aim of this study was to evaluate radiation exposure to the eye and thyroid in pain physicians during the fluoroscopy-guided cervical epidural block (CEB). Methods: Two pain physicians (a fellow and a professor) who regularly performed C-arm fluoroscopy-guided CEBs were included. Seven dosimeters were used to measure radiation exposure, five of which were placed on the physician (forehead, inside and outside of the thyroid protector, and inside and outside of the lead apron) and two were used as controls. Patient age, sex, height, and weight were noted, as were radiation exposure time, absorbed radiation dose, and distance from the X-ray field center to the physician. Results: One hundred CEB procedures using C-arm fluoroscopy were performed on comparable patients. Only the distance from the X-ray field center to the physician was significantly different between the two physicians (fellow: 37.5 ± 2.1 cm, professor: 41.2 ± 3.6 cm, P = 0.03). The use of lead-based protection effectively decreased the absorbed radiation dose by up to 35%. Conclusions: Although there was no difference in radiation exposure between the professor and the fellow, there was a difference in the distance from the X-ray field during the CEBs. Further, radiation exposure can be minimized if proper protection (thyroid protector, leaded apron, and eyewear) is used, even if the distance between the X-ray beam and the pain physician is small. Damage from frequent, low-dose radiation exposure is not yet fully understood. Therefore, safety measures, including lead-based protection, should always be enforced.

• Journal of Preventive Medicine and Public Health
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• 제52권2호
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• pp.72-81
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• 2019

Objectives: The current study presents a new conceptual framework for physician-induced demand that comprises several influential components and their interactions. Methods: This framework was developed on the basis of the conceptual model proposed by Labelle. To identify the components that influenced induced demand and their interactions, a scoping review was conducted (from January 1980 to January 2017). Additionally, an expert panel was formed to formulate and expand the framework. Results: The developed framework comprises 2 main sets of components. First, the supply side includes 9 components: physicians' incentive for pecuniary profit or meeting their target income, physicians' current income, the physician/population ratio, service price (tariff), payment method, consultation time, type of employment of physicians, observable characteristics of the physician, and type and size of the hospital. Second, the demand side includes 3 components: patients' observable characteristics, patients' non-clinical characteristics, and insurance coverage. Conclusions: A conceptual framework that can clearly describe interactions between the components that influence induced demand is a critical step in providing a scientific basis for understanding physicians' behavior, particularly in the field of health economics.

• Safety and Health at Work
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• 제10권1호
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• pp.80-86
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• 2019

Background: Emigration of health-care workers is a problem within global health systems which affects many countries, including Peru. Several factors have caused health-care workers to emigrate, including burnout syndrome (BS). This study aims to identify the association between BS and its dimensions with the intention of physicians and nurses to emigrate from Peru in 2014. Methods: A cross-sectional study, based on a secondary analysis of the National Survey of Health Users (ENSUSALUD - 2014) was conducted. Sampling was probabilistic, considering the 24 departments of Peru. We include the questionnaire for physicians and nurses, accounting for 5062 workers. BS was measured by the Maslach Burnout Inventory-Human Services Survey. Adjusted odds ratio (OR) was calculated using multiple logistic regression. Results: Of the study population, 44.1% were physicians, 37.7% males, and 23.1% were working in Lima. It was found that 2.8% [95% confidence interval (CI): 2.19-3.45] of health-care workers had BS. The overall prevalence of intention to emigrate among health-care workers was 7.4% (95% CI: 6.36-8.40). Association was found between BS and intention to emigrate in Peruvian health-care workers (OR = 2.15; 95% CI: 1.05-4.40). Emotional exhaustion was the BS dimension most associated with intention to emigrate (OR = 1.80; 95% CI: 1.16-2.78). Conclusion: Physicians and nurses from Peru who suffered from BS were more likely to have intention to emigrate. Policies should be established to reduce BS as a strategy to control "brain drain" from health-care workers of Peru.

• 임상간호연구
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• 제16권2호
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• pp.57-67
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• 2010

Purpose: The purposes of this study were to compare the level of perception and to identify factors associated with perception on patient safety culture among health care providers working in an operating room(OR). Methods: A cross-sectional survey design was used. Data were collected conveniently from 154 RNs and 116 physicians working in a tertiary hospital in Seoul. Patient safety culture was measured using "The Hospital Survey on Patient Safety Culture" developed by the Agency for Healthcare Research and Quality (AHRQ). Descriptive statistics, t-test, ANOVA, and Spearman rank correlation coefficients were used for statistical analysis with the SPSS version 17.0. Results: The perception level of nurses and physicians on patient safety culture was "moderate" (3.14). Compared to physicians, nurses showed a significantly lower perception on the items of "teamwork within units" (t=-6.904, p<.001) and "overall perception of patient safety" (t=-4.327, p<.001), but had a higher perception about "frequency of events reported" (t=2.769, p=.006). The physicians' professional positions, years of working experience, age, and working hour per week were identified as factors associated with patient safety culture. Conclusion: Level of perception on patient safety culture may vary among health care providers working in the OR. The study finding suggests that a tailored education and training strategies should be considered to develop an effective safety culture for healthcare professionals working in OR.

• 보건행정학회지
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• 제2권1호
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• pp.17-41
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• 1992

During the month of October, 1990, 676 practicing physicians in Taegu City were surveyed by mail questionnaires about their general characteristics and the reasons why they chose Taegu as a practice location and 331 out of them responded completely. Collected data were analyzed to provide basic reference data for future health manpower policy which intends to solve the problem of geographical maldistribution of physicians, The major findings are as follows: For the question asking why Taegu area is favored, following lists are as the order of their magnitude of the reasons replied by more than 20% of the respondents: 1) Taegu is a foundation of life until now(81.3%) 2) Better educational environments are available for their offsprings(73.7%) 3) They can have intimate relationship with acquaintances or friends sharing same or similar interests(61.0%) 4) Due to characteristics of their specialty, metropolitan seems to fit better(52.0%), 5) They graduated from the medical school in Taegu(49.8%) 6) Never thought of selecting practice location in other area than Taegu without any specific reasons(45.9%) 7) Intelligent communications are available with other physicians(39.9%) 8) More opportunities to participate in social life, such as medical, or alumni association etc., can be given(33.2%) 9) No specific knowledge or relationships with other area are available(32.6%) 10) They finished internship or residency training in Taegu area(31.4%) 11) Facilitation of transferring patients including emergent patients can be obtained (30.8%) 12) Continuing medical educational programs are available(29.9%) 13) Sufficient medical demands are provided because of the large population(28.1%) 14) More chances to be grown up as a medical professionals can be achieved(25.7%) 15) More leizure time can be utilized for cultural activities(23.9%) 16) They had experiences to work in hospitals or facilities in Taegu area(23.3%) 17) Medical facilities of fellow physicians or alumni can be used(20.5%) In addition, 37% of female physicians answered that their spouse strongly influenced them to choose Taegu, and 33.3% of physicians with age of thirty replied that parents did so. Physicians of specialty in radiology, clinical pathology, anatomical pathology, and anesthesiology considered that patients from other hospitals and medical facilities would be referred often to them and that less competition seemed to be expected in their specialty (30.8%). In contrast, general practitioners anticipated that larger population would increase the medical demand(62.5%). 28.6% of medical practitioners who graduated medical schools in other are than Taegu and 22.0% of medical practitioners who were trained in hospitals of other area than Taegu were influenced to choose Taegu by their spouses. In consideration of above findings, we may conclude that long term and rational manpower policies should be implemented to solve the problem of geographical maldistribution of physicians as well as short term physician-inducing policies, and they have to be incorporated with equitable community development.

• 의료법학
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• 제19권1호
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• pp.113-142
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• 2018

최근 의사에 의한 형사범죄 사건 발생 시 죄의 종류에 관계 없이 일정 수준 이상의 형을 선고받게 되면 면허취소처분이 이루어져야 한다는 의견이 제기되고 있으며, 이에 대한 법안이 국회에 대표발의 되는 등 논의가 본격화될 것으로 전망된다. 국민 일반이 의사에게 기대하는 도덕성 윤리성이나 법치의식의 수준, 다른 전문직역에 대한 면허취소제도 등을 고려할 때 의사의 형사범죄에 따른 면허취소는 일정부분 타당하다고 평가될 수 있다. 그러나 정제되지 않은 추단이나 감정적 판단에 기인하여 허술한 제도설계가 이루어질 경우 예기치 못한 부작용이 발생할 가능성이 있다. 사회적 용인가능성이 없는 중대한 형사범죄에 대해서는 의사 면허취소처분을 통하여 국민일반을 위험으로부터 보호하는 조치가 타당하다고 평가될 수 있을 것이다. 그러나 고위험 의료행위가 갖는 구명성과 높은 과실위반 노출성, 사회적 유용성 등의 특성을 감안할 때 업무상과실치사상죄 및 일부 경미한 범죄행위는 반사회성이 높은 형사범죄행위와 동일하게 평가하기 어려운 측면이 있다. 의사는 다른 전문직과 동일하게 취급될 필요성이 있는 동시에, 위험을 감수하고 환자의 생명을 다루는 특수성을 지닌 전문가이므로 의료의 본질적 특수성 및 보건의료시책상의 필요성 등을 고려하여 보다 구체적이고 실증적인 제도 도입 논의가 이루어져야 할 것이다. 이에 따라 본고에서는 위와 같은 판단과 문제의식에 기초하여 의사의 직업윤리 및 국내 외 형사범죄와 연계된 의사면허취소제도를 살펴보고 우리나라의 실정에 맞는 다양한 입법론적 대안을 살펴봄으로써 합리적인 제도수립에 도움이 되고자 한다.