• 대한한의학회지
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• 제31권1호
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• pp.112-121
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• 2010

Objectives: The aim of this study was to reflect upon the process of the legislation of the National Medical Services Law for traditional Korean medicine practitioners (TKM practitioners), especially at the Assembly plenary session of 1951. Methods: Various primary sources related to the legislation were examined, especially those in National Assembly Records and newspapers. Results: In 1950, the National Assembly wanted to establish the National Medical Services Law (國民醫療法) replacing the colonial medical services law (朝鮮醫療令), but it ended in failure. So in 1951, the National Assembly tried again. First, legislator Han Gukwon (韓國源), with 83 other legislators, introduced a bill for the new national health care system. The Society and Health (社會保健委員會) and the Legislation and Judiciary subcommittees (法制司法委員會) deliberated on this bill, and each proposed an amendment to the National Assembly. In the process of careful deliberation of these three proposals, the Ministry of Health and legislator Kim Ikgi (金翼基) each came up with a further amendment. Ultimately, Kim Ikgi's amendment was accepted by the National Assembly. According to his proposal, TKM practitioners were titled 'Hanuisa (漢醫師)', and the medical office name of TKM practitioners became 'Hanuiwon (漢醫院)'. Conclusions: The National Medical Services Law passed in 1951 was the beginning of the unique dual national medical license system of Korea. It recognized Western medicine and TKM practitioners equally under the national license system.

• 대한한의학회지
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• 제21권4호
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• pp.129-137
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• 2000

Objectives: The aim of this study was to investigate the attitude toward the oriental hospital among 1,234 outpatients. Methods: A questionnaire about the general characteristics of patients, the decision-maker of use and the reason of choice or alteration was implemented. Results: The results of this survey as follows: Among outpatients 56.4 % were female in sex, 25.6 % were below 9 years of age; in educational level, 50.1 % were college graduates. Among outpatients, 33.6% chose the oriental hospital as their first choice and the rest were recommended by other persons. The recommenders were mostly relatives(73.9 %), female(73.4 %), young(30-39 years old, 40.1 %), high educational level (above the college, 54.9 %) people. 37.8 % among outpatients were secondary selection after the western medical clinic for the same symptom and sign. 7.0 % were the concomitant users of both therapies. 62.8 % among the concomitant users did not notify the western doctor about the dual therapies. The reasons they did not notify their Western doctors were 'be afraid of western doctor s bias' (42.6 %), 'no special reason' (29.6 %). Conclusions: The appropriate transfer system between oriental and western clinic must be constructed and the proper recognition about dual therapies will be needed among patients and doctors who practice both kinds of medicine.

• 한국방사선학회논문지
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• 제17권2호
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• pp.207-213
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• 2023

전산화단층촬영(computed tomography, CT) 영상은 양성자 브레그 피크 위치 추정 및 치료 계획 시뮬레이션의 기초로 사용된다. Hounsfield Unit(HU) 기반의 양성자 저지능비(stopping pwer ratio, SPR) 예측 과정에서 환자의 밀도와 원소 구성의 작은 차이로 양성자 빔의 경로를 따라 브레그 피크 위치의 불확실성이 발생한다. 본 연구에서는 브레그 피크 위치 예측 불확실성 감소를 위하여 이중에너지 전산화단층촬영 영상 기반의 양성자 저지능비 예측 정확도의 잠재력을 연구를 하였다. 양성자 빔의 저지능비를 추정하기 위해 전산화단층촬영 시스템(Somatom Definition AS, Siemens Health Care, Forchheim, Germany)을 이용하여 전자밀도팬텀(CIRS Model 062M electron density phantom, CIRS Inc., Norfolk, VA, USA)의 단일에너지 및 이중에너지 영상을 획득하였다. 이를 검증하기 위해 미국 국립 표준기술 연구소(National Institute of Standards and Technology, NIST)에서 제공하는 표준 데이터를 통하여 추정한 실제 저지능비와 비교하였다. 그 결과 잡음이 제거된 이중에너지 영상 기반 방법을 통한 양성자 빔의 저지능비 예측에서 정확도 개선 가능성을 확인할 수 있었으며, 인체의 다양한 밀도와 원소 구성을 가진 대체물을 더욱 다양하게 제작하여 저지능비를 예측 할 경우 더욱 향상된 양성자의 브레그 피크 위치 예측이 가능할 것으로 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권11호
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• pp.4867-4868
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• 2016

Prostatic adenocarcinoma is the commonest solid malignancy seen in Omani elderly males 60-80 years of age. The Gleason grade is the most widely used grading system for prostatic carcinoma and is recommended by the World Health Organization. A peer review was carried out at the Pathology Department of Sultan Qaboos University Hospital (SQUH), Oman, to assess the quality of reporting at the center. The aim of this study was to determine inter-observer variation among 7 pathologists working at a tertiary care center in Oman. A total of 47 consecutive prostatic biopsies were interdependently reviewed by seven pathologists and the results obtained were compared with each other and the original diagnosis. This peer review indicated a fair inter-observer agreement (0.482) among 7 pathologists in the department, with fair to moderate agreement when the results were compared to the reported diagnosis, comparable to the published literature. Dual and sub-specialty reporting are being instituted to improve the performance in this vital aspect of pathology.

• 한국보육지원학회지
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• 제9권5호
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• pp.513-538
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• 2013

우리나라는 1921년 태화기독교 여성관 탁아프로그램으로 보육이 시작된 이후 1991년 영유아보육법이 제정되는 등 질적인 보육을 제공할 수 있는 정책적 기반이 꾸준히 발전해왔다. 약 90년 정도 된 보육의 역사에서 보육정책을 담당하는 부처는 시대에 따라, 그리고 관련 법의 규정에 따라 보건사회부, 농업진흥청, 내무부, 문교부, 노동부 등 여러 부처로 분산되어 왔으나, 1991년 제정된 영유아보육법에 의해 보건복지부로 일원화되었고 2004년에는 여성가족부로, 2007년에는 다시 보건복지부로 이관되었다. 우리나라의 보육정책은 1991년 제정된 영유아보육법을 기점으로 교육부 관할의 유치원과 보건복지부 관할의 어린이집의 이원체제로 운영되어 왔다. 최근 출산율의 급속한 저하로 인해 출산율 회복을 위한 정책 개발과 보육의 질적 향상을 도모할 수 있는 방안에 대한 필요성에 의해 다양한 보육정책이 시행되고 있다. 본 연구에서는 우리나라 현재 보육정책의 주요 특징과 앞으로 다가올 시대를 위해 보육정책이 나아가야 할 방향과 과제에 대해 논의하였다.

• 대한한의학회지
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• 제43권3호
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• pp.16-26
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• 2022

Objectives: Traditional Korean medicine (TKM) has been supplied as part of a national health care system in South Korea under a dual medical system, however it has been difficult to mix western medicine and TKM medical practices in existing hospitals. For the objective of innovative integration between them, Comprehensive and Integrative Medicine Hospital were founded in Daegu, South Korea. Here, we discussed the clinical outcomes of cancer patients who received integrative cancer treatment (ICT). Methods: A total of 678 patients previously diagnosed with cancer were retrospectively checked in our institution for 2 years. After applying inclusion/exclusion criteria, 573 patients were eligible for the final analysis. The overall survival (OS) of these patients in the aftercare period were determined. We looked at how clinical factors and treatments including chemotherapy, complementary and alternative medicine (CAM), and TKM affected the OS. Results: At the first visit, 212 subjects had no evidence of disease after tumor resection and 355 ones with advanced cancer, who receiving ICT including chemotherapy, CAM, and TKM showed better OS compared to the CAM including TKM or the best supportive care (median OS = 216, 78, and 46 days, respectively). The median OS was not reached in TKM only, even though the sample size was small (N=12). Even after adjusting for clinical factors associated to liver, renal, and hematologic manifestation, ICT still remained significant. Conclusions: We demonstrated that ICT might be beneficial for advanced cancer regardless of the performance status, liver and renal function, since it positively affected the OS.

• 의료법학
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• 제23권3호
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• pp.117-137
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• 2022

오늘날 의료체계는 질병의 치료만을 위한 체계가 아니라 종합적인 건강관리체계(health care system)로 변화하고 있다. 그러나 현행 의료법은 그런 '협업'도 무면허 의료행위라는 일탈행위로 낙인찍고, 의사의 위험관리영역에서 행위한 비의료인은 물론 그와 협업한 의료인까지도 무면허의료행위죄로 처벌하고 있다. 무면허 의료행위를 규제하는 법제도와 의료현실 사이의 간극을 좁히기 위해서는 무면허 의료행위를 이원적이고 국가주의적이며 신분중심적으로 규율하는 구조적 한계를 극복해야 한다. 무면허의료행위죄의 보호법익은 '사람의 생명, 신체'라는 개인적 법익뿐만 아니라 '국가의 의료인면허제도의 유지·보호'라는 국가적 법익으로 이중적 성격을 가지는데, 여기서 유념해야할 것은 형벌을 가하는 본죄들의 규정이 보호하는 법익의 판단기준은 본래 '인격적 법익론'에서 찾아야 한다는 점이다. 그리고 어떤 행위가 의료행위인지 그리고 그 위험성을 판단할 때 행위의 주체(신분)에 편중하지 않고 행위와 수단의 차원을 함께 빠짐없이 형평성 있게 고려해야 한다. 즉 그 행위로 인해 초래될 수 있는 부작용의 위험이 합리적으로 관리되고 있는지에 따라 무면허의료행위에 해당되는지 여부가 좌우되어야 할 것이다. 의료의 본질이 치료자와 환자 간의 상호신뢰와 상호이해가 되어야 함을 일깨우는 치료적 대화의 지평을 고려할 때, 의료법 정책은 다원적 의료인격들 사이에서 일어나는 협업의 가능성을 원천적으로 차단하지 않는 방향으로 나아가야 바람직하다고 할 것이다.

• 대한한방내과학회지
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• 제33권3호
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• pp.298-305
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• 2012

Objectives : This study was aimed to promote the cooperative system of Korean and Western medicine in the dual health care system through a survey of physicians on recognition, problems and solution of the cooperative system. Methods : The research took place at Dongguk University Hospital from May 25 to 27, 2009 with 44 professors, residents, and interns employed by the hospital. Results : Of total 44 surveyed doctors, positive and moderate responses on the cooperative system between Korean and Western medicines were 40.9% and 43.2%, respectively. They scored it positive (62.5%) and moderate (31.3%) based on their experiences. These results can be supposed to represent the environment for the interdisciplinary medicine. Even in the interdisciplinary hospital of Korean and Western medicine, 68.2% of responders had no experience of the cooperative medical system. Expected interdisciplinary efficient departments were ordered rehabilitation medicine, neurology and orthopedics and associated with musculoskeletal disorders, the most frequent diseases treated by Korean traditional medicine. Conclusions : Korean and Western medical doctors, as medical personnel, intellectual persons as well as specialists, need a recognition and attitude to understand and respect each others' medicine. However, both groups also realize there are many complicated issues in the treatment of patients. It is difficult to require a change of Western doctors' perceptions and attitude toward Korean traditional medicine only with results of a survey. For the efficient cooperative system in the medical field, Korean medical doctors will need to study and consider specific problems mentioned by Western medicine.

• 대한예방한의학회지
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• 제17권3호
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• pp.1-18
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• 2013

Objectives: Korea has a dual medical system where traditional Korean Medicine (KM) and Western Medicine (WM) exist au equal terms with exclusive practice boundaries. The aim of this study was to identify complementary and substitute relationships between KM and WM in Korea. Methods: The data of 19,413 respondents were collected from the 2009 Korea Health Panel dataset. General characteristics and the medical utilization of respondents were analyzed descriptively. the Univariable Analysis was used to compare the factors that affected KM and WM utilization, and the Multivariable Analysis was applied to identify complementary or substitute relationships between the respondents' choices for KM and WM. The data were analyzed by the seven disease groups; diseases of nervous system, circulatory system, respiratory system, digestive system, skin and subcutaneous tissue, musculoskeletal system, and connective tissue, injury, poisoning and others. Results: 13.6% and 76.9% of respondents used KM and WM respectively last 12 mouths. 12.7% used both, and 0.9% used KM only. In overall, respondents who visited KM institutions used also WM. However, according to the analysis of choices of medical institutions, non-pharmacological KM treatment and WM has been used as a substitute for another in the diseases of the skin and subcutaneous tissue, diseases of the musculoskeletal system, and connective tissue, injury, poisoning and others. Conclusions: Despite some exceptional disease areas, Korean people use KM complementarily to WM, and this result can rationalize the recent Korean government policies encouraging the cooperation of KM and WM. This study can he used for the future policies development for KM service delivery.

• 문화기술의 융합
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• 제6권4호
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• pp.591-598
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• 2020

2020년 2월 COVID-19의 1차 대유행 이후 국내외적으로 원격의료에 대한 수요가 크게 증가하였고, 이에 대부분의 국가에서는 원격의료 관련 규제를 완화하였다. 우리나라 역시 2월 이후 한시적으로 '비대면진료'라는 이름으로 원격의료를 허용하고 있다. 원격의료는 만성질환 관리에 매우 효과적이고 정보통신기술의 발전에 따라 적용 가능한 진료과목이 점차 확대되고 있어, 의료서비스 질 향상 및 새로운 진료모형의 창출에 기여할 것으로 기대된다. 그러나 원격의료 참여를 매개로 한 의료공급자 간 차별화 효과를 낳을 수 있고 이는 대형병원 쏠림의 왜곡된 의료서비스산업구조의 문제점을 더욱 악화시킬 우려가 있다. 따라서 일차 진료기관을 중심으로 한 만성질환 관리 주치의제도의 정착을 통해 원격의료의 확대와 지역의료기반의 안정화를 동시에 도모하고, 상급종합병원 및 외국인환자유치기관에 대해서는 재외국민과 외국인 대상 원격의료 제공 능력을 지원하는 이원적 지원 정책 추진이 필요하다.