• Title/Summary/Keyword: Doctor-doctor Relationship

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The Effects of the Designated Doctor System on Health Care Utilization of Medical Aid Beneficiaries with Chronic Diseases (선택의료급여기관 제도가 만성질환을 가진 의료급여수급권자의 의료이용에 미치는 영향)

  • Kim, Min Jung;Cho, Young-Ha;Park, Nam Hee
    • Research in Community and Public Health Nursing
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    • v.26 no.3
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    • pp.278-291
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    • 2015
  • Purpose: This study was conducted to examine differences in health care utilization and related costs between before and after the introduction of the designated doctor system, and to find out factors making the differences. Methods: Data were collected from 200 medical aid beneficiaries having one or more chronic diseases, registered in the designated doctor system during the year of 2012, and the relationship between the use of health services and claimed medical expenses was analyzed through paired t-test and multiple regression analysis using the SPSS 18.0 program. Results: There was a decrease in the number of total benefit days and the number of outpatient and medication days, but some cases showed an increase after the designation of medical institution. In general, hospital stay increased after the introduction of the system. However, the number of medical institutions utilized was reduced in most cases after designation. Conversely, medical expenses increased in most cases after the designation of medical institution. Conclusion: These results suggest that a detailed scheme to designate medical institutions should be made in consideration of the seriousness of illness and classification of medical institutions not only for the beneficiaries' enhanced health but for the effective management of medical aid fund.

The Effect of Leadership and Organizational Culture on Organizational Effectiveness : A Dental Clinics-Based Study (의료기관에서 리더십과 조직문화가 조직유효성에 미치는 영향에 관한 연구 -치과의원 중심으로-)

  • Kim, Yong-Tea;Shin, Dong-Myeon
    • Health Policy and Management
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    • v.20 no.3
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    • pp.73-103
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    • 2010
  • This study aims to explore how the transformational leadership (consisting of three factors"charisma, individualized consideration, and intellectual stimulation) and the organizational culture (typified by developmental, rational, consensual, and hierarchical culture) are related to the organizational effectiveness (consisting of job satisfaction, organizational commitment, and intention to leave a job) of dental clinics. We found the following empirical results through a survey of 378 persons who work in dental clinics. Firstly, the respondents acknowledged charismatic leadership as the typical type of leadership ; as for organizational culture, a culture of consensus is recognized as the representative type. Secondly, transformational leadership has different effects according to the type of organizational culture: a positive influence in developmental and rational cultures, but a negative influence in consensual and hierarchical cultures. Thirdly, developmental culture has proven to be the most suitable for increasing job satisfaction and organizational commitment. The developmental, rational, and consensual cultures have all contributed to reducing intention to leave among clinic staff, whereas in the hierarchical culture, intention has been elevated. Fourthly, transformational leadership has a positive effect on the job satisfaction and organizational commitment; the intent to leave has been lessened under individualized consideration and charismatic leadership, but has been increased under leadership of intellectual stimulation. Fifthly, it is consideration and charisma that help to increase organizational effectiveness. These influences will become more effective through a developmental culture. Based on the above empirical results, we propose practical measures to improve the organizational effectiveness of clinics, in particular dental clinics. In order to build developmental culture, the doctor (manager) should produce an atmosphere in the clinic in which staff members are able to create and jointly own ideas and then promote awareness of staff participation. Additionally, in order to bring leadership of charisma and consideration into full play, the doctor should shape a relationship of mutual trust mainly by recognizing and praising the work of clinic staff. Finally, the doctor needs to acknowledge that organizational effectiveness can be significantly improved by increasing the transparency of the business.

Factors Related to Job Retention of Physicians in Public Hospitals (국공립병원 의사의 근무지속의사 관련 요인)

  • Oh, Moo-Kyung;Kwon, Yong-Jin;Lee, HeyJean;Lee, Jin-Seok
    • Health Policy and Management
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    • v.22 no.3
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    • pp.365-382
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    • 2012
  • Background : Public hospitals suffer worsening shortage of physicians and face great pressure of recruiting doctors. This study is aim to identify the factors associated with retention of physicians who are working in public hospitals. Methods : We conducted a cross-sectional and self-administered questionnaire survey in July, 2011. A total of 333 physicians responded from the 31 public hospitals. We analyzed the difference of job retention across the variables among doctors stratified as salaried and public health doctors. We used chi-square test and multiple logistic regression analysis. Results : To the salaried doctor, longer work period(OR=2.04 in 3rd quartile), professional autonomy(OR=2.69), and positive attitude toward public health(OR=2.39) affect to the higher job retention whereas complain of low income(OR=0.33) and complain of poor clinical environment(OR=0.26) affects to the lower job retention. To the public health doctors, community connections such as hometown(OR=6.27), spouse factors(OR=3.49), and positive attitude toward public health(OR=3.19) affect to the higher job retention. But longer work period(OR=0.17 in 3rd quartile) affects to the lower job retention. Conclusions : Associated factors of job retention vary across physician's status. Professional autonomy has major impact on the job retention to the salaried doctor. And familial factors as well as community relationship have greatest impact to the public health doctor. Positive attitude toward public health is associated with the higher job retention to the both of salaried and public health doctors.

Medicolegal Problems in Pediatric Area (소아과 영역에서 의료분쟁)

  • Kwon, Soo Jeong;Jang, Ji Young;Kim, Nam Su;Yum, Myung Kul;Seol, In Joon;Jung, Ku Won
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.813-819
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    • 2005
  • Purpose : Medicolegal problems start when the patient asserts the mistake of doctor and doctor does not accept it. The purpose of this study is to assess the actual condition of medicolegal problems and to provide solutions of medicolegal problems in the pediatric field. Methods : There is not official statistical data about medicolegal problems in our country. We gathered data of legal insurance program of Korean Medical Association(KMA) and court cases and other fragmentary data. Results : Between 1981 and 1995, of total 2,338 cases reported to legal problem insurance program of KMA, most common ones were 748 cases of obstetrics and gynecology. Pediatric case was ranked at the 5th, 74 cases(3.1%). According to analysis of 41 medicolegal cases' after 1990, maltreatment of patient had the highest incidence of 14 cases, injection and medication were related to 12 cases, misdiagnosis was 9 cases, patient management were related to 4 cases, and others were 2 cases. The trial result of the medicolegal cases was that 31 cases were compensated, and 8 cases were defeated, and 2 cases were still in the process. Conclusion : The aspect of medical legal problem has the tendency of radicalism and systematization. This brings an economic destitution in the patient and gives damage to a doctor. In order to reduce medicolegal problem, doctor should offer a duty of explanation and efforts to his best to satisfy patient and endeavor to make an intimate doctor-patient relationship.

A Study on the Health Professional's Perception of Postpartal care (건강전문가의 산후관리 인식에 대한 연구)

  • Jang, Moon-Hee;Yoo, Eun-Kwang
    • Women's Health Nursing
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    • v.5 no.3
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    • pp.313-326
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    • 1999
  • This study sought to find out the level of perception of postpartal care and the meaning and opinion of traditional postpartal care (Sanhujori) from health professional. The subjects were 188 health professionals who work at University hospital, clinics, Oriented clinics, and midwifery clinics in Seoul and Chung-Buk, Korea. Data were collected from 8th April, 1999 to 6th May, 1999. The data were analyzed through the SPSS program by use of frequency, percentage, t-test, ANOVA and Scheffe test as a post hoc contrast, $x^2$-test, and stepwise multiple regression. The results of the study were as follows: mean age of the subject was 33.0 years and female was 58.0%. Occupation of the subject was nurse 28.7%, doctor 22.3%, midwife 21.3 Korean Oriental doctor 27.0%. Mean period of career was 7.6 years and the subject who experienced Sanhujori was 54.3%. The subject who did not know 6 principles of Sanhujori was 73.9%. In the opinion on traditional Sanhujori method 68.1% of respondents expressed that Sanhujori is scientific postpartal care which fits Korean people's physical constitution and culture. On the opinion of effective postpartal care in 97.9% of respondents expressed that it is to in hospital postpartal care and traditional Sanhujori perform it according to Korean culture constitution. On the opinion of Sanhujori, 96.6% of respondents expressed that it is necessary to understand Sanhujori with consideration which was adapted to Oriental culture and to verify it through continual study. On the opinion of the effect of the level of performance of Sanhujori upon women's health life, 43.2% of respondents expressed that the level of performance of Sanhujori has great effect on women's general health, including postpartal recovery, Sanhujori prevention, and so on. On the opinion of Sanhujori of women who undergo Caesarean operation, 57.7% of respondents expressed that women who undergo Caesarean operation perform Sanhujori with more attention. On the opinion of Sanhujori center (sanhujorwon), 56.3% of respondents expressed that the center is necessary for women's health and health professional are required to manage the center scientifically. On considering the level of importance of post care according to occupation, midwife showed highest level of importance of traditional Sanhujori doctor the lowest level. Midwife showed the hi level of importance of postpartal care and K Oriental doctor showed the lowest level of importance of women's postpartal care. On considering the relationship between the level of importance of postpartal care and general characteristics, sex, career, clinical department and whether they know 6 principles of Sanhujori or not were statistically significant at the level of 5%. In the stepwise multiple regression analysis, the main influencing variables on the level of importance of postpartal care were occupation, sex, and clinical department. In conclusion, this finding confirmed that professionals were considering the traditional Sa importantly for women's health. Above all things necessary for health professional to integrate concept of traditional Sanhujori into practical nu intervention program, to apply it to profes practices in order to reestablish effective integrative postpartal caring system, and to Sanhujori scientific through performing continual research.

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The Relationship between Access to Usual Source of Care and Health Literacy: A Comparison between Urban and Rural Areas (상용치료원 보유와 건강정보 이해능력의 관계: 도시와 농촌 비교)

  • Seungyeon Cho
    • Journal of agricultural medicine and community health
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    • v.49 no.3
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    • pp.205-215
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    • 2024
  • Objective: This study aimed to estimate the impact of having and the type of usual source of care on the health literacy of rural residents. Methods: Using data from the 2021 Korea Health Panel Survey, the regression model was estimated, in which the presence and type of usual source of care, categorized as medical institutions and primary care physicians, were incorporated as explanatory variables. The level of health literacy was used as the dependent variable. Additionally, statistical analysis was conducted to compare how socio-demographic backgrounds and the presence and type of usual source of care are associated with health literacy between urban and rural residents. Results: The effect of usual source of care on the level of health literacy was significant only when the service provider was the public health institution. However, this effect was smaller for rural residents than for urban residents. When the usual source of care was an internal medicine or Korean traditional medicine doctor, the level of health literacy increased than the other types of doctor. Conclusion: To improve rural residents' health literacy, it is necessary to enhance access to public health care service and provide education programs.

A study for the relationship between the cognition difference and satisfaction for the medical service and the revisiting (의료서비스의 인식차이와 만족이 재방문에 미치는 영향에 관한 연구)

  • Lee, Kyoung-Woo
    • Korea Journal of Hospital Management
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    • v.8 no.3
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    • pp.143-160
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    • 2003
  • Due to the dramatic and situational change in medical industry, it has became very important to keep existing patients and to attract new patients by monitoring the medical consumer's expectation and various needs and ensuring the patients' satisfaction. This study regards the patients' satisfaction as the final object of medical service. So the object of this study is to provide useful data for the decision making and medical service marketing by exploring the problems generated by the cognition difference for the medical service between inpatients and outpatients, by responding for the problems and by examining the relationship between the satisfaction with the medical service and revisiting. To achieve the object of this study, literature research and empirical analysis were used. I establish the research model based on the existing service marketing and some hypotheses were chosen for the empirical analysis. As a result of empirical analysis for the five hypotheses, two hypotheses were chosen. First, there was cognition difference about accessibility and convenience between inpatient and outpatient. I guess that the satisfaction degree of inpatient is higher than the outpatient because the inpatient has the reliability for the hospital and determines the hospitalization or emergent coming to hospital. Second, the fifth hypothesis, "the satisfaction of patient will influence the revisiting." was chosen. The hypothesis is not only coincident with existing scholars and studies but also it provides the meaningful points for medical service marketing. The result shows that the parties concerned with hospital management should endeavor for the patient satisfaction in medical service, and that hospital management should be medical consumer centered. To measure the quality of medical service, the cognition differences for accessibility, convenience, physical environment, and human service were evaluated and the result shows that the cognition difference for the accessibility and convenience was outstanding. The analysis shows that there was cognition difference in the four categories among six subcategories in the human service -- the attitude of medical technologist, the attitude of doctor, the length of time for doctor's diagnosis for the patient and doctor's explanation. Therefore, I think that further study is required for the cause analysis for service categories which have cognition difference between inpatient and outpatient. I think the result will be very useful. Through this study, the relationship between patient satisfaction with the medical service and revisiting was verified. And it suggests that, to face the changing medical environment actively and to improve the quality of medical service, marketing strategy should be focused not on medical service providers but on medical service consumers and that the further studies for the medical consumer should be continued.

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Study on the Fancy Relationship of Viscera under the Diao-hou-yong-shen (조후용신(調候用神)을 활용한 월별(月別) 장부간(臟腑間)의 호오관계)

  • Kim, Hyun-Jung;Kim, Yong-Chan;Kim, Byung-Soo;Kang, Jung-Soo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.5
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    • pp.1062-1070
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    • 2008
  • The human body and nature respond to each other. The change of nature influences to directly human body. One of the change is the weather change. and there is order in the change. The order is twelve months. To explain the weather change of the cold, hot. dry and wet. we can use Four seasons, The twenty-four seasons, or The twelve month. To explain the five elements of the chinese cosmogony, The four season is useful, and the change of weather, the twenty-four seasons is good. But, the viscera is explained by the ten celestial stems and the twelve horary sings. Thus the twelve horary sings is most useful to explain, because one year is composed by twelve months. The twelve season and fancy of the ten celestial stems is explained fully by Diao-hou-yong-shen. Diao-hou-yong-shen is expressed by the zodiac signs, and explained by the disposition of the zodiac sings. In addition to the oriental medical science is also explained and expressed by the zodiac signs. Therefore, I think that the change of viscera, according to weather, is based on the Diao-hou-yong-shen, and I get some results. In the acting of viscera, there are some relationship between organs. The relationship is not influenced directly by the weather of four seasons, unless there are some special details. If the energy of the month, which rules one specific organ, is weak, doctor should fill up the organ. If not, the organ tends to get sick. According to the full or weak of the five elements which is under the month, the useless or harmful elements should be taken off, and useful and needful elements should be serviced. The balance between cold, hot, dry and wet should be maintained. However, the fancy of the viscera is very different. So, doctor should be careful to maintain balance. The full and weak between Yin and Yang should be considered when doctor think about cold and hot in the month.

Research Trends on the 'Convergence of Chinese and Western Medicine' in China, and Lessons Learned (중국의 중서의회통파에 대한 연구동향과 한국 한의계가 얻을 수 있는 교훈)

  • Lee, Choong-Yeol
    • The Journal of Korean Medical History
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    • v.30 no.2
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    • pp.13-31
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    • 2017
  • This study investigates research trends on the Convergence of Chinese and Western Medicine (中西醫匯通, CCWM), by first defining the concepts and the scope of this emerging field, identifying different types of convergence, and suggesting methods to evaluate the process. The author investigates the relationship of CCWM to the Self-Strengthening Movement and the doctrine of Zhongtixiyong (中體西用). Lessons that Korean Medicine (KM) can learn from this approachto help establish relationship between Korean and Western Medicine, are investigated. Proponents of CCWM suggest different types of convergence such as Zhongzhongcanxi (衷中參西), Zhongxizhezhong (中西折衷), and ZhongyiKexuehua (中醫科學化), to accommodate the change in the power dynamics between Chinese and Western medicines. The rigid dual medical system in Korea significantly hinders the potential for convergence. The current system is based on the relativistic model in which the scope of practice for the KM doctor and the Western Medicine doctor are mutually exclusive. Philosophically, the convergence of East-West medicine can be supported by pluralism and monism, while relativism sees it as impossible. A conservative pluralistic model might consider Bogu (補救) of Eastern Medicine, while a more progressive pluralistic model might build a New Medicine which combines the knowledge and techniques of Eastern and Western medicines. An example of monistic model is CAM (Complementary and Alternative Medicine), which aims to scientifically verify the efficacy and safety of the Eastern therapeutic practices and integrate them into Western medicine. This article proposes that as communication and fusion between medical disciplines are essential virtues of contemporary scholarly development, a change that enables the convergence of East-West medicine is needed.

A Study on Moral Judgement and Ethical Values of Nursing students (간호학생의 도덕판단과 윤리적 가치관)

  • Kwon, Young-Mi
    • The Journal of Korean Academic Society of Nursing Education
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    • v.8 no.1
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    • pp.17-28
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    • 2002
  • The purpose of this study was to provide the basic sources for educational program that identifies moral judgement and ethical values of nursing students. The subjects consisted of 114 nursing students in college. Data were collected by the Korean Form of Moral Development Inventory(Shin, 1997) and Nursing Ethical Values(Lee, 1990) from March 5 to 21. 2002. The findings were as follows: 1. The mean score of the stage 5B was higher than the score of other stages. The mean score of P(%) was 39.15. No significant difference were found between P(%) and general characteristics. 2. The mean score of the nursing ethical values was 3.38. The nursing students took the position of deontology slightly. In nurse-colleague relationship area(4.22), the subjects should to taking evidently deontological position. 3. According to general characteristics, no significant difference was found except nurse-patient relationship area among subcategory of ethical values. The mean score of this area by influence person of moral development were significantly different at the .05 level. 4. The trend of subjects in action choices on 4 dilemmas of the DIT showed between-subjects variability. Action choices on 'Heinz and the drug', 'Doctor's dilemma', and 'webster' were 'pro' in most of subjects, whereas 'escaped prisoner' was 'con'. 5. The ethical values in human-life area associated with action choices on 'Heinz and the drug' was significantly different . And the nursing ethical values, human-life area, and nurse-nursing task relationship area were significantly different according to action choices on 'Doctor's dilemma'. 6. There was found little correlation between action choices on 4 dilemmas of the DIT and moral judgement. Also little correlation was shown between action choices on 4 dilemmas of the DIT and ethical values. No significant correlation were found between moral judgement and nurse ethical values.

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