• Health Policy and Management
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• v.9 no.3
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• pp.21-32
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• 1999

The purpose of this study is to assess individual decisive factors for distribution of medical specialists in Korea. A data set was constructed using several published data sources. including the Korean Medical Association's physician master file as a principal source for physician information. Linear logistic regression analysis was performed to assess the relationship between the location of private specialist clinic for practice with six variables related with individual characteristics: age. sex. location of postgraduate training hospital. location of medical school graduated, size of hospital for training, and specialty. Analysis showed that location of practice. classified into urban and rural areas, was significantly associated with the variables of sex. location of postgraduate training hospital. location of medical school. In addition, significant association was found between the location of practice which was categorized into "near-Seoul area" and others, and sex, location of postgraduate training hospital. and location of medical school. We could conclude that to improve area maldistribution of physicians locations of hospitals for training and medical schools have to have the highest priority in the policymaking.icymaking.

• Sleep Medicine and Psychophysiology
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• v.1 no.1
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• pp.9-19
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• 1994

Disorders of intitating and maintaining sleep(DIMS : insomnia) may be a symptom of some other disease or the basic, root problem in some patients. DIMS is usually treated by private physicians or psychiatrists, initially. Many physicians can do to improve the quality of life of the sleep disordered patients by appropriate evaluation and management For the effective management of DIMS patients, the accurate differential diagnosis is essential. In polysomnographic evaluation for insomnia, the physician should consider the aspects of cost-effectiveness to provide the maximal benefits for the patients. For the purpose of this, evaluation of DIMS complaints outside the sleep disorder clinic, indication for referral to a sleep disorder clinic, the role of polysomnopraphy in evaluating DIMS, and polysomnographic findings of different types of DIMS are discussed, together with possible way to diagnose them.

• Korea Journal of Hospital Management
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• v.6 no.1
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• pp.85-106
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• 2001

Since physical damages caused by passive smoking had been widely recognized, the Korea parliament enacted the National Health Promotion Law on September, 1995. The law specified nonsmoking areas in all public facilities, including hospitals. But this law is not strictly enforced. The benefits of a nonsmoking policy can not be expected by the public. Even though hospitals should preserve a smoke-free-environment, most of hospitals are not under full controls against smoking. The purpose of this study is to identify factors related to smoking in general hospitals. Field study and surveys were simultaneously performed at study hospitals in Busan. 9 of 24 general hospitals were selected and survey was performed for 10 days by investigators during January of 2000. Nine hospitals had nonsmoking regulations, but only 8 hospitals had designated nonsmoking areas. Two hospitals among those hospitals had a nonsmoking committee. Patients' smoking rate was 35.0%, while hospital employees' smoking rate was 22.5%. The smoking rates of physicians, nurses, administrators and medical technicians were 45.38%, 0.85%, 31.73% and 40.70%, respectively. In the question of the severity of damages caused by passive smoke, only 29.2% of the smoking group considered smoking as a serious health risk, while 69.4% of non-smoking group did. Christian employee showed lower smoking rate compared to other employee did. Even though physicians should educate patients and other professions about smoking, physicians' smoking rate (45.4%) was higher than other professions. As a consequence, this study insists that general hospitals should enhance their nonsmoking policy and implement any practical policy for smoking free hospital environment.

• Journal of Preventive Medicine and Public Health
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• v.53 no.5
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• pp.362-370
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• 2020

Objectives: Despite greater access to training positions and the presence of more women in emergency medicine, it has remained a men-dominated field. This study aims to identify the key issues causing the gender gap in Korea and establish measures to overcome them. Methods: Using the annual statistical reports of the National Emergency Medical Center and data published on the Korean Society of Emergency Medicine website, cases that listed the current status and positions of members in its organization and its committees were analyzed. Secondary analysis was conducted using data from the 2015 Korean Society of Emergency Survey that included physicians' demographics, academic ranking, years of experience, clinical work hours, training and board certification, core faculty status, position, and salaries. Results: As of September 2019, women account for only 12.7% of the total number of emergency physicians (EP) in Korea; of 119 chair/vice-chair academic positions, women represented only 9.2%. Women EP were more often assistant professors and fellowship-trained, with fewer in core faculty. However, they worked the same numbers of clinical hours as their men counterparts. The median annual salary of women EP was less than that of men EP after adjusting for academic hospital rank, clinical hours, and core faculty status. Conclusions: A gender gap still exists among Korean EP, and women earn less than men regardless of their rank, clinical hours, or training. Future studies should evaluate more data and develop system-wide practices to eliminate gender disparities.

• Health Policy and Management
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• v.1 no.1
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• pp.72-94
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• 1991

The number of disputes between physicians and patients caused by medical malpractice are showing a sharp increasing over the past several years. The disputes on medical malpractice may be resolved either in court or by direct negotiation between both sides concerned. There are no special acts relating to the civil or penal liability of the physicians in Korea. The medical disputes are decided merely through legal technicalities and without reference to actual medical practice. The current system which does not compensate injured patients adequately or equitably leads to taking a long time consuming for dispute resolution processes. The things make worsed, the problem is due to not being of insurance system or a proper funds for compensation. This research proposes a outline of new and comprehensive alternative for these problems and failure of conventional resolution of medical disputes. So far, we have learned lessons from the excperiencies of resolving medical malpractice disputes of Japan and the United States. The proposal first calls for an administrative arbitration and pretrial screening panels as a condition precedent to trial. The proposal also includes to facilitate with the funds for compensating the injured.

• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.226-229
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• 2017

Chronic obstructive pulmonary disease (COPD) had been considered the only major disease that is continuing to increase in prevalence. There were a few studies about the change of the prevalence of COPD, which showed the prevalence of COPD did not increase. In this review, we report on the trends in the prevalence of COPD in Korea using the data from Korea National Health and Nutrition Examination Survey (KNHANES). The prevalence of COPD in 2015 was 13.4% (male, 21.6%; female, 5.8%). The prevalence of COPD did not change much, which ranged from 13.1% to 14.6% during the period from 2010 to 2015. Among the subjects found to have COPD by spirometry, only 2.8% had been diagnosed as COPD by physicians during the period from 2011 and 2015. In conclusion, the prevalence of COPD did not change significantly during the period from 2010 to 2015. And most COPD patients still had not been diagnosed by physicians and consequently had not been treated appropriately.

• Tuberculosis and Respiratory Diseases
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• v.68 no.5
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• pp.290-293
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• 2010

A hidden primary tumor presenting as an isolated lung mass is a diagnostic challenge to physicians because the diagnosis of lung cancer is likely to be made if the histologic findings are not inconsistent with lung cancer. A large lung mass was found incidentally in a 59-year-old man. Although adenocarcinoma was diagnosed by percutaneous needle biopsy, thyroid transcription factor-1 (TTF-1) immunostaining was negative, raising suspicion that there was another primary site. There was no abnormal finding except for the lung mass on a $^{18}FDG$-PET/CT scan and the patient did not complain of any discomfort. Finally, prostatic cancer was confirmed through the study of tumor markers and prostate-specific antigen (PSA) immunostaining. Because of the rare presentation of a single lung mass in malignancies that have another primary site, physicians should carefully review all data before making a final diagnosis of lung cancer.

• The Korean Journal of Pain
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• v.28 no.4
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• pp.254-264
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• 2015

Background: Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea. Methods: Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. Results: Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. Conclusions: More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur.

• Korean Journal of Adult Nursing
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• v.17 no.4
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• pp.622-634
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• 2005

Purpose: The purpose of this study was to evaluate the applicability of the evidence based guideline for prompted voiding by Lyons & Specht (2001) in National Guideline $Clearinghouse^{TM}$ for use in Korea based on the experts' opinions. Method: The target expert group consisted of 8 registered nurses, 6 physicians, and 5 nursing professors who are experts in urinary incontinence. This study used a questionnaire survey. The appropriateness, applicability, and the present application of each recommendation in the guideline were analyzed with descriptive statistics using the SPSS program, with content analysis based on the experts' opinions. Result: The scores on each recommendation's appropriateness showed the high degree of agreement among nurses, physicians, and nursing professors. However, the recommendation for 'use of oxybutinin' showed the lowest score as 5.89. It was notable that the most recommendations scored lower for applicability compared with appropriateness. The reasons for lower scores for applicability were the lack of clinicians' knowledge of assessment and management, and the lack of resources in clinical settings in Korea. Conclusion: This study will augment the understanding of the actual urinary incontinence management in Korean clinical settings and can be used as the baseline data for further study of tailoring international guidelines into local and national clinical settings.

• Journal of Trauma and Injury
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• v.33 no.3
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• pp.153-161
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• 2020

Purpose: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure and extremely time-dependent, and the proficiency of the physician is important. Due to a lack of REBOA education programs in Republic of Korea, few physicians have been trained in the procedure. In this study, we examined how REBOA education affects clinical outcomes in a single center. Methods: A retrospective study conducted from February 2017 to June 2020 at a regional trauma center. We collected data of patients who underwent REBOA and analyzed the factors that influenced the outcome. The patients were divided into the educated and non-educated groups (based on REBOA training received by their physicians), and the success and failure groups. Results: A total of 24 patients underwent REBOA during the study. There were eight patients in the success group and 16 patients in the failure group. There are no significant differences between the educated and non-educated groups in sex, age, ISS, shock, injury-to-REBOA time, injury mechanism, injury sites, arrest, access site, type of catheter, type of REBOA, target Zone, mortality, and the result of REBOA. The non-educated group had a higher risk for failure compared to the educated group in multivariate analysis (odds ratio [OR] 154.64, 95% confidence interval [CI] 1.11-22.60). Conclusions: Failure in REBOA is harmful to patients. The risk of failure is increased in the non-educated group. Physicians working in the trauma center or emergency department need to complete the REBOA education program.