• 유통과학연구
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• 제19권2호
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• pp.5-14
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• 2021

Purpose: We examined informational justice, cognitive trust, and satisfaction in healthcare distribution market and their associations within the physician-patient (provider-purchaser) relationship. Methodology: 253 valid survey samples collected from patients and used structural equation modelling for analysis. Findings: We postulated that (1) physicians' informational justice has a positive impact on patients' cognitive trust, (2) patients' cognitive trust has a positive impact on satisfaction, and (3) patients' perceived informational justice has a positive impact on satisfaction. Participants were 253 people who had visited a hospital in South Korea in the past year. Results confirmed that the presence of informational justice has a positive impact on patients' cognitive trust and satisfaction in the physician-patient relationship. Additionally, once cognitive trust was built, it positively influenced patients' satisfaction. We discussed the concept and the impacts of informational justice in light of our analyses regarding patients' perceived cognitive trust and their satisfaction in the physician-patient relationship. Implications: These results emphasize the importance of ethics in healthcare, particularly physicians' frankness and honesty when providing information to patients. Further, these findings present implications for physician education, as part of their training must involve building their patients' cognitive trust as a prerequisite for developing patient satisfaction.

• 보건행정학회지
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• 제17권4호
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• pp.31-53
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• 2007

The purpose of a national health care system is to improve health care outcome among population. The objective of the study was to explore the determinants of health outcome in the 24 OECD countries between two health care financing systems. The study employed the pooled time series and cross-sectional analysis with tax-funded and social insurance-funded countries over the period of 1980 to 1999 using OECD Health Data 2002. The study revealed that health expenditure per capita, physicians per 1,000 of the population and calorie intake were positively significantly associated, smoking rate was negatively associated with health outcome while controlling all variables in the tax-funded countries. But in the insurance-funded countries, health expenditure per capita and the number of physicians were not statistically significant factors explaining health outcome. Only the calorie intake was positively associated with, and smoking rate, alcohol consumption per capita, and total nitrogen oxide emission per capita were negatively significantly associated with health outcome. In conclusion, healthy life style factors were much more important to improve health outcome in the both systems.

• 보건행정학회지
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• 제9권4호
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• pp.1-14
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• 1999

The purpose of this study was to estimate the magnitude of patient's actual cost-sharing for hospital services in the National Health Insurance which has been estimated with only a few hospitals or limited number of patients. Also we aimed at analysis of factors influencing the magnitude. Sources of analyzed data were two databases. 1997 medical benefits record of the National Federation of Medical Insurance and 1997 Statistics for Hospital Management from the Korea Institute of Health Services Management(KIHM). We merged two databases and related records for 224 hospitals. based on the identification details of each hospital. The average percent of patients' cost-sharing was 51.7% of total hospital revenues from the insurance. with 40.3% of revenue in inpatient and 67.4% in outpatient. respectively. The contributing hospital factors to the magnitude of cost-sharing were size of hospitals. teaching status. location. number of employed physicians. etc. Larger and university hospital. urban location. and with more physicians were positively correlated with higher level of cost-sharing. Additionally, the higher the expenses of inpatient's treatment was, the higher the size of patient's cost-sharing was. These findings suggest that present level of patients' cost-sharing is quitely high and it is urgent to reduce the patient's cost-sharing to the reasonable level. It would be necessary to extend the coverage of insurance benefits and to develop policies focusing on larger hospitals and inpatient services.

• Safety and Health at Work
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• 제12권4호
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• pp.490-495
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• 2021

Introduction: The risk of experiencing psychiatric symptoms related to the COVID-19 pandemic is high among healthcare workers whose occupations are in public health, emergency medicine, and intensive or critical care. Materials and methods: A cross-sectional study aimed to assess the prevalence of fear of COVID-19 among 411 frontline Egyptian physicians during the COVID-19 pandemic; identify determinants and predictors for fear of COVID-19; determine the impact of fear of COVID-19 on job satisfaction; and detect the impact of fear of COVID-19 on turnover intention. Three standardized scales (fear of COVID-19, job satisfaction, and turnover intention scores) were used for data collection via online Google Form. Results: Regarding fear relating to the COVID-19 pandemic, 16.5% of the study subjects were classified as experiencing a severe fear level, while 78.1% experienced a moderate degree. A significant association between the level of fear relating to COVID-19 and the work department. The highest degree of fear is in a general-educational-university facility. Regarding job satisfaction, 42% of those having a severe level of fear are dissatisfied. Fear of COVID-19 is negatively associated with job satisfaction while positively significant correlated with turnover scores, a positive significant predictor of turnover intention. Job satisfaction is negatively associated with turnover intention; a negative significant predictor of turnover intention. Conclusions: Frontline Egyptian physicians reported higher levels of fear relating to the COVID-19 pandemic (moderate to severe). Increased fear levels relating to COVID-19 have a relationship with lower levels of job satisfaction and higher levels of job turnover.

• Journal of Hospice and Palliative Care
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• 제16권4호
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• pp.242-252
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• 2013

목적: 본 연구는 의료인의 호스피스 완화의료에 대한 인식 및 지식과 죽음에 대한 태도 정도를 파악하고자 하는 것이다. 방법: 대상자는 B광역시 소재하는 의사 84명, 간호사 172명으로 총 256명을 대상으로 실시하였고, 자료수집기간은 2012년 4월 5일부터 동년 4월 30말까지 실시되었다. 결과: 호스피스 완화의료에 대한 목적에 대한 인식에서는 의사와 간호사 모두 '호스피스가 질병으로 더해오는 통증을 완화시켜주고 편안을 도모한다'는 항목에 가장 높게 인식하고 있는 것으로 나타났고, 호스피스 완화의료에 대한 필요성에 대한 인식에서는 의사와 간호사 모두 '말기 환자는 감정의 변화를 많이 겪는다' 라는 항목이 가장 높게 나타났다. 호스피스 완화의료에 대한 지식은 두 군 다 낮게 나타났고, 하위영역에서는 '통증과 증상관리'에서 두 집단 간 차이가 있었으며, 의사가 간호사보다 지식이 더 높은 것으로 나타났다(의사: $6.97{\pm}1.82$, 간호사: $5.68{\pm}1.93$, P<0.001). 죽음에 대한 태도는 두 집단 간에 통계적으로 유의한 차이는 없었다. 결론: 본 연구의 결과를 통해서 의료인의 호스피스 완화의료의 인식 및 지식의 향상과 죽음에 대한 자신의 태도를 정립할 수 있도록 돕는 교육프로그램의 개발이 마련될 것을 제안한다.

• Journal of Preventive Medicine and Public Health
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• 제26권4호
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• pp.614-627
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• 1993

It is well known that a physician's personal characteristic affects his practice pattern. Furthermore, a physician's specialty has powerful influences on his practice pattern. However, despite the fact that specialization has received the most attention for its influence on physician's service behavior, few studies have been conducted on the variations of contents and volume of physician's services. This study has intended to identify factors influencing the practice variations according to various physician characteristics. There are some other evidences that medical care providers are different in using of health services and resources in Korea. Four physician characteristics were selected for the analysis, two demographical factors, age and sex, and two practice factors, place of practice and medical specialty. Also, three indicators of service amount (total amount of insurance claim bill, number of visits per case, number of prescriptions per case) were selected. From the pool of insurance claims for ambulatory care received by the Korean National Federation of Medical Insurance(NFMI), 84,898 cases were randomly sampled. In the meantime using physician database of NFMI, 613 general practitioners (GP), 107 regular family physicians (FP), 483 'grandfather' family physicians(GFP), and 1,157 specialist practitioners(SP) were randomly sampled. Their different practice contents were compared concerning the specialty, age groups, sex, and practice sites (urban-rural) Specialist physicians tend to provide more costly care than do generalists. General practitioners and family physicians usually make fewer following visits and prescriptions. Age is also the important factor in determining the amount of services, which is highest at the physician's age group of 40's. Female doctors and urban practitioners use much more resources than their counterparts respectively. Research findings suggest that physician's characteristics particularly the specialty can affect practice patterns and resource utilizations. Other characteristics such as age and sex are not controllable but physician's specialty is relatively easily controllable during the entire phases of policy implementation. This is all the more true in the individual's initial decision of his specialty. Specialization therefore should receive policymaker's attention for its potential influence on medical care utilization and health care expenditure.

• 의료법학
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• 제7권1호
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• pp.323-386
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• 2006

A combination of information technology and medical care has given rise to a new type of medicine, i.e., telemedicine. Broadly defined, telemedicine is the transfer of electronic medical data from one location to another. Both at home and abroad, telemedicine has come to success in establishing appropriate equipment and solutions for such non-conventional medicine. Sooner or later, telemedicine is believed to find itself as one of the universal treatments. In order to facilitate the full-fledged development of telemedicine, a number of legal and institutional problems have to be settled. In Korea, the Medical Act was amended to include such provisions as telemedicine, electronic medical records, electronic prescriptions, etc. and the Act came into force on March 31, 2002. Telemedicine is in common with the conventional medicine in that a physician treats a patient. However, telemedicine is basically differentiated in the followings: - The offer and acceptance of treatment and medication are usually made on-line; - Telemedicine is inherently dangerous because a physician cannot meet face-to-face with a patient; and - Joint and several liability is borne by all the physicians involved in a telemedical consultation. As a result, telemedicine is vulnerable in nature to medical malpractice. Accordingly, there must be some new theories and arguments in the formation of contract and torts. The discussion on the civil liability covers the above-mentioned issues, and would give an insight or guidelines in the concerted operation of provisions with respect to telemedicine. This study delves into the civil liability of physicians involved in telemedical consultations and treatments based upon the conventional malpractice theory.

• 대한한의학원전학회지
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• 제27권1호
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• pp.1-13
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• 2014

Objective : "Dochangbup" is one of the therapies that remove pathogenic qi[邪氣] from the Emetic Method in the Miscellaneous Disorders part of Dongeuibogam東醫寶鑑. It is, in particular, the method of treatment that removes phlegm[痰], the cause of various disorders. Method : Application of "Dochangbup" had a long history in Korea as well. The meaning and application of "Dochangbup" are mentioned in various texts from early Chosun dynasty to the post liberation. Result : In China, there are a lot of medical texts by physicians throughout Ming and Qing Dynasty, with GeZhiYuLun格致餘論 at the top of the list, dealing with the meaning and applicable scope of "Dochang" method and pharmacy of "Hacheongo霞天膏". Most of the physicians are affiliated with Dan Xi School, regarding ZhudanXi朱丹溪 as a suzerain. In "Dongeuibogam", it is mentioned that "Dochangbup" can treat various disorders caused by phlegm. Though, when there is a possibility of harming original qi[元氣] during the treatment or grave deficiency in patients, it is requested to consider tonifying while purging. Conclusion : "Dochangbup" can be applied not only to the disorders mentioned in classical medical texts, like heart pain[心痛], leg disease[脚氣], urine turbidity[小便濁], involuntary discharge of semen[遺精], cough[咳嗽], blood spitting[喀血], but also to metabolic syndrome such as obesity, hypertention and diabetes, commonly found in the modern era.

• 한국직업건강간호학회지
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• 제20권2호
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• pp.212-220
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• 2011

Purpose: This study was to investigate the prevalence & types of workplace violence toward nurses in hospitals, and to understand nurse's coping response, cause of violence and prevention strategy. Methods: The data were collected from 254 nurses working in 9 hospitals in Jeju Province by the self-report from June to August 2010. Results: The respondents experienced unpleasant or insulting words (89.8%), verbal threat (38.2%), physical threat (67.7%), physical injury (32.7%), severe physical injury (2.8%), and sexual harassment (26.4%) during the last one year. The frequent offenders were patients, patients' family and physicians in order. The causes of violence which nurses perceived were personality of offenders (76.4%), lack of assessment of aggressive patients or care givers (42.1%), and lack of explanation to patients or caregivers (33.5%). They reported that coping strategies for workplace violence were 'established reporting system (63.4%)', 'building a cooperative circumstances within team members (58.3%)', and 'formulation of hospital policies for violence prevention and coping (54.3%)'. Conclusion: These findings showed nurses are at considerable risk for workplace violence, and they experience various types of violence from patients, caregivers, and physicians. We suggest that hospitals formulate appropriate policies, guidelines and programs to prevent and cope with workplace violence in hospitals.

• 대한핵의학회지
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• 제34권6호
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• pp.439-444
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• 2000

PACS (Picture Archiving and Communication System) is being rapidly spread and installed in many hospitals, but most of the system do not include nuclear medicine field. Although additional costs of hardware for nuclear medicine PACS is low, the complexity in developing viewing software and little market have made the nuclear medicine PACS not popular. Most PACS utilize DICOM 3.0 as standard format, but standard format in nuclear medicine has been Interfile. Interfile should be converted into DICOM format if nuclear images are to be stored and visualized in most PACS. Nowadays, many vendors supply the DICOM option in gamma camera and PET. Several hospitals in Korea have already installed nuclear PACS with DICOM, but only the screen captured images are supplied. Software for visualizing pseudo-color with color lookup tables and expressing with volume view should be developed to fulfill the demand of referring physicians and nuclear medicine physicians. PACS is going to integrate not only radiologic images but also endoscopic and pathologic images. Web and PC based PACS is now a trend and is much compatible with nuclear medicine PACS. Most important barrier for nuclear medicine PACS that we encounter is not a technical problem, but indifference of investor such as administrator of hospital or PACS. Now it is time to support and invest for the development of nuclear medicine PACS.