• 한국정보컨버전스학회논문지
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• 제7권1호
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• pp.25-46
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• 2014

본 연구에서는 금융기관에서 발생하는 금융사고의 발생현황 및 발생원인을 살펴보고, 국내 및 외국의 금융사고 사례, 현재시점에서 금융사고 예방을 위한 활동에 대하여 살펴보고 앞으로 금융기관들이 금융사고에 어떻게 대처해 나아가야할지에 대한 방안을 제시하였다. 이 방안을 제시하면서 금융사고 발생 전 예방활동, 금융기관 정상영업 중 예방활동, 금융사고 후 활동으로 나누어 제시하였다. 그 내용은 다음과 같다. 1. 금융사고 발생 전 예방활동을 강화해야 한다. 이를 위해서는 첫째, 지속적인 내부통제를 위한 강화가 필요하다. 둘째, 금융사고의 개연성을 미리 차단할 수 있는 직원 윤리교육과 내부 제보자에 대한 포상제도가 확대 운영되어야 한다. 셋째, 금융사고 피해금액을 보전하기 위한 종합보험에 가입하여야 한다. 2. 금융기관 정상영업 기간 중 예방활동을 강화해야 한다. 이를 위해서는 첫째, 거래고객에 대한 본인인증 제도를 도입 운영하여야 한다. 둘째, 일 거래/주 거래/월 거래 등에 대한 대사 및 감시기구 확대 운영하여야 한다. 셋째, 금융사고 예방 등을 위한 대고객 문자통보서비스를 확대 운영하여야 한다. 넷째, 금융사고 정보고시제도를 확대하여 운영하여야 한다. 3. 금융사고 후 활동을 강화해야 한다. 첫째, 경영진에 대한 책임 부과 등을 통한 사고예방 인식을 제고 시켜야 한다. 둘째, 금융사고자에 대한 형사고발 등 제재를 강화하여야 한다. 셋째, 금융사고 금액은 반드시 전액을 환수할 수 있는 법 제도적인 장치와 결의가 있어야 한다.

• Perspectives in Nursing Science
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• 제7권1호
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• pp.10-22
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• 2010

Purpose: Through a thorough examination of the CCSC (Community Comprehensive Support Center) system in Japan, this study suggests a scheme to provide community-based preventive health care services for the elderly in Korea. Methods: The study inquired into the applicability of the Japanese model by reviewing the data related to the CCSC project, aided by both in-depth interviews with staff in the field and consultations with specialists. Results: Rearrangement of the Visiting Health Management Project system is needed to manage the collective or individual visiting care management for frailty prevention of the elderly in communities. The delegated service system for preventive care in the community, including direct management by one of the public health centers, also needs to be reviewed and the application of stricter standards for the selection of the agency or corporation to run the delegated service is necessary. Long-Term Care Insurance, along with national and local grants, is to be considered as a financial resource for the community-based preventive health care model for the elderly. By making active use of education rooms at district offices, senior citizen centers in neighborhoods for the elderly with easy access can be created. The project needs to raise active supports from communities, develop programs which can be absorbed into particular local cultures, and promote the understanding of the preventive project in local communities. The preventive program should focus on first solving the problems of depression, seclusion, and lack of mobility of the elderly. Second, the program should instruct physical self-management for exercise-nutrition-dental maintenance, and third, the program should strengthen the cognitive abilities of the elderly. In addition, it is necessary to systematize and implement counter-plans of the family and community to protect the elderly who has mental and cognitive problems. Finally, by establishing a network of public health welfare resources based upon research on a community level, assessment and planning for the health of the elderly should be one with their family, and comprehensive consultation and recommendations should be provided to the family. Conclusion: Taking into consideration the experience Japan has had with respect to a similar project, it is appropriate to develop and implement a service system which would combine the Visiting Health Management Project system which has already been established and a preventive health care model for the elderly on a community level.

• 한국의료질향상학회지
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• 제11권1호
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• pp.32-45
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• 2004

Objective : The aim of this study were to measure quality of life(QOL) in liver transplant recipients, to compare QOL between living donor liver transplant recipients and cadaveric liver transplant recipients and to investigate whether SF-36 may be used as a disease-specific instrument in liver transplant recipients. Methods : We conducted a single-center cross-sectional study of 133 LT recipients ages 13 to 65 years, all of whom had had Liver Transplantation(LT) at least 1 months previously. QOL was assessed using a self-completion questionnaire consisting of the Bang Whal Ran(1991) instruments and the 36-Item Short-Form Health Survey(SF-36) health status profile measure. We investigated whether the SF-36 instrument may be used as a disease-specific instrument in LT recipients. Individual scale scores range from 0 to 100, with higher score reflecting better health. Data on demographics, clinical status at pre transplantation 1 day, post transplantation clinical status, and graft function were collected to identify predictors of post transplantation QOL. Results : Standard measures for test-retest reliability, internal consistency, and discriminant and concurrent validity were examined. The reliability of the SF-36, as measured by test-retest correlation(Pearson coefficients: 0.729, p=0.002) and by internal consistency(Cronbach's alpha: 0.9431) exceeded conventional acceptability criteria. The correlation between domain scores of SF-36 and the Bang Whal Ran(l991) was clear and logical in that the clinical characteristics of SF-36 strongly correlated with the clinical component summary score of the Bang Whal Ran(l991)(r = 0.8155, P<.01). SF-36 scale scores were compared between Cadaveric Liver Transplant recipients and Living Donor Liver Transplant recipients. Donor types of post LT did not influence HRQOL(p>0.05). 87% of the liver transplant recipients were satisfied to get LT. Satisfaction of post LT showed significantly greater HRQOL(p<0.001). Conclusion : SF-36 is found reliable and valid. This study indicates thet Donor Type did not influence HRQOL after LT. The information gained from this study will help us to better define expectations and the clinical course after liver transplantation to patients and their families.

• 농촌의학ㆍ지역보건
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• 제32권1호
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• pp.13-26
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• 2007

Objectives: This study was conducted to investigate the association between health risk factors and mortality in Juam cohort. Methods: The subjects were 1,447 males and 1,889 females who had been followed up for 68.5 months to 1 January 2001. Whether they were alive or not was confirmed by the mortality data of the National Statistical Office. A total of 289 persons among them died during the follow-up period. The Cox's proportional hazard regression model was used for survival analysis. Results: Age, type of medical insurance, self cognitive health level, habit of alcohol drinking, smoking, exercise and BMI level were included in Cox's proportional hazard model by gender. The hazard ratio of age was 1.07(95% CI: 1.05-1.10) in men, 1.09(95% CI: 1.06-1.12) in women. The hazard ratio of medical aid(lower socioeconomic state) was 1.43(95% CI 1.02-2.19) in women. The hazard ratios of current alcohol drinking and current smoking were respectively 1.69(95% CI: 1.01-2.98), 1.52(95% CI: 1.02-2.28) in women. The hazard ratio of underweight was 1.56(95% CI 1.08-2.47) in men. The hazard ratios of underweight, normoweight, overweight, and obesity were respectively 1.63(95% CI: 1.02-2.67), 1.0(referent), 0.62(95% CI: 0.32-1.63), 1.27(95% CI: 0.65-3.06), which supported the U-shaped relationship between body mass index and mortality among the men over 65. Conclusions: The health risk factors increasing mortality were age, underweight in male, age, lower socioeconomic state, current alcohol drinking, current smoking in female. To evaluate long-term association between health risk factors and mortality, further studies need to be carried out.

• 한국산학기술학회논문지
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• 제17권6호
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• pp.449-458
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• 2016

본 연구는 700병상이상 병원의 3개 수술실 간호사를 대상으로 물품관리 업무역량(물품관리능력, 인식정도, 지식정도)과 업무 만족도를 파악한 후에, 3개 수술실 간에 결과의 차이가 있는지 여부와 물품관리 업무역량과 업무만족도의 상관성을 분석하고 관련된 영향요인을 파악하여 수술간호 업무역량과 업무만족도 향상을 위한 교육과 간호업무 개선활동의 기초자료를 제공하고자 실시되었다. 연구는 구조화된 설문지를 이용하여 자기기입식으로 시행되었고, 연구대상은 현재 6개월 이상 수술실에서 수술간호에 참여 중인 간호사로 하였고 연구 참여자는 181명이였다. 연구결과 물품관리능력의 평균평점은 4.2점(${\pm}0.56$), 인식정도 3.4점(${\pm}0.76$), 지식정도는 3.5점(${\pm}0.40$)이고 업무 만족도는 3.4점(${\pm}0.55$)이었다. 3개 수술실 간호사 그룹 간의 물품간호 업무역량과 업무만족도의 결과에 차이는 없었고, 물품관리능력과 지식정도는(r=.627, p<0.01)이고, 지식정도와 인식정도는(r=.663, p<0.01)이며, 인식정도와 만족도는 (r=.485, p<0.01)로 양의 상관관계가 있었다. 수술실 간호사의 일반적 특성이 물품관리 업무역량과 업무만족도에 미치는 관련요인으로는 연령이 물품관리 업무역량에 유의하게 영향을 미치는 요인이고, 그 외의 항목은 유의하지 않았다. 이와 같은 연구결과를 기반으로 병원 간호사들의 지속적인 인력관리와 교육, 병원간의 의사소통 채널의 효율적인 관리를 위한 자료로 활용하여 수술실 간호사 역량과 만족도의 유지 및 향상에 기초자료를 제공하고자 한다.

• 보건행정학회지
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• 제16권3호
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• pp.86-106
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• 2006

The purpose of the study is 1) to explore clinic and hospital CEOs' satisfaction and expectation level on the affiliation with the larger size teaching hospitals, 2) to find the factors influencing the satisfaction and expectation level on the affiliation with the large hospitals. Data for analysis was collected to use self-administrative structured questionnaire on 335 CEOs of small or middle sized clinics and hospitals affiliated with large sized teaching hospitals located in Seoul and Kyung Ki Province. For the study, the researchers develop the constructs for questions on the satisfaction and the expectation of the affiliation, the attitude, knowledge on the affiliation, previous relationship of the affiliation, and selection guideline of the affiliation with exploratory factor analysis and reliability test. Through the confirmative factor analysis using AMOS 4, the researchers develop constructs based on exact relationship between constructs and questions. CEOs' expressive and unexpressive satisfaction level are 2.54 of 5 point(38.5 of 100) and 2.78 of 5 point(44.5 of 100), and the expressive and unexpressive expectation level are 2.77 of 5 point(44.3) and 3.16 of 5 point(54.0). These levels are relatively row for importance of affiliation. Expectation levels do not influence satisfaction levels. Attitude of affiliation influences expressive expectation and unexpressive satisfaction, reason for affiliation unexpressive satisfaction, and previous relationship to affiliated hospitals influence both of expressive and unexpressive satisfaction. The expressive expectation level and the expressive satisfaction level influence unexpressive expectation and unexpressive satisfaction, respectively. There is cognitive dissonance between expectation and satisfaction, therefore numbers of affiliation might be smaller or weaker in the future than present time. Many CEOs feel environmental press such as competition and the press of health insurance, but they might not think affiliation is best solution. Therefore, large hospitals try to give affiliated clinics and hospitals practical benefits to increase satisfaction and expectation levels, and they need to new affiliation form such as joint venture and joint ownership. The expectation and the satisfaction level was influenced by CEOs' gender, type of health service facilities, distances between the affiliated facility and the large mother hospital, and reason for affiliation.

• Journal of Preventive Medicine and Public Health
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• 제37권2호
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• pp.111-119
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• 2004

Purpose : To identify those factors influencing the post-operative satisfaction in myopia patients receiving laser in situ keratomileusis (LASIK) Methods : This study included 288 consecutive patients who received LASIK between July and December 2001 from two eye clinics located in Seoul and Pusan. Factors that were considered to influence post-operative satisfaction included pre-operative baseline characteristics, pre-operative expectation for treatment outcomes, and treatment outcomes. Before undergoing LASIK, study subjects were asked to rate the degree of their expectation for the improvement of visual functions and symptoms after LASIK on a 5-point Likert-type scale: where 1 referred to 'somewhat worse,' 2 to 'no change,' 3 to 'somewhat improved,' 4 to 'improved,' and 5 to 'very improved.' Self-administered questionnaire was used to evaluate baseline visual functions and symptoms on a 5-point scale before LASIK. At 6 months after LASIK, the evaluation was repeated to measure treatment outcomes in terms of the difference in the score before and after LASIK. Post-operative satisfaction was also measured at 6 months on a 5-point scale. Multiple regression analysis was performed to examine the independent relationship between influencing factors and postoperative satisfaction. Results : A total of 171 patients (59.4%) participated in the 6-month follow-up investigation. The average expectation scores for the improvement in visual functions and symptoms were 3.8 and 3.4, respectively. The average score for the 7 questions assessing satisfaction was 4.0. The results of the regression analysis showed that the post-operative satisfaction increased with improvement in the visual function ($\beta$=0.16, p<0.05) and symptoms ($\beta$=0.25, p<0.05), the degree of preoperative refractive error ($\beta$ =0.26-0.67, p<0.05) and in male patients ($\beta$=0.31, p<0.1). The pre-operative expectation was not a statistically significant factor in explaining postoperative satisfaction in the regression model. Conclusion : The finding from this study was that patients with very severe myopia tended to be more satisfied with the treatment than those with mild myopia, which implies that LASIK can be more beneficial to those suffering from a severe visual condition. Patient satisfaction was also significantly affected by the treatment outcomes experienced after LASIK. This suggests that improving the clinical outcome is the most fundamental requirement for the improvement of patient satisfaction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권6호
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• pp.504-508
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• 2004

Surgical process of oral and maxillofacial area as well as dental treatment are stressful situations to the patients. It is well known that serum level of stress hormones including adrenocorticotropic hormone(ACTH) and cortisol increase when the body is exposed to stress. However, there have been few studies on demographic and clinical factors related with stress. Therefore, the purpose of this study was to supply data to cope with stress more comprehensively and efficiently by analyzing the effect of factors related with stress in addition to surgical procedure. Prospective cohort study method was selected. Serum levels of ACTH and cortisol were measured by sampling bloods pre-operatively and post-operatively from 45 patients who had been operated at the Bundang Jesaeng Hospital department of oral and maxillofacial surgery. To evaluate factors associated with stress, patients were classified according to gender, age, method of payment(insurance or self), experiences of operation, kind of operations(expected operations or unexpected operations). Relative risk was calculated to assess relationships between changes of serum level of ACTH and cortisol and factors related with stress, whereas Chi-square analysis was executed to evaluate statistical significance. With regard to serum level of ACTH, relative risk was 1.3 in the group of the patients who were less than 40 years old. With regard to serum level of cortisol, relative risk was 1.8 for women compared with men, 1.4 in the group of the patients who were less than 40 years old and 1.6 in the group of the patients who had not experienced any other operations. In addition to surgical procedure, factors related with stress included gender, age, method of payments, experiences of operation and kind of operations. Therefore, we should provide comprehensive schemes to reduce stress of the patients going through oral and maxillofacial surgery.

• 해양환경안전학회지
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• 제11권2호
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• pp.41-49
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• 2005

해양사고가 발생하게 되면 총론적으로는 해원의 형사책임은 자기부죄의 원칙상 해원이 직접 부담하지 아니할 수 없다. 그러므로 해원의 형사책임에 대한 대책은 형사상의 절차(영장실질심사제도, 구속적부심제도 등)를 최대한 이용하여 자신의 형사책임을 줄이는 방법 밖에는 없을 것이다. 기존법률의 개정을 통해 형벌을 낮추는 것도 하나의 방법이 될 것이다. 각론적으로 벌금 관련한 예로서 현행 해양오염방지법상의 과실로 인한 기름유출사고의 벌금인 3천만원은 유출량에 관계없이 최고액수가 벌금으로 나오는 경향이 있으므로 이를 유출량에 따라 차등화 시키는 것도 고려해볼 가치가 있을 것으로 판단된다. P&I의 벌금납부는 일반의 인식과는 달리 P&I가 법적의무를 부담하거나 P&I납부를 인정하는 경우에만 전보가 가능하다. 이러한 문제를 해결하기 위해서는 새로운 집단적 보험이나 공제제도를 신설하는 것도 하나의 대안이 될 것이다. 또한 해원들은 법률적인 문제에 대하여 전문가가 아니므로 법률적인 문제에 연루되게 되면 변호사 등 법률전문가의 조력을 체계적으로 받을 수 있도록 선주협회나 해기사협회 등에서 대안을 마련할 필요가 있다. (예 농어민무료법률구조지원사업 등). 끝으로 별도의 법률을 제정하든지 그렇지 않으면 기존의 교통사고처리특례법을 개정하여 해양사고부분을 삽입하는 것도 대안일 수 있을 것이다.

• 문화기술의 융합
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• 제3권2호
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• pp.21-30
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• 2017

본 연구는 뇌혈관질환자의 년간 총직접비용에 대하여 조사하였다. 본 연구를 위하여 2012년 한국의료패널 조사자 중 2012년 한 해 동안 뇌혈관질환으로 응급, 입원, 외래서비스를 1건 이상 이용하였다고 응답한 265명을 대상으로 하였다. 뇌혈관질환자 일반사항은 2012년에 한국의료패널 응답자 중 뇌혈관질환으로 응급, 입원, 외래서비스를 이용한 응답자의 비율이다. 연구방법은 응급, 입원, 외래서비스의 평균의료비와 가중평균을 적용하여 직접비용을 산출한 후 년간 총직접비용을 산출하였다. 연구결과는 뇌혈관질환자가 1인당 연 평균 본인부담 의료비 지출액은 약 561,934원이고, 남성은 669,557원, 여성은 448,696원이다. 건강보험 가입자의 경우 뇌혈관질환으로 인한 1인당 본인부담액은 평균 634,459원이고 의료급여 수급자는 160,236원이었다. 뇌혈관질환자가 265명의 연 평균 총직접비용은 약 162,165,690이고, 남성은 193,223,955원, 여성은 129,486,685이다. 건강보험가입자의 경우 뇌혈관질환으로 인한 1인당 총직접비용은 평균 183,095,125원이고 의료급여 수급자는 46,241,705원이었다. 가구소득별로 보면, 가구 소득 3분위에 속한 환자는 672,268원으로 가장 높게 나타났으며, 5분위에 속한 환자는 108,970,650원 으로 뇌혈관질환자의 총직접비용이 가장 낮았다.