• Title/Summary/Keyword: 의료 서비스의 질

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Different Abortion Approaches in Europe and Women's Health: Implications for Korean Abortion Debates (유럽 각국의 낙태 접근과 여성건강 - 한국 낙태논쟁에 대한 함의 -)

  • Chung, Jin-Joo
    • Issues in Feminism
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    • v.10 no.1
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    • pp.123-158
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    • 2010
  • For the last several months, abortion debates have sparkled in Korea. The government has escalated the need of active punishment of illegal abortions to solve low fertility problems, while some obstetricians and gynecologist have proclaimed stoppage of illegal abortions suing colleague doctors who has conducted illegal abortions. Women's rights groups and researchers have also responded to the abortion debate claiming that women's decisions over their pregnancy are important in making of abortion policies. To contribute to Korean abortion debates, his paper aims to analyze European experiences of abortion polices in relation to the consequences on women's health. For the analysis of European abortion experiences, three countries - Ireland, U.K, and Netherland -are chosen. These three countries are selected since their legal and social acceptance of abortion and the level of safe abortion system are different. Each country is reviewed by national abortion policy, legal regulation, medical system and the role of civil society. The analysis shows several implications for abortion debates occurring in Korea. Various systematic policy mechanisms - abortion on women' request, abortions without complicated doctor's referrals, transparent and anonymous counseling and information provision regarding abortion, training and education for medical professionals to guarantee high quality abortion, abortions funded publicly for women to improve their access to abortions, steady monitoring and auditing abortion procedures and outcomes for safe abortion and so on - are required in Korean society. Two track procedures - safe abortion on women's request and prevention of unwanted pregnancy - are needed for reproduction of healthy women and society.

Primary Adenosquamous Carcinoma of the Stomach (위에서 발생한 선-편평세포암종)

  • Cho, Yong-Kwon;An, Ji-Yeong;Hong, Seong-Kweon;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.31-35
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    • 2006
  • Purpose: A primary adenosquamous carcinoma of the stomach is relatively rare, accounting for only about 0.5% of all gastric cancers. However, its histopathologic characteristics are still unclear, and the most appropriate form of therapy has not been established yet. Materials and Methods: We retrospectively reviewed the clinicopathologic features of 8 patients with pathologically confirmed primary adenosquamous carcinomas out of 8,268 patients who underwent gastric cancer surgery at Samsung Medical Center between September 1994 and December 2004. Results: The median age of the 8 patients was 49 ($41{\sim}69$) years, and the male : female ratio was 5 : 3. In 3 patients, the tumor was located at the mid body of the stomach, and in 5 patients, at the lower body or antrum. The tumor sizes were $2.5{\sim}8cm$. Seven patients showed metastases to the regional lymph nodes. The UICC stage distribution were: 5 stage II, 2 stage III, and 1 stage IV. In the stage IV patient, a palliative gastrojejunostomy was performed, and he died 5 months after surgery. Of the 7 patients who underwent a radical gastrectomy and adjuvant chemotheratpy, the median survival was 34 ($12{\sim}66$) months, 2 patients died of cancer recurrence, and 4 patients are being followed up without evidence of recurrence. Conclusion: As for an adenocarcinoma of the stomach, a radical gastrectomy including regional lymph node dissection and postoperative adjuvant therapy should be performed for appropriate treatment of an adenosquamous carcinoma of the stomach.

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Constructing a Conceptual Framework of Smart Ageing Bridging Sustainability and Demographic Transformation (인구감소 시대와 초고령 사회의 지속가능한 삶으로서 스마트 에이징의 개념과 모형에 관한 탐색적 연구)

  • Hyunjeong Lee;JungHo Park
    • Land and Housing Review
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    • v.14 no.4
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    • pp.1-16
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    • 2023
  • As population ageing and shrinking accompanied by dramatically expanded individual life expectancy and declining fertility rate is a global phenomenon, ageing becomes its broader perspective of ageing well embedded into sustained health and well-being, and also the fourth industrial revolution speeds up a more robust and inclusive view of smart ageing. While the latest paradigm of SA has gained considerable attention in the midst of sharply surging demand for health and social services and rapidly declining labor force, the definition has been widely and constantly discussed. This research is to constitute a conceptual framework of smart ageing (SA) from systematic literature review and the use of a series of secondary data and Geographical Information Systems(GIS), and to explore its components. The findings indicate that SA is considered to be an innovative approach to ensuring quality of life and protecting dignity, and identifies its constituents. Indeed, the construct of SA elaborates the multidimensional nature of independent living, encompassing three spheres - Aging in Place (AP), Well Aging (WA), and Active Ageing (AA). AP aims at maintaining independence and autonomy, entails safety, comfort, familiarity and emotional attachment, and it values social supports and services. WA assures physical, psycho-social and economic domains of well-being, and it concerns subjective happiness. AA focuses on both social engagement and economic participation. Moreover, the three constructs of SA are underpinned by specific elements (right to housing, income adequacy, health security, social care, and civic engagement) which are interrelated and interconnected.

The Medical Doctors' Opinion of Public Health Center on the Development and Supply of Medical Doctor for Public Health Sector (공공보건분야 의사 인력 양성과 개발에 대한 보건소 근무 의사들의 인식)

  • Lee, Kyeong-Soo;Lee, Jung-Jeung;Kim, Jin-Sam;Hwang, Tae-Yoon;Son, Hyo-Kyung;Kim, Chun-Bae
    • Journal of agricultural medicine and community health
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    • v.34 no.3
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    • pp.303-315
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    • 2009
  • Objectives: This study, as for activating measures for capable medical physicians to penetrate into the public health sector, is to provide a basic informations which are used for the enlargement of human resources of physicians in the public health sector, by investigating the perception of physicians, who are now working in the public health center, on the training and development of physicians in the public health sector. Methods: The subjects of this study were 126 individuals. The data was analyzed by frequency analysis using SPSS ver. 17.0K. Results: According to the investigation of 'how to support physicians in public health sector', the necessity of almost questions is considered to be important. Especially, regarding to investigation on 'obstacles of physicians' entrance to public health sector', 'relatively low salary' and 'lack of promotion chances' were thought to be considerable. The most significant education programs to work for public health sector is to improve the ability of health administration planning and service performance. Conclusions: The important methods to reinforce and easily obtain the human resources of physicians in public health sector are not only to improve the penetration of physicians to public health sector, but also to enhance the ability of present physicians, even though sufficient recruitment of physicians is essential.

Using CR System at the Department of Radiation Oncology PACS Evaluation (방사선 종양학과에서 CR System을 이용한 PACS 유용성 평가)

  • Hong, Seung-Il;Kim, Young-Jae
    • Journal of the Korean Society of Radiology
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    • v.6 no.2
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    • pp.143-149
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    • 2012
  • Today each hospital is trend that change rapidly by up to date, digitization and introducing newest medical treatment equipment. So, we introduce new CR system and supplement film system's shortcoming and PACS, EMR, RTP system's network that is using in hospital harmoniously and accomplish quality improvement of medical treatment and service elevation about business efficiency enlargement and patient Accordingly, we wish to introduce our case that integrate reflex that happen with radiation oncology here upon to PACS using CR system and estimate the availability. We measured that is Gantry, Collimator Star Shot, Light vs. Radiation, HDR QA(Dwell position accuracy) with Medical LINAC(MEVATRON-MX) Then, PACS was implemented on the digital images on the monitor that can be confirmed through the QA. Also, for cooperation with OCS system that is using from present source and impose code that need in treatment in each treatment, did so that Order that connect to network, input to CR may appear, did so that can solve support data mistake (active Pinacle's case supports DICOM3 file from present source but PACS does not support DICOM3 files.) of Pinacle and PACS that is Planning System and look at Planning premier in PACS. All image and data constructed integration to PACS as can refer and conduct premier in Hospital anywhere using CR system. Use Dosimetry IP in Filmless environment and QA's trial such as Light/Radition field size correspondence, gantry rotation axis' accuracy, collimator rotation axis' accuracy, brachy therapy's Dwell position check is available. Business efficiency by decrease and so on of unnecessary human strength consumption was augmented accordingly with session shortening as that integrate premier that is neted with radiation oncology using CR system to PACS. and for the future patient information security is essential.

Levels of Physicians' Self-assessment of Life Satisfaction and Associated Factors (임상의사의 삶의 만족도 자가평가 수준과 관련 요인)

  • Jong Sun Ok;Hyeongsu Kim
    • Journal of agricultural medicine and community health
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    • v.48 no.1
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    • pp.28-40
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    • 2023
  • Objectives: This study aimed to identify the level of self-assessment of life satisfaction and various factors related to the life satisfaction of Korean physicians. Methods: This study is a secondary data analysis using the 2016 Korean physician survey Korean Physician Survey(KPS) data collected by the Research Institute for Healthcare Policy of the Korean Medical Association. The member database(DB) of the Korean Medical Association was used for sampling and the target population was formed and surveyed by using stratified quota sampling. A questionnaire was sent by E-mail as an online survey method and was conducted for a total of 7 weeks from November 21, 2016 to January 8, 2017. The final number of respondents was 8,564 (response rate 13.8%). In this study, a total of 7,228 physicians, excluding residents and public health doctors who are currently treating patients directly, were studied. Factors affecting the life satisfaction of physicians were analyzed using ordinal logistic regression analysis. Results: The physical factors positively related to the life satisfaction of physicians were those who were in their 60s, female, and thought they had good health status. As for psychological factors, stress was low. As for economic factors, satisfaction with income was high. As for social factors, the physicians lived with their families and were satisfied with the time they could spend with them. Also, the physicians were satisfied with the social respect they received as a doctors. Conclusions: Based on the results of this study, it is thought that a multifaceted approach is needed to increase the life satisfaction of physicians.

The Demand for Home Nursing Care of Hospital Inpatients in Brain-Spine and Musculoskeletal Diseases (종합병원의 뇌.척수.근골격계 입원환자의 가정간호요구)

  • Kim, Sang-Soon;Kim, Gui-Jae
    • Journal of Home Health Care Nursing
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    • v.1
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    • pp.57-70
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    • 1993
  • This study was carried out to investigate agreement, content and demand for home nursing care of hospital inpatients in brain, spain and musculoskeletal diseases .The data was collected by interviewing with 242 patients who were hospitalized in university hospital on Taegu, from September 6,60 October 9, 1993. Of 242 patients, 66.1% agreed to home nusing care system and rate of agreement was highest between 30 years to 49 years of age as 75.5%, in middle urban area residents as 75.9% and was lowest in medicaid as 40.0% in general chareacteristics. The rate of agreement according to type of diagnosis was highest inpatients with spinal diseases as 75.6% according to functional status was the highest in patients who had daily living activity freely as 69.4% according to prognosis in patients at terminal stage as 80.0% and the rate of agreement to home nursing care of patients who wanted early discharege was 73.9%. The first-ranking reasom of agreement to home nursing care was asking for continuous relationship with doctor as 37.3% and there was statistically significant difference in reasons of agreement to home nursing care according to functional status of patients. The first-ranking reason of eary discharge among patients who wanted early discharge(74.8%) was because of long time stay in hospital. Among 23 items of nursing activity that patient wanted, the first-ranking item was recovery promotion, prevention of complication, education and counseling for health as 76.4%, drug management was 2nd-ranking item as 62.1% and the third was regular checking of vital signs as 55.9%. The lowest item of demand for home unring care was hospice care(3.9%) and airway keep(9.1%).

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Cost Analysis of Home Nursing Care Patients in Rural Hospital (농촌 지역 중소병원의 가정간호사업소 등록환자의 방문비용분석)

  • Kim, Jin-Soon;Kum, Ran;HwangBo, Soo-Ja
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.91-101
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    • 1999
  • The home nursing care system is an integral part of the health care delivery system in order to meet the various needs of consummer, in particular, early discharge patient from the hospital, patient with long term care needed and the elderly. To find out the cost of home nursing care services, the home nursing care records of patients registered by home nursing care units established in public hospital with 150beds during the period of 1996 - 1997 were analyzed. The subjects were 102patients, 45 of male patients and 57 of female patients, those who live in a rural area in Kymiggi - Do The results obtained are as follows : 1. The male patients accounted for 44.1% of the total, with 45cases : group aged 60 years and more was the largest group, accounting for 79.5%. 2. The most frequent disease revealed was the osteoporosis which constitute 35.3% of the total registered patients, followed, in order, by malignant tumor, cerebrovascular disease. 3. It revealed that the cost per visit for the male was 47,764won ; the female, 46,078 won per visit. Noteworthy the cost per visit was high in the older patient. It was clearly that the gender, years of age and the cost per visit were statistically significant at 0.01 level and 0.05 level. 4. The cost per visit for the non complicated disease was slightly higher than the complicated disease, but it is not statistically significant, the cost per visit by type of disease varied, the cost per visit for COPD was the highest, followed, in order, by in malignant tumor, cancer, diabetes, osteoporosis etc. 5. It revealed that home nursing care cost for a eligible disease for home nursing care was less than the cost for hospitalization of the same disease, therefore, we expect that the home nursing care is cost efficiency. In conclusion, the home nursing care costs are needed to analyze further in comparison with the hospitalization costs for a certain disease.

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Study on the channel of bipolar plate for PEM fuel cell (고분자 전해질 연료전지용 바이폴라 플레이트의 유로 연구)

  • Ahn Bum Jong;Ko Jae-Churl;Jo Young-Do
    • Journal of the Korean Institute of Gas
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    • v.8 no.2 s.23
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    • pp.15-27
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    • 2004
  • The purpose of this paper is to improve the performance of Polymer electrolyte fuel cell(PEMFC) by studying the channel dimension of bipolar plates using commercial CFD program 'Fluent'. Simulations are done ranging from 0.5 to 3.0mm for different size in order to find the channel size which shoves the highst hydrogen consumption. The results showed that the smaller channel width, land width, channel depth, the higher hydrogen consumption in anode. When channel width is increased, the pressure drop in channel is decreased because total channel length Is decreased, and when land width is increased, the net hydrogen consumption is decreased because hydrogen is diffused under the land width. It is also found that the influence of hydrogen consumption is larger at different channel width than it at different land width. The change of hydrogen consumption with different channel depth isn't as large as it with different channel width, but channel depth has to be small as can as it does because it has influence on the volume of bipolar plates. however the hydrogen utilization among the channel sizes more than 1.0mm which can be machined in reality is the most at channel width 1.0, land width 1.0, channel depth 0.5mm and considered as optimum channel size. The fuel cell combined with 2cm${\times}$2cm diagonal or serpentine type flow field and MEA(Membrane Electrode Assembly) is tested using 100W PEMFC test station to confirm that the channel size studied in simulation. The results showed that diagonal and serpentine flow field have similarly high OCV and current density of diagonal (low field is higher($2-40mA/m^2$) than that of serpentine flow field under 0.6 voltage, but the current density of serpentine type has higher performance($5-10mA/m^2$) than that of diagonal flow field under 0.7-0.8 voltage.

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Toothbrushing Behavior and Oral Health State of Immigrant Workers (외국인 이주노동자의 칫솔질행태와 구강건강상태)

  • Nam, In-Suk;Yoon, Sung-Uk;Kim, Jung Sook
    • Journal of dental hygiene science
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    • v.15 no.1
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    • pp.1-11
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    • 2015
  • This study analyzed the tooth brushing behavior and oral health status of foreigner immigrant workers and obtained the following results. Statistical significance based on different general characteristics. Gender, educational background, period of stay, health insurance, medical expense coverage, and whether or not one has friends or regular gatherings were significant traits for frequency, while age, marital status, income, and health insurance were traits for part (p<0.05). Statistical significance (p<0.05) was found in marital status and health insurance for time used to brush teeth, period of stay and whether or not one attends a regular gathering for tooth brushing training, and gender, educational background, period of stay, roommate status, medical expense coverage, and whether or not one attends a regular gathering for supplemental oral product usage. The averages of decayed, missing, and filled teeth (DMFT) index and community periodontal index of treatment needs (CPITN) for general characteristics were 6.98 and 3.03 respectively, and gender, roommate status, income, health insurance for DMFT index, and gender, age, marital status, educational background, roommate status, income, health insurance for CPITN were statistically significant (p<0.05). Tooth brushing frequency and part showed statistical significance (p<0.05) for DMFT index based on tooth brushing behavior, while tooth brushing part and time used to brush teeth were significant for CPITN. DMFT index was high at 8.34 for '3 times or more' in tooth brushing frequency, while DMFT index was high at 7.91 and CPITN was low at 2.94 for tooth brushing part. '3 minutes or longer' in time used to brush teeth was the lowest in CPITN at 2.88. As a result of analyzing the correlation between tooth brushing behavior and DMFT index, CPITN, tooth brushing frequency and part in DMFT index, and tooth brushing part and time used to brush teeth in CPITN showed significance (p<0.05). Based on the above results, we must promote the significance of brushing teeth and implement continuous training for correct tooth brushing management to enhance the oral health of foreign immigrant workers.