• 의학교육논단
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• 제14권1호
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• pp.37-49
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• 2012

The main purpose of this study is to examine the improvement and discourse of the medical education system in Korea since 1990. In particular, this study, focusing on the graduate medical education system initiated in 2002, has explored the discussions that led to the system's establishment and what the context of those discussions. To meet this objective, this study analyzed research report related to the medical education system authored by members of the government and medical community, suggestions to the government, discussion materials, and data with regard to the Medical (Dental) Education Eligibility Test. The improvement of the medical education system in Korea has been an important issue in education reform by the expansion of the number of years of higher education, the requirements for increased levels of professional knowledge by improving public educational standards, and the basic formation policy of higher education consisting of graduate school, special graduate school, and professional graduate school. Nevertheless, the views of the government and the medical community on improving medical education system have made an obvious difference. This was due to different aims about how to improve the medical education system and different perception of the degree and medical education system. The medical community at least tended to prefer the status of academic positions over professional positions. The policy of medical education for people with a bachelor's degree which was introduced in 2002 spread to many colleges of medicine based on the government's administrative and financial support policy. Even so, the absence of accompanying policy by the relevant government agencies and department of education, which could have ensured the success of the system, has led to continued debate. In conclusion, without a consistent and persistent government policy, the graduate medical education system has led to confusion in many medical institutions. Above all, an evidence-based policy decision and policy approach based on a long-term perspective are necessary in order to improve the medical education system.

• 한국융합학회논문지
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• 제11권9호
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• pp.333-340
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• 2020

본 연구의 목적은 의료서비스의 불만을 해결하고 서비스 품질을 향상시키기 위하여 도입된 의료서비스디자인이 의료내적, 외적요소에서 발생하는 의료권위주의의 해소에 기여한 점은 무엇인지 알아보고 의료서비스산업을 더욱 발전시키기 위해 필요한 시사점을 도출하는 것이다. 연구의 방법은 첫 번째로 문헌연구를 통하여 의료권위주의의 개념을 고찰하고 의료권위주의가 나타나는 의료내적요소와 외적요소의 구성요인에 대하여 살펴보았다. 두 번째로 의료내적요소와 외적요소에 내재되어 있는 의료권위주의를 해소한 국내외 의료서비스디자인의 사례를 조사하여 핵심 결과를 중심으로 문제해결의 핵심 포인트와 의의를 분석하였다. 세 번째로 사례분석을 통하여 환자에 대한 존중과 존엄성을 세울 수 있는 환자중심의료문화의 형성, 의료권위주의 해체를 위한 의료진 내부의 인습타파, 의료정보공유를 위한 공정한 소통시스템의 구축을 시사점으로 도출하였다.

• 한국중재학회지:중재연구
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• 제26권4호
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• pp.129-149
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• 2016

Medical dispute means the dispute between the hospital and the patient due to a medical accident. In general, medical accidents must be in accordance with the terms that are used in the medical dispute adjustment method stated in Article 2 (definition). In relation to this, there is a need to discuss an efficient operation scheme for Alternative Dispute Resolution (ADR) in medical disputes. In addition, it is necessary to look at issues of civil liability and criminal liability. In particular, in the consumer dispute arbitration committee, there is a case to make a "decision not to adjust" in aggressive intervention in the process of conflict resolution. The medical staff, on the basis of its "decision," can use this as a proven material for civil and criminal cases. This is rather upon the determination of the consumer council as a typical side effect to defend the user's perspective. This is the "decision" as was expressed from an order, "not adjusted." It is also determined to be easy and clearly timely. In the medical litigation, it is requesting the burden of proof of a patient's cause-and-effect relationship with the doctors committing negligence and medical malpractice. This seems to require the promotion of legislation in the direction to reduce future cases. It is determined that the burden of proof of medical accidents must be improved. The institution receiving the medical accident should prevent a closure report. Further, it is necessary to limit the transition to a franchise point. In this paper, we understand the problems of the current medical dispute resolution system, trying to establish a medical dispute resolution system desirable through an efficient alternative. In addition, it wants help in the protection and realization in medical consumers' and patients' rights. The relevant authorities will take advantage of these measures. After all, this could contribute to the system for a smooth resolution of a medical dispute.

• 한국응급구조학회지
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• 제4권1호
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• pp.63-71
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• 2000

Exceptive clause of ambulance stated in Road Traffic Laws of ambulance car accidents is not properly applied and emergency staffs who transfer over 85% of emergency cases are to be forced to start out to the emergency field with unstable conditions which they may be punished on the criminal and civil laws. Hereby this study makes the following suggestions to activate the duties of transferring emergency cases by emergency staffs, promote their morale and diminish the victim of emergency staffs due to traffic accidents. 1) It is prescribed that ambulance car drivers should be protected legally by applying the exceptive clauses thoroughly regulated in special case clauses because ambulance cars are used for the purpose of saving the human life. 2) On the traffic accidents occurred during the transfer of emergency cases, the special insurance system is created for treating the ambulance car accidents, not to bind the emergency staff's mistake to traffic law and the victims are compensated by the nation on the basis of insurance system and emergency staffs have the systematic security. 3) On the road over six lanes, emergency lane is set on the center and ambulance car should be used as the exclusive lane. 4) Ambulance car drivers must have the habit of transferring emergency cases rapidly within the range of legal operation.

• 한국지능정보시스템학회:학술대회논문집
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• 한국지능정보시스템학회 2001년도 The Pacific Aisan Confrence On Intelligent Systems 2001
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• pp.343-351
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• 2001

World practice is evidence of that computer systems of an intellectual support of medical activities bound up with examination of patients, their diagnosis, therapy and so on are the most effective means for attainment of a high level of physician\`s qualification. Such systems must contain large knowledge bases consistent with the modern level of science and practice. To from large knowledge bases for such systems it is necessary to have a medical ontology model reflecting contemporary notions of medicine. This paper presents a description of an observation ontology, knowledge base for the physician of general tipe, architecture, functions and implementation of problem independent shell of the system for intellectual supporting patient examination and mathematical model of the dialog. The system can be used by the following specialist: therapeutist, surgeon, gynecologist, urologist, otolaryngologist, ophthalmologist, endocrinologist, neuropathologist and immunologist. The system supports a high level of examination of patients, delivers doctors from routine work upon filling in case records and also automatically forms a computer archives of case records. The archives can be used for any statistical data processing, for producing accounts and also for debugging of knowledge bases of expert systems. Besides that, the system can be used for rise of medical education level of students, doctors in internship, staff physicians and postgraduate students.

• 한방재활의학과학회지
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• 제28권1호
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• pp.97-107
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• 2018

Objectives This is one of the manuals of East-West integrative medicine which was created by the committee on integrative medicine of Chung-Yeon Korean Medicine Hospital. The purpose of this manual is to support clinical decision-making and communication between Korean and western medical staff in a Korean medicine hospital during the rehabilitation of patients after knee surgery. Methods The draft was made by two rehabilitation specialists in Korean medicine. After a rehabilitation specialist in western medicine reviewed the draft and exchanged their ideas, a revised version that reflects the goal of consultation was made. Then the committee agreed to adopt the manuals through the process of review and feedback in addition to face-to-face discussions. Results This manual describes clinical decision-making for rehabilitation after arthroscopic partial meniscus resection, meniscus refixation, reconstruction of anterior and posterior cruciate ligaments. Therefore, it contains the schedule of rehabilitation treatment by the surgical technique, general goal of the rehabilitation by phase, guide for patients and postoperative infection management. Conclusions Despite some limitations, this manual has significance as the first example of a decision-making protocol suggestion for East-West integrative rehabilitation treatment after a knee surgery in one medical institution.

• 보건행정학회지
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• 제11권1호
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• pp.62-86
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• 2001

This study purports to Investigate the determinant of job satisfaction and the organizational commitment of medical insurance review nurses working at Korean hospitals. The independent variables contain three groups of determinants: organizational characteristics variables(job autonomy, work unit control, role variety, role ambiguity, role conflict, workload, resource inadequacy, coworker support, supervisor support, distributive justice, promotional chances, job security, and job hazard), environmental variables(job opportunity, spouse support, and parent support), and psychological variables (met expectation, work involvement, positive affectivity, and negative affectivity). The sample used in this study consisted of 445 medical insurance review nurses from 89 hospitals nationwide. Data were collected with self-administered questionnaires and analyzed using multiple regression analysis. The results of the study are as follows : 1) the following variables, listed in order of size, have significant effects on job satisfaction : role ambiguity(－), distributive justice(＋), work involvement(＋), role variety(＋), met expectation(＋), negative affectivity(－), job autonomy(＋), and positive affectivity(＋). 2) the following variables, listed in order of size, have significant effects on organizational commitment: met expectation(＋), work involvement(.＋), distributive justice(＋), job security(＋), role variety(＋), positive affectivity(＋), negative affectivity(－), resource inadequacy(＋), and tenure(－). 3) the variance of job satisfaction and organizational commitment explained by the variables used in the study are 30.0% and 39.1% respectively. 4) In comparison to the results of other studies on the determinants of job satisfaction and organizational commitment of clinical nursing staff working at hospitals, the results of this study indicate that three variables of distributive justice, work involvement, and role variety are especially important for improving the level of job satisfaction and organizational commitment of medical insurance review nurses.

• 간호행정학회지
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• 제17권3호
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• pp.327-335
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• 2011

Purpose: The objective of this study was to analyze the effects of medical staffing level as bed-to-medical staff ratio on patient outcomes as length of stay (LOS) among hospitals in Korea. Methods: Two hundred and fifty one hospitals participated in the study between January and March 2008. Data for the study was requested by an electronic data interchange from the Health Insurance Review Agency in 2008. In data analysis, SPSS WIN 15.0 program was utilized for descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: The mean score for length of stay was 13.6 days. The mean of operating bed-to-nurse ratio was 7.93:1. The predicting factors for LOS were bed-to-nurse's aide ratio, bed-to doctor's ratio, severely ill patient rate, and hospital type. These factors explained 28.9% of the variance in patient outcomes. Conclusion: This study results indicate that the relationship between medical staffing level and patient outcomes is important in the improvement of the quality of patient care. Thus, improvements in the quality of the nurse practice environment could improve patient outcomes for hospitalized patients.

• Child Health Nursing Research
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• 제14권1호
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• pp.5-13
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• 2008

Purpose: This study was done to describe utilization status of emergency medical service for children at one university affiliated hospital located in Seoul. Data were obtained from the medical records of patients under 13 years of age who visited the ER from January 1 to December 31, 2006. Method: Medical records missing the time of discharge were excluded in the analysis of waiting time, which resulted in 19,766 cases. Data were analyzed using SPSS WIN 14.0 version. Result: There were slightly more boys (58.4%), average age of the children was 3.97 years of age. More children at the aged 1 to 3 years (51.3%) visited the ER. Fever was the most frequent complaint: 5,180 cases (24.38%). The other complaints were head or facial laceration (10.55%), vomiting (9.63%), abdominal pain (8.06%), cough (7.67%), and painful limb swelling (6.34%). Average waiting time before the first medical examination was 17 minutes, and average ER stay time was 3 hours and 23 minutes. Conclusion: The results suggest the need to assign a nurse specialist for pediatric ER to provide more efficient care for the children. Also, extra staff assignment during the evening shift or extending office hours of local pediatricians should be considered.

• 보건교육건강증진학회지
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• 제14권1호
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• pp.1-9
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• 1997

The health education in hospitals has many problems including lack of the division specialized in health education, lack of implementation system of health education, insufficient professional health education and insufficient health education materials. Despite these restraints, hospitals should reinforce health education program as a part of active response centered on disease prevention and health promotion targeting healthy people who have potential health risk before the onset of disease, rather than passive approach emphasizing the treatment. Accordingly, health education team should be organized in a hospital, in which health educators can provide the following education services. First of all, hospitals themselves should provide active community services in collaboration with community organizations. In addition, multi-disciplinary approach in cooperation with schools, work places should be reinforced to establish the comprehensive health education system. The establishment of medical service referral system with other medical institutions and the linkage system for medical information exchange are also needed. The utilization of education materials obtained through these system should be open to community residents as well as patients. Finally, medical staff working in hospitals should try to provide the high-quality health education that is as high as the level of medical services. The high-quality health education is possible when its level is based on one required by community residents and the county rather than the international or arbitrary standard.