• Journal of Chest Surgery
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• 제49권sup1호
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• pp.28-36
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• 2016

Background: This study aimed to develop the models for regional cardiac surgery centers, which take regional characteristics into consideration, as a policy measure that could alleviate the concentration of cardiac surgery in the metropolitan area and enhance the accessibility for patients who reside in the regions. Methods: To develop the models and set standards for the necessary personnel and facilities for the initial management plan, we held workshops, debates, and conference meetings with various experts. Results: After partitioning the plan into two parts (the operational autonomy and the functional comprehensiveness), three models were developed: the 'independent regional cardiac surgery center' model, the 'satellite cardiac surgery center within hospitals' model, and the 'extended cardiac surgery department within hospitals' model. Proposals on personnel and facility management for each of the models were also presented. A regional cardiac surgery center model that could be applied to each treatment area was proposed, which was developed based on the anticipated demand for cardiac surgery. The independent model or the satellite model was proposed for Chungcheong, Jeolla, North Gyeongsang, and South Gyeongsang area, where more than 500 cardiac surgeries are performed annually. The extended model was proposed as most effective for the Gangwon and Jeju area, where more than 200 cardiac surgeries are performed annually. Conclusion: The operation of regional cardiac surgery centers with high caliber professionals and quality resources such as optimal equipment and facility size, should enhance regional healthcare accessibility and the quality of cardiac surgery in South Korea.

• 한국치위생학회지
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• 제15권2호
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• pp.235-243
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• 2015

Objectives: The purpose of the study is to investigate the oral health and oral health beliefs in industrial workers and to analyze the influencing factors on dental health care utilization. Methods: The subjects were 280 adults from 16 to 64 years old in Seoul and Gyeonggi from June 20 to July 31, 2014, A self-reported questionnaire was completed after receiving informed consent. The independent variables consisted of predisposing, enabling, and need factors. The predisposing factors included gender, age, residence area, number of family. The enabling variables included monthly income, education, occupation, type of employment. The need factors included subjective oral health recognition and oral health belief model. These three variables had a direct and indirect influence on dental clinic use. The types of occupation were classified into desk duties, merchandizing and service duties technology and others by KSCO-6. Results: The relating factors to dental health care utilization were sex, oral health beliefs perceived benefits, perceived barriers, and self-efficacy. Female tended to have the higher oral health beliefs perceived benefits, perceived barriers(p<0.01), self-efficacy(p<0.05). Conclusions: Those who received frequent oral examination and health instruction tended to have a favorable impact on maintenance of oral health status and improvement in quality of life.

• 대한치과의사협회지
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• 제55권1호
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• pp.7-20
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• 2017

The purpose of this study is to analyze the data on the medical personnel education system and license scheme and provide the basic material for an enhanced qualification system. In China, dental education reform has been underway with a view to providing an inclusive basic medical service package to the whole country by 2020. It is also estimated that the number of Korean dental medicine students in China would be fewer. And most of them desire to get a job in China after acquiring the Chinese license, suggesting little prospect of a massive inflow into Korea in the near future. In Japan, students are required to complete a clinical training program for over 1 year after receiving licenses to become an independent practitioner. But they can apply for the Korean preliminary examination without this post-graduation process. For this reason, the quality issue in license effectiveness review has been seriously discussed. It is deemed desirable to limit the Korean accreditation to Japanese graduates from the dental schools certified by the Japanese dental accreditation body.

• Physical Therapy Rehabilitation Science
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• 제7권2호
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• pp.61-66
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• 2018

Objective: Patellofemoral pain syndrome (PFPS) is a condition that is characterized by patellar discomfort or pain that is aggravated during certain activities such as ascending/descending stairs. The Patellofemoral Disability Index (PDI) was developed to assess the effect of pain on functional activities in individuals with PFPS. The objectives of the current study were to determine the internal consistency, test-retest reliability, and validity of this index. Design: Cross-sectional study. Methods: Forty-one subjects who had PFPS with a mean age of $28.8{\pm}5.0years$ and a mean body mass index of $25.6{\pm}4.7kg/m^2$ participated in the study. All subjects were concurrently enrolled in a clinical trial for which they were instructed to complete hamstring-resistance exercises for 4 weeks. Over the course of the intervention, they completed both the PDI and the Oswestry Disability Index (ODI) at baseline after two weeks, and after four weeks. Pearson correlation coefficient was used to assess the criterion validity. Cronbach's ${\alpha}$ was used to examine the internal consistency. Intraclass correlation coefficients with 95% confidence interval were computed to examine test-retest reliability. Results: Subjects' responses within both the PDI and the ODI yielded Pearson correlation coefficient values that were positive and highly significant (range, 0.73-0.97; p<0.001). There was a high level of internal consistency (Cronbach's ${\alpha}{\geq}0.8$), with the exception of stair climbing (Cronbach's ${\alpha}=0.65$). Intraclass correlation ranged from 0.87 to 0.92, indicating high levels of test-retest reliability. Conclusions: The PDI is a valid, reliable, and feasible method of assessing pain and functional ability in patients with PFPS.

• 경영정보학연구
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• 제20권2호
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• pp.111-137
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• 2018

의료보험 혜택의 증가 및 베이비붐 세대의 노인 인구 증가 등에 기인하여 2020년에는 헬스케어로 소비되는 금액이 미국 GDP의 20%를 차지할 것으로 전망되고 있다. 이처럼 헬스케어 산업이 발전하면서 병원의 의료서비스 간 경쟁도 치열해지며, 의료서비스 품질을 관리하고자 하는 병원의 니즈가 증가해 왔다. 더불어 온라인 리뷰가 병원 품질을 예측하는 하나의 도구로 활용되면서 병원 온라인 리뷰에 대한 관심 또한 증대되었다. 소비자들은 의료서비스 제공자를 선택함에 있어서도 온라인 리뷰를 참고하는 경향을 보이며, 서비스를 제공받은 후 서비스 품질에 대해 온라인상에서 평가를 진행한다. 따라서 본 연구는 온라인 리뷰 사이트인 Yelp의 병원 리뷰를 중심으로 고객이 평가한 서비스 품질 유형의 감성 수준이 병원 평가에 미치는 영향을 파악하는 것을 목적으로 한다. 본 연구는 1차적으로 온라인에서 수집한 대량의 텍스트 데이터를 SERVQUAL 이론의 다섯 가지 서비스 품질 측정 지표로 구분한다. 다음으로 지표 별 감성 수준을 병원 단위로 도출한 뒤, 각 SERVQUAL 지표의 감성 수준이 병원 평가에 미치는 영향을 계량경제학적으로 분석한다. 또한, 병원의 네 가지 특성인 운영 목적(비영리 여부), 병원이 위치한 도시의 인구밀도, 보유 침대 수, 그리고 응급센터로 운영 여부가 병원 평가에 어떠한 상호작용 효과를 나타내는지 분석한다. 본 연구 결과를 통해 병원 경영 실무자들에게 온라인 상의병원 평판을 긍정적으로 형성해 나가려면 어떠한 서비스 품질을 더욱 집중 관리해야 하는지 방향을 제시해 줄 수 있을 것으로 기대한다.

• Perspectives in Nursing Science
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• 제15권2호
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• pp.49-69
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• 2018

Purpose: The purpose of this study was to derive contextual indicators of medical provider quality and assess their relative importance along with the individual utilization of antenatal care (ANC) and institutional births with a skilled birth attendant (SBA) in India using a multilevel framework. Methods: The 2015~2016 Demographic and Health Survey (DHS) from India was used to assess the outcomes of neonatal, infant, and under-five child mortality. The final analytic sample included 182,980 children across 28,283 communities, 640 districts, and 36 states and union territories. The contextual indicators of medical provider quality for districts and states were derived from the individual-level number of ANC visits (<4 or ${\geq}4$) and institutional delivery with SBA. A series of random effects logistic regression models were estimated with a stepwise addition of predictor variables. Results: About half of the mothers (47.3%) had attended ${\geq}4$ ANC visits and 75.8% delivered in institutional settings with SBAs. Based on ANC visits, 276~281 districts (43.1~43.9%) and 13~16 states (36.5~44.4%) were classified as "low" quality areas, whereas 268~285 districts (41.9~44.5%) and 8~9 states (22.2~25.0%) were classified as "low" quality areas based on institutional delivery with SBAs. Conditional on a comprehensive set of covariates, the individual use of both ANC and SBA were significantly associated with all mortality outcomes (OR: 1.17, 95% CI: 1.08, 1.26, and OR: 1.10, 95% CI: 1.02, 1.19, respectively, for under-five child mortality) and remained robust even after adjusting for contextual indicators of medical provider quality. Districts and states with low quality were associated with 57~61% and 27~43% higher odds of under-five child mortality, respectively. Conclusion: When simultaneously considered, district- and state-level provider quality mattered more than individual access to care for all mortality outcomes in India. Further investigations are needed to assess the importance of improving the quality of health service delivery at higher levels to prevent unnecessary child deaths in developing countries.

• Journal of Medicine and Life Science
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• 제21권3호
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• pp.78-82
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• 2024

Universities are essential in the educating medical school students and create an excellent educational environment for them. We checked the status of personnel turnover at a local medical school to determine the form of entry into the workplace after resignation. According to their intention, the total number of resignations was 54, with individuals being 42.22±5.92 years old (32-64 years old) and having 5.53±4.20 years of service. Resignations under 3 years were 20, and under 15 years or more were nine. By year, the number of professors resigned the most at 11 in 2020 and seven in 2022. Regarding present employment after resignation, 28 individuals (51%) moved to other universities or university hospitals, eight (14%) to general hospitals, 15 (27.8%) to clinics or employment, and three (5.6%) elsewhere. As a result of the analysis, by dividing into the metropolitan areas including Seoul, the area excluding the metropolitan area, and the Jeju area based on the area where a bachelor's degree was obtained, 65.5% and 42.9% of the metropolitan and non-metropolitan area were transferred to universities and university hospitals, respectively. Further, the Jeju area was employed in general or private hospitals. The resignation of a professor from a local medical school varies slightly depending on the demand for medical care in other regions, including metropolitan areas, but tends to continue. Therefore, it is necessary to determine directions for continuing education.

• 한국의료질향상학회지
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• 제10권2호
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• pp.204-215
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• 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.

• 보건행정학회지
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• 제19권1호
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• pp.62-80
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• 2009

The purpose of this study was to examine the factors influencing the attitude toward the increasing role of private health insurance(PHI). In the Korea Welfare Panel Data 2007, a sample of 1,675 (adjusted by weight value: 1,607) respondents on an opinion on promoting PHI was used in the study. With independent variables including socio-demographic characteristics, health status, health-related behavior, and opinions on welfare service, ordered-probit model was used to analyze the attitude toward PHI. Negative opinion on the increasing role of PHI were responded by 54.6%(n=877) of the respondents, whereas 22.2%(n=373) were positive and 23.2%(n=357) were neutral. Old people, the better off, those with worse self-assessed health status, and those having an experience of health examination tend to have the positive attitude toward the increasing role of PHI. Women, those with chronic diseases or disorders and those who do not agree that comprehensive welfare benefits reduce work incentive showed negative attitude toward PHI. When comparing the needs for PHI before and after medical utilization, ex-ante need tends to strengthen the tendency to support private health insurance. This study will contribute to the discussion on the optimal mix of public and private health insurance in Korea by a better recognition of attitude toward PHI and health care system.

• 센서학회지
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• 제19권6호
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• pp.435-442
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• 2010

Typically, the vital signs that are representing the state of human body, are the body temperature, sphygmus, respiration and blood pressure. The body temperature is the result of metabolic regulation and human steady-state body temperature is maintained from 35.9 to $37.4^{\circ}C$ by heat regulatory center. The body temperature is indicative of infection and especially it should be monitored to requiring intensive care patients or after surgical patients. But, measuring of body temperature to a heavy workload on nursing staff has been recognized. And, the health service of nurse is limited by simple tasks such as the measurement and record of vital sign. In this paper, the body temperature monitoring telemetry system was proposed to prove the recoding and transmission of body temperature patch system according the standard(ISO TS11073-92001). We proposed the transmission protocol to suit the MFER(medical waveform format encoding rules). The telemetry patch system was implemented and it was verified by experiments.