• Korea Journal of Hospital Management
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• v.6 no.1
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• pp.147-163
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• 2001

The purpose of this study was to find out the restructuring strategy for five provincial hospitals through the business analysis and survey of the service area. Through the survey of the service area of 5 hospitals. service area was classified into three groups, such as underserved area, adequate area, and overserved area. The strategy for the restructuring the clinical departments was set up based on the result of the business analysis and characteristics of the service area. The result of the study was as follows; 1) Whether or not a provincial hospital has specialized in specific area according to the circumstances and the needs of the community was the major factor influencing on the operating result of the hospital. 2) Provincial hospitals at the underserved area has to invest according to the changes of the occupancy rate and increasing pattern of the number of patients while maintaining the status as a general hospital. 3) Provincial hospitals at the adequate area has to lower the grade from the general hospital down to the hospital first and has to upgrade the competency through the restructuring the clinical departments and investment in specific area. 4) Provincial hospitals at the overserved area has to lower the grade from the general hospital down to the hospital first and has to seek ways to change the hospital fundamentally into geriatric hospital, pneumoconiosis hospital or psychiatric hospital etc. Provincial hospitals incapable to compete with private hospitals and clinics has to lower the grade from the general hospital down to the hospital first, to specialize in specific area and to restructure some clinical departments into rental base or self-operating basis. In case such methods are judged not so good solution, provincial hospitals has to find out ways such as shut-down of several departments or operating under the attending system.

• Journal of Preventive Medicine and Public Health
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• v.26 no.4 s.44
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• pp.661-671
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• 1993

In order to compare the geographical distribution of physician by level of medical care and specialty, a log linear model was applied to the annual registration data of the Korean Medical Association as of the end of December, 1991 which was supplemented from related institutions and adjusted with relevant sources. Those physicians in primary and secondary care institutions were not statistically significantly unevenly distributed by province-level catchment area. There were some differences in physician distribution among big cities, medium and small-sized cities, and counties; however, those physicians for primary care level were equitably distributed between cities and counties. Specialties for secondary care physicians were less evenly distributed in county areas than in city areas, and generalists are distributed more evenly in cities and counties than in big cities. There is a certain limitation due to underregistration in the annual physician registration to the Korean Medical Association; however, the geographical distribution of physicians has been improved quantitatively. It is strongly suggested that specialties and the level of medical care should be considered for further physician manpower studies.

• Health Policy and Management
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• v.34 no.2
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• pp.211-221
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• 2024

Background: The public health crisis caused by coronavirus disease 2019 emphasizes the need to expand and strengthen public hospitals. However, the overall perception of public hospitals remains negative. This negative perception can hinder the roles and functions of public hospitals, so this study aims to analyze the factors affecting negative perceptions of public hospitals. Methods: We used data from a survey on the public healthcare of Chungcheongbuk-do residents conducted by the Chungcheongbuk-do Public Health Policy Institute, and 1,916 adults aged 19 or older who responded to the survey were included in the study. Logistic regression analysis was used to analyze the impact of experiences with public hospitals use and evaluations of public healthcare and public hospital policies on the negative perception of public hospitals. Results: The experience of not using public hospitals (adjusted odds ratio [aOR], 1.69; 95% confidence interval [CI], 1.04-2.74) and negative evaluations of public healthcare and public hospital policies were found to significantly impact negative perceptions of public hospitals. In public healthcare policies, negative evaluations of the provision of essential medical care (aOR, 4.14; 95% CI, 2.59-6.62), regional disparities (aOR, 1.59; 95% CI, 1.02-2.49), coverage (aOR, 1.99; 95% CI, 1.25-3.16), and quality of care (aOR, 2.39; 95% CI, 1.50-3.80) were significantly associated with negative perceptions of public hospitals. In public hospital policies, negative evaluations of facilities and equipment (aOR, 3.74, 95% CI, 2.36-5.94), medical specialties and services (aOR, 1.91; 95% CI, 1.21-3.01), and quality of medical service (aOR, 2.71; 95% CI, 1.72-4.25) were also significantly associated with negative perceptions of public hospitals. Conclusion: This study emphasizes the need to improve perceptions of public hospitals by considering the experience with public hospitals use and evaluation of public healthcare and public hospital policies.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.4
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• pp.283-293
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• 2015

Purpose: The aims of this study are to analyze and to visualize distribution of patients visiting at a dental college hospital, using geographic information system (GIS). The visualized data can be utilized in patient care and treatment planning, ultimately leading to the assessment of risk evaluation and prevention of dental diseases. Materials and Methods: Patient information data was obtained from Dankook University Dental Hospital including the unit number, gender, date of birth, and address from 2007 to 2014. Patient distribution was visualized using GIS. Statistical analyses were performed using SAS 9.3 and ArcGIS 10.1. Five factors including proximity, accessibility, age, gender, and socioeconomic status were investigated as the explanatory variables of the patient distribution. Results: The visualized patient data showed a nationwide scale of the patient distribution. There was a little difference in characteristics for each department. As closer at Dankook University Dental Hospital, visitors increased. And it strongly showed that elderly patients in rural areas tend to visit more. Conclusion: The distribution of patients has been shown to be significantly affected by the proximity, accessibility, age, gender and socioeconomic status. The underlying reason remains to be further studied.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.12
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• pp.4896-4906
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• 2010

This study was conducted in order to promote students' interest in overseas employment and to present methods of improving education that suits globalization and internalization. From responses to individual written survey questionnaires answered by $3^{rd}$grade 200 students who are studying dental hygiene at colleges in Daegu. They had most interested in Japan (60.3%), and they want to work abroad if they are given the changes (38.1%), which indicate that the dental hygiene majors have much interest and positive attitude in overseas employment. In Japan, there are 158 schools had department of dental hygiene (51 to 2 years, 101 to 3 years, 6 to 4 years). Especially, Kanto area has 25 private schools. When compared Korea and Japan, they similar were curriculum, 39 at 3 years, 44 at 4 years, respectively. The current national board dental hygiene examination system was 200 in total score, and 19 in total subjects. The 9 basic clinical courses including oral anatomy have 100 scores, and the 8 subjects including preclinical course have 50 scores, one dental assistant course have 50 scores. In Japan, 4 years pre-dental hygiene curriculum content provide certificate of dental hygiene after graduation. They provide additionally 'social worker' in Tokyo University, 'teacher in nursing' in Hirosima University. They scheduled the various foundational knowledge and skill such as competencies to communicate effectively, to participate community health program, and to make decisions regarding dental hygiene service.

• Health Policy and Management
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• v.34 no.2
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• pp.163-177
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• 2024

Background: This study aims to examine changes in fraudulent claim counts and total reimbursements before and after enhancements in counterfeit claim controls and monitoring of provider claim patterns under the "Proactive self-audit pilot program of fraudulent claims." Methods: This study used the claims data and hospital information (July 2021-February 2022) of the Health Insurance Review and Assessment Service. The data was collected from 1,129 hospitals assigned to the pilot program, selected from the providers who filed a claim for reimbursement for intravenous injections. Paired and independent t-tests, along with regression analysis, were utilized to analyze changing patterns and factors influencing claim behaviors. Results: This program led to a reduction in the number of fraudulent claims and the total amount of reimbursements across all levels of hospitals in the experimental groups (except for physicians below 40 years old). In the control group, general hospitals and hospitals demonstrated some significant decreases based on the duration since opening, while clinics showed significant reductions in specified subjects. Additionally, a notable increase was observed among male physicians over the age of 50 years. Overall, claims and reimbursements significantly declined after the intervention. Furthermore, a positive correlation was found between hospital opening duration and claim numbers, suggesting longer-established hospitals were more likely to file claims. Conclusion: The results indicate that the pilot program successfully encouraged providers to autonomously minimize fraudulent claims. Therefore, it is advised to extend further support, including promotional activities, training, seminars, and continuous monitoring, to nonparticipating hospitals to facilitate independent improvements in their claim practices.

• Health Policy and Management
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• v.2 no.1
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• pp.42-65
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• 1992

To survey the specialties or sujects of practice displayed by the private practitioners the authors visited 691 clinics in Taegu from April 1 to May 18, 1991, At the same time, a mail questionnaire was administered to ask the number of displayed subjects of practice, and the reasons for displaying the subjects, reasons for not displaying in case of no specialty was displayed, composition of patients, and role as a specialist. The questionnaire was returned by 308(44.6%) practitioners. The distributions of private practitioners by specialty were 13.9% for internal medicine (IM), 11.7% for pediatrics(Ped), 13.0% for obstetrics '||'&'||' gynecology(OBGY), 11.1% for general surgery(GS), 10.0% for family practice(FP), and 5.3% for general practitioner(GP). Ninety percent of the specialists have displayed their specialty in their offices. Among all the private practitioners, 61.9% of them have displayed their subjects of practice and 23.7% have shown telephone number. Among private practitioners who displayed the subjects of practice, 80.6% have signs of 'subjects of practice'. Mean number of the displayed subjects of practice for the all private practitioners is 1.20, and 1.93 for the private practitioners who displayed subjects of practice. FP and GS have displayed their subjects of practice in 91.2% and 87.0% respectively and OBGY have displayed in 32.2%, the lowest percentage among all the soecuaktues. IM specialists displays pediatrics as a major subject of practice in 72.1% the pediatricians display IM in 88.9% the OBGYs display pediatrics in 77.8%, and the GSs display IM in 51.9%. Most commonly displayed subjects of practice are Ped and IM. Sixty-five percent of the private practitioners answered that they don't display their specialties because their clinics are "primary health care facility". The reasons for displaying the subjects of practice and its relevance with their own specialty(45.6%), and the difficulty in clinic management only with the patients for their own specialty(36.9%). The proportion of clinics whose patients of other specialty are than their own specialty accounted less than 10% was 52.8% and that accounted more than 51% was 16.0%. Specially, 51.4% of GS specialists cared more than 51% of patients of other specialty area than their own specialty. Most of the patients of IM, Ped, and OBGY specialists are the patients of their own specialty. However, 56.8% of GS care more of IM patients and only 24.3% of them care mostly GS patients, The respondents to the mail questionnaire who stated that they can not play the role of specialist well are 30.5% and especially 72.9% of the GS specialists state so. The proportion of respondents who do not suffort the private practice of specialists is 71.1%. Among the surgical specialists, 82.7% of them rarely perform operation. The reasons for not performing operation are insufficient insurance fee (76.9%), and risk of operation(58.0%), so as the OBGY specialists. Above finidngs suggest that most of the specialists, especially surgeons, in the private practice can not play their role as a specialist. It is necessary to develop a policy that facilitates the production of practice and the retention of the specialists in the hospitals.s.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.12
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• pp.4863-4872
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• 2010

This study examined the disease conditions of patients from a farming and fishing village area. In order to analyze the medical service utilization, the necessary data were obtained from established health and medical care service plans from medical treatment related organizations. The following results were based on the analysis of data from the medical records of 2,365 discharged patients during a six months period from July to December 2009 at a general hospital in an aging farming and fishing village area. Results: The sex of the patients investigated was male 55.3%, female 44.7%, and the most frequent age category at 42.0% was 70 years of age or older. Based on type of hospital admission, 65.5% of patients who were admitted were originally outpatients. Patients were admitted according to the following departments: 49.7% for the department of internal medicine, 16.7% for the department of orthopedics, and 13.8% for the department of neurosurgery. The average number of days hospitalized was 14.8 days. The following ranks the principal diagnosis among patients in this study: S00-T98 18.4%, J00-J99 15.5%, and I00-I99 11.5%. The average number of diagnosis listed per patient was 5.6. There was a statistically significant difference for the following general characteristics according to principal diagnosis list: gender, type of insurance, admission process, and age category distribution had statistically significant differences. Monthly distribution of principal diagnoses were statistically significant difference. There was a statistically significant difference for principal diagnosis lists according to the average number of days admitted and the number of diagnosis. The results of this study showed the types of disease from typical farming and fishing village regions as disease from external injury due to the work environment of farming and fishing village regions and excessive labor throughout the year, respiratory disease, and various chronic disease from aging.

• Journal of Preventive Medicine and Public Health
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• v.31 no.2 s.61
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• pp.310-322
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• 1998

In order to reinforce the role of primary care physician and o improve doctor-patient relationship, the Korean government tried to introduce 'Family Doctor Registration Program' into Seocho-Gu in Seoul, Ansung-Gun and Paju city in Kyunggi-Do in Oct. 1996. Community residents and doctors in those area did not show much interest in this project because of low incentives. We have done this study to see how much people know 'Family Doctor Registration Program' and what is people's real needs about 'Family Doctor Registration Program'. We selected 1,800 telephone numbers in Seoul, Chongju city, and Ansung-Gun by multi-stage stratified random sampling. Three trained survey personnels called them and got answers to the premade questionnaire until they completed the questionnaires of 200 persons in each community. The calling time was 7-9 p.m. from Monday to Friday, 3-9 p.m. on Saturday, and 9 a.m. to 9 p.m. on Sunday. We dropped out the persons who did not respond 3 times. The subjects consisted of 222 male and 367 female residents. Their ages ranged from 20 to 78: 24.8% in their 30s, 23.4% in their 20s, 22.5% in their 40s in male, and 35.2% in theirs, 22.5% in their 40s, 18.5% in their 20s in female. 9.9% of male and 13.2 % of female had their Family Doctors. The specialties of their Family Doctors were internists in 56.2%, general surgeons in 11.0%. The persons who did not have their family doctors were asked which doctors they would prefer if they had choices of family doctor. The results were internists in 50.3%, family physicians in 13.0%, pediatricians in 4.8%. Only 16.0% residents knew that government tried to introduce Family Doctor Registration Program. The 'Family Doctor Registration Program' was not well known to people. The results of our study showed that more effective incentives and public notifications are needed to activate this program.

• The Korean Nurse
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• v.20 no.4 s.112
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• pp.39-49
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• 1981

기존 간호 영역 내 간호는 질적으로, 양적으로 급격히 팽창 확대되어 가고 있다. 많은 나라에서 건강관리체계가 부적절하게 분배되어 있으며 따라서 많은 사람들이 적절한 건강관리를 제공받지 못하고 있어 수준 높은 양질의 건강관리를 전체적으로 확대시키는 것이 시급하다. 혹 건강관리의 혜택을 받는다고 해도 이들 역시 보다 더 양질의 인간적인 간호를 요하고 있는 실정이다. 간호는 또한 간호영역 자체 내에서도 급격히 확대되어가고 있다. 예를들면, 미국같은 선진국가의 건강간호사(Nurse practitioner)는 간호전문직의 새로운 직종으로 건강관리체계에서 독자적인 실무자로 그 두각을 나타내고 있다. 의사의 심한 부족난으로 고심하는 발전도상에 있는 나라들에서는 간호원들에게 전통적인 간호기능 뿐 아니라 건강관리체계에서 보다 많은 역할을 수행하도록 기대하며 일선지방의 건강센터(Health center) 직종에 많은 간호원을 투입하고 있다. 가령 우리 한국정부에서 최근에 시도한 무의촌지역에서 졸업간호원들이 건강관리를 제공할 수 있도록 한 법적 조치는 이러한 구체적인 예라고 할 수 있다. 기존 간호영역내외의 이런 급격한 변화는 Melvin Toffler가 말한 대로 ''미래의 충격''을 초래하게 되었다. 따라서 이러한 역동적인 변화는 간호전문직에 대하여 몇가지 질문을 던져준다. 첫째, 미래사회에서 간호영역의 특성은 무엇인가? 둘째, 이러한 새로운 영역에서 요구되는 간호원을 길러내기 위해 간호교육자는 어떤 역할을 수행해야 하는가? 셋째 내일의 간호원을 양성하는 간호교육자를 준비시키기 위한 실질적이면서도 현실적인 전략은 무엇인가 등이다. 1. 미래사회에서 간호영역의 특성은 무엇인가? 미래의 간호원은 다음에 열거하는 여러가지 요인으로 인하여 지금까지의 것과는 판이한 환경에서 일하게 될 것이다. 1) 건강관리를 제공하는 과정에서 컴퓨터화되고 자동화된 기계 및 기구 등 새로운 기술을 많이 사용할 것이다. 2) 1차건강관리가 대부분 간호원에 의해 제공될 것이다. 3) 내일의 건강관리는 소비자 주축의 것이 될 것이다. 4) 간호영역내에 많은 새로운 전문분야들이 생길 것이다. 5) 미래의 건강관리체계는 사회적인 변화와 이의 요구에 더 민감한 반응을 하게 될 것이다. 6) 건강관리체계의 강조점이 의료진료에서 건강관리로 바뀔 것이다. 7) 건강관리체계에서의 간호원의 역할은 의료적인 진단과 치료계획의 기능에서 크게 탈피하여 병원내외에서 보다 더 독특한 실무형태로 발전될 것이다. 이러한 변화와 더불어 미래 간호영역에서 보다 효과적인 간호를 수행하기 위해 미래 간호원들은 지금까지의 간호원보다 더 광범위하고 깊은 교육과 훈련을 받아야 한다. 보다 발전된 기술환경에서 전인적인 접근을 하기위해 신체과학이나 의학뿐 아니라 행동과학 $\cdot$ 경영과학 등에 이르기까지 다양한 훈련을 받아야 할 필요가 있다. 또한 행동양상면에서 전문직인 답게 보다 진취적이고 표현적이며 자동적이고 응용과학적인 역할을 수행하도록 훈련을 받아야 한다. 그리하여 간호원은 효과적인 의사결정자$\cdot$문제해결자$\cdot$능숙한 실무자일 뿐 아니라 소비자의 건강요구를 예리하게 관찰하고 이 요구에 효과적인 존재를 발전시켜 나가는 연구자가 되어야 한다. 2. 미래의 간호교육자는 어떤 역할을 수행해야 하는가? 간호교육은 전문직으로서의 실무를 제공하기 위한 기초석이다. 이는 간호교육자야말로 미래사회에서 국민의 건강요구를 충족시키기는 능력있는 간호원을 공급하는 일에 전무해야 함을 시사해준다. 그러면 이러한 일을 달성하기 위해 간호교육자는 무엇을 해야 하는가? 우선 간호교육자는 두가지 측면에서 이 일을 수정해야 된다고 본다. 그 하나는 간호교육기관에서의 측면이고 다른 하나는 간호교육자 개인적인 측면엣서이다. 우선 간호교육기관에서 간호교육자는 1) 미래사회에서 요구되는 간호원을 교육시키기 위한 프로그램을 제공해야 한다. 2) 효과적인 교과과정의 발전과 수정보완을 계속적으로 진행시켜야 한다. 3) 잘된 교과과정에 따라 적절한 훈련을 철저히 시켜야 한다. 4) 간호교육자 자신이 미래의 예측된 현상을 오늘의 교육과정에 포함시킬 수 있는 자신감과 창의력을 가지고 모델이 되어야 한다. 5) 연구 및 학생들의 학습에 영향을 미치는 중요한 의사결정에 학생들을 참여시키도록 해야한다. 간호교육자 개인적인 측면에서는 교육자 자신들이 능력있고 신빙성있으며 간호의 이론$\cdot$실무$\cdot$연구면에 걸친 권위와 자동성$\cdot$독창성, 그리고 인간을 진정으로 이해하려는 자질을 갖추도록 계속 노력해야 한다. 3. 미래의 간호원을 양성하는 능력있는 간호교육자를 준비시키기 위한 실질적이면서도 현실적인 전략은 무엇인가? 내일의 도전을 충족시킬 수 있는 능력있는 간호교육자를 준비시키기 위한 실질적이고 현실적인 전략을 논함에 있어 우리나라의 실정을 참조하겠다. 전문직 간호교육자를 준비하는데 세가지 방법을 통해 할 수 있다고 생각한다. 첫째는 간호원 훈련수준을 전문직 실무를 수행할 수 있는 단계로 면허를 높이는 것이고, 둘째는 훈련수준을 더 향상시키기 위하여 학사 및 석사간호교육과정을 발전시키고 확대하는 것이며, 셋째는 현존하는 간호교육 프로그램의 질을 높이는 것이다. 첫째와 둘째방법은 정부의 관할이 직접 개입되는 방법이기 때문에 여기서는 생략하고 현존하는 교과과정을 발전시키고 그 질을 향상시키는 것에 대해서만 언급하고자 한다. 미래의 여러가지 도전에 부응할 수 있는 교육자를 준비시키는 교육과정의 발전을 두가지 면에서 추진시킬 수 있다고 본다. 첫째는 국제간의 교류를 통하여 idea 및 경험을 나눔으로서 교육과정의 질을 높일 수 있다. 서로 다른 나라의 간호교육자들이 정기적으로 모여 생각과 경험을 교환하고 연구하므로서 보다 체계적이고 효과적인 발전체인(chain)이 형성되는 것이다. ICN같은 국제적인 조직에 의해 이러한 모임을 시도하는 것인 가치있는 기회라고 생각한다. 국가간 또는 국제적인 간호교육자 훈련을 위한 교육과정의 교환은 한 나라안에서 그 idea를 확산시키는데 효과적인 영향을 미칠 수 있다. 충분한 간호교육전문가를 갖춘 간호교육기관이 새로운 교육과정을 개발하여 그렇지 못한 기관과의 연차적인 conference를 가지므로 확산시킬 수도 있으며 이런 방법은 경제적인 면에서도 효과적일 뿐만 아니라 그 나라 그 문화상황에 적합한 교과과정 개발에도 효과적일 수 있다. 간호교육자를 준비시키는 둘째전략은 현존간호교육자들이 간호이론과 실무$\cdot$연구를 통합하고 발전시키는데 있어서 당면하는 여러가지 요인-전인적인 간호에 적절한 과목을 이수하지 못하고 임상실무경험의 부족등-을 보충하는 방법이다. 이런 실제적인 문제를 잠정적으로 해결하기 위하여 1) 몇몇 대학에서 방학중에 계속교육 프로그램을 개발하여 현직 간호교육자들에게 필요하고 적절한 과목을 이수하도록 한다. 따라서 임상실무교육도 이때 실시할 수 있다. 2) 대학원과정 간호교육프로그램의 입학자의 자격에 2$\~$3년의 실무경험을 포함시키도록 한다. 결론적으로 교수와 학생간의 진정한 동반자관계는 자격을 구비한 능력있는 교수의 실천적인 모델을 통하여서 가능하게 이루어 질수 있다고 믿는 바이다.