• Clinical and Experimental Pediatrics
• /
• v.50 no.1
• /
• pp.1-6
• /
• 2007

In the United States, The concept of designation for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in 1976. The extent of perinatal health care regionalization varies widely from one area to the other. facilities that provide hospital care for newborn are classified into three categories on the basis of functional capabilities; level I-primary or basic care, level II-secondary or specialty care, level III-tertially or subspecialty care. These facilities should be organized within a regionalized system of perinatal care. The transport system of newborn infants should be organized for referral of high risk newborn to centers with the personnel and resources needed for their degree of risk and severity of illness. In Korea, The korean society of neonatology was established and articulated in the 1994. During the past decade, the number of neonatologist has increased and neonatal intensive care units have proliferated in Korea. However, no standard definitions exist for the graded levels of complexity of care that neonatal intensive care units provide and no uniform guideline or recommendation for regionalization and referral system of high risk neonate have been established. With the rapid changing neonatal care system in Korea, the optimal neonatal care demands regionalization of care in utilization of manpower resources and in efficient use of advanced technology and facility.

• Korean Journal of Psychosomatic Medicine
• /
• v.1 no.1
• /
• pp.14-24
• /
• 1993

The author discussed present problems and future prospects of psychosomatic medicine in clinical, educational, research, and social aspects. In general, psychosomatic field. particularly. consultation-liaison(C-L) psychiatry in Korea seems to remain on early developmental phase. However, positive change in the general publics' and societal view of psychiatry, specialization of medicine and development of medical technology, implementation of delivery system in medical care could contribute to development of this field. In future, clinically, liaison activity will be more activated. and this field will be developed as main subspecialty of psychiatry. In addition. C-L psychiatry will be subspecialized. and prevention and humanization of medical care could be more emphasized. In education. the main place of education for medical students and psychiatric residents will be changed from closed ward to general ward in which consultation-liaison activity can be performed. In research. consultation liaison model suitable for Koreans will be developed and studies on disease mechanism will be more promoted. In social aspects, this field could influence the general publics' view of psychiatry and change the whole areas of medicine and society toward integration. In order to achieve these goals, medical insurance system and cost relevant to C-L activity should be essentially improved.

• The Journal of Korean Physical Therapy
• /
• v.29 no.6
• /
• pp.316-323
• /
• 2017

Effort to improve balance ability in the field of rehabilitation has been constantly issued and developed up to now. A variety of subcomponent of postural control including function and cognition should be needed in many body systems and be complicatedly linked to each system. In South Korea, although decreased postural dysfunction due to neurological or musculoskeletal disorders has been well documented, we do not have many experience and knowledge of vestibular rehabilitation for maintain and improve balance function. In the United States, vestibular physical therapy is already acknowledged as clinical subspecialty by American Physical Therapy Association. However, there is no curriculum subject related to vestibular rehabilitation in standard education of physical therapy and no specialist who has clinical experience and knowledge of this realm. Therefore, we reviewed general information and basic knowledge of vestibular rehabilitation such as current state of vestibular disorder in South Korea, pathology, major causes of vestibular dysfunction including peripheral vestibular disorders, vestibular neuritis, benign paroxysmal positional vertigo, and central disorder, evaluation of vestibular dysfunction, and treatment for vestibular dysfunction new approaches. We expect that physical therapist in South Korea recognize clinical significance of vestibular exercise and that clinical concern and research will be begun in near future.

• Archives of Plastic Surgery
• /
• v.50 no.1
• /
• pp.130-140
• /
• 2023

Microsurgery, which deservedly sits on top of the reconstruction ladder, has been a boon to plastic surgery. It is because of this marvelous tool that plastic surgeons the world over have been able to tackle many reconstructive dilemmas, which were once considered to be an improbability. Microsurgery-aided revolutions have rendered a new meaning to all forms of reconstruction-whether it is postoncological, posttraumatic, or postlymphedema reconstruction. As the most advanced reconstructive medium at our disposal that has broadened the horizons of plastic surgery exponentially, it is but obvious that many budding plastic surgeons are drawn toward this subspecialty. In lieu of the aforementioned facts, it is necessary to sensitize all such aspiring surgeons about the various intricacies concerning the field of microsurgery. This article with its focus on the six desirable microsurgical attributes of "Clarity, Curiosity, Perseverance, Passion, An Open Mindset and Action," is meant to be a modest attempt on part of the authors to share their microsurgical insights, procured through their respective journeys, with budding aspirants, hoping to sensitize as well as motivate them for the challenging path that lies ahead.

• Korean Medical Education Review
• /
• v.26 no.1
• /
• pp.41-47
• /
• 2024

The ultimate goal of career guidance is to help medical students develop a career plan that matches their personal characteristics, allows them to train in their desired subspecialty, and helps them to adapt well to medical practice after graduation. Gachon Medical School has designed a longitudinal career guidance program called GLORI (Gachon Longitudinal Orientation and Career Development), which is based on the outcome of each phase. The program consists of regular courses and portfolio-based career guidance from a mentor professor. In phase 2 (basic medical science), the "Career Seminar" course was developed. This course focuses on self-understanding through a psychological inventory, exploration of postgraduate career paths, and interviews with professors in specialties of interest. In phase 3 (the integration of basic and clinical science), the "Exploring Nonclinical Career Options" course was introduced. This course presents perspectives from doctors who have followed various pioneering career trajectories, including biomedical engineering, medical journalism, writing, public health, health care administration, the pharmaceutical and medical device industries, and other areas. All teaching methods were designed to encourage student participation. The assessment methods are assignment-based, including self-reflective reports and presentations. In addition, a portfolio-based career guidance program is implemented in phases 3 and 4 (clinical clerkship). It is expected that this case study will serve as a practical example for developing comprehensive career guidance programs for medical schools.

• Korean Journal of Psychosomatic Medicine
• /
• v.20 no.1
• /
• pp.14-17
• /
• 2012

There were several documents that might reflect the great concern on the education of psychosomatic medicine in medical school from the 1960s. But the hour of class and proportion of psychosomatic medicine have been quite small among the total lecture time of psychiatry. Notwithstanding the importance of biopsychosocial perspective in practice and research there have been no agreement on the goal and content of teaching psychosomatic medicine in the medical school curriculum. Consultation-liaison psychiatric activity in the hospital were currently under-developed and educational content and process were not systematic. We should have established the goal of psychosomatic education in the medical school that includes making doctor who could not only cure disease but also care the ill patients. And we should develop the curriculum that covers essential area of psychosomatic medicine and checking system to monitor the process of education. With the continuance of psychosomatic perspectives from medical school education to clinical subspecialty we can make progress in this field.

• Quality Improvement in Health Care
• /
• v.10 no.2
• /
• pp.204-215
• /
• 2003

Background : ICD-10 Classification, which is used domestically as well as internationally, has limited use in the clinical practice since it is developed for at disease statistics and epidemiology. Therefore, the purposes of this study were to improve the quality of diagnosis by constructing a new disease classification based on the diagnoses doctors currently make in the clinical setting and connecting this classification with OCS and EMR, and to meet the demands of doctors for high quality medical study data in medical research. Methods : The specialists in each ophthalmic subfield collected clinical diagnoses and abbreviations based on the ophthalmology textbooks and confirmed the classifications. Total number of clinical diagnoses collected was totaled 672, for which ideal diagnoses had been selected and a new model of disease classification model in connection with ICD-10 was constructed. The constructed classification of clinical diagnoses consisted of six steps: the first step was the classification by ophthalmic subspecialty field; the second to fifth steps were the detailed classification by each specialty field; the sixth step was the classification by site. Results : After introducing the new disease classification, research on the use and a pre-post comparison was conducted. The result from the research on the use of the clinical diagnoses in inpatient and outpatient care has shown a gradually increasing tendency. From the pre-post comparison of EMR discharge summary diagnoses, the result demonstrated that the diagnosis was stated correctly and in detail. Since the diagnosis was stated correctly, code classification became correct as well, which makes it possible to construct high quality medical DB. Conclusion : This construction of clinical diagnoses provides the medical team with high quality medical information. It is also expected to increase the accuracy and efficiency of service in the department of medical record and department of insurance investigation. In the future, if hospitals wish to construct a classification of clinical diagnosis and a standard proposal of clinical diagnosis is presented by a medical society, the standardization of diagnosis seems to be possible.

• Archives of Plastic Surgery
• /
• v.39 no.3
• /
• pp.238-243
• /
• 2012

Background : The publication rate of presentations at medical international meetings has ranged from 11% to 78% with an average of 45%. To date, there are no studies about the final rate of publications at scientific meetings associated with plastic surgery from Korea. The present authors investigated the publication rate among the presentations at meetings associated with plastic surgery. Methods : The titles and authors of the abstracts from oral and poster presentations were collected from the program books of the Congress of the Korean Society of Plastic and Reconstructive Surgeons (CKSPRS) for 2005 to 2007 (58th-63rd). All of the abstracts presented were searched for using PubMed, KoreaMed, KMbase, and Google Scholar. The titles, key words from the titles, and the authors' names were then entered in database programs. The parameters reviewed included the publication rate, type of presentation including running time, affiliation, subspecialty, time to publication, and publication journal. Results : A total of 1,176 abstracts presented at the CKSPRS from 2005 to 2007 were evaluated. 38.7% of the abstracts, of which oral presentations accounted for 41.0% and poster presentations 34.8%, were published as full papers. The mean time to publication was 15.04 months. Among journals of publication, the Journal of the Korean Society of Plastic and Reconstructive Surgeons was most used. Conclusions : Brilliant ideas and innovative approaches are being discussed at CKSPRS. The 38.7% publication rate found from this research appeared a bit lower than the average rate of medical meetings. If these valuable presentations are not available as full papers, the research would be a waste of time and effort.

• Archives of Plastic Surgery
• /
• v.49 no.2
• /
• pp.207-214
• /
• 2022

Background Fellowship training is becoming more popular in plastic surgery, with over half of residents pursuing advanced training. Here, we investigate how clinical and research fellowship training impacts career trajectory and scholastic achievement in academic plastic surgery. Methods Plastic surgery faculty members, from programs recognized by the American Council of Academic Plastic Surgeons, were identified using institutional Web sites. Data extracted included faculty demographics, training history, academic positions, and research productivity. Continuous and categorical variables were compared using t-tests and chi-square, respectively. Results In total, 949 faculty members were included, with 657 (69%) having completed fellowship training. Integrated program residents were more likely to complete a fellowship when compared with independent residents (p < 0.0001). Fellowship trained faculty were more likely to have graduated from a higher ranked residency program, in terms of both overall and research reputation (p = 0.005 and p = 0.016, respectively). When controlling for years in practice, there was no difference found in number of publications, Hirsch index (h-index), or National Institutes of Health funding between faculty between the two cohorts (p > 0.05). In a subanalysis comparing hand, craniofacial, microsurgery, and research fellowships, those who completed a research fellowship had higher h-indices and were more likely to reach full professor status (p < 0.001 and p = 0.001, respectively). Fellowship training had no effect on being promoted to Chief/Chair of departments (p = 0.16). Conclusion Fellowship training is common among academic plastic surgeons. In this study, both clinical and research fellowships were associated with various aspects of academic success. However, fellowship training alone did not affect attainment of leadership positions.

• Korea Journal of Hospital Management
• /
• v.28 no.2
• /
• pp.44-65
• /
• 2023

Purposes: As super-aging population and low fertility rates are threatening the sustainability of the National Health Insurance funds, enhancing the efficiency of hospital management is paramount. In the past, studies analyzing the efficiencies of hospitals primarily made inter-hospital comparisons, but it is important to assess hospitals' internal efficiency and develop improvement measures in order to attain practical improvements in hospital efficiencies. The purpose of this study is to analyze the efficiencies of specialists by medical specialty in a hospital in order to provide foundational data for efficient hospital management. Methodology/Approach: We used the activity-based costing (ABC) data and hospital statistical data from one tertiary hospital in Seoul to analyze the efficiency of specialists by medical specialty. Efficiency was analyzed and compared among specialists using the data envelopment analysis developed by Charnes, Cooper, and Rhodes (DEA-CCR) model and the slacks-based measure (SBM) models. The input variables were labor cost, material cost, and operational expenses, and the output variables were the number of outpatients, number of inpatients, outpatient revenue, and inpatient revenue. Findings: First, there was a marked deviation in efficiency across specialists. Second, there was a marked deviation in efficiency across medical specialties. Third, there was little difference in efficiency according to the specialist's sex, age, and job position. Fourth, the SBM model produced more conservative results and better explained efficiency parameters than the CCR model. Practical Implications: The efficiency of a specialist was more influenced by their medical specialty than their personal characteristics, namely sex, age, and job position. Therefore, Further research is needed to analyze the efficiencies of each subspecialty and identify factors that contribute to the variations in efficiencies across medical specialties, such as clinical practices and fee structures.