• 한국시스템다이내믹스연구
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• 제17권1호
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• pp.5-24
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• 2016

This study structurally analyzes major inefficiency of Korea's healthcare delivery system by utilizing the systems thinking. In particular, the phenomenon of patient's concentrated visits to large hospitals, waste of resource due to competitions between clinics and large hopitals, and the structure of oversupply were visualized using the causal loop diagram. The inefficient structure of healthcare delivery system can be understood more clearly by utilizing the major system archetypes of 'success to the successful', 'tragedy of commons', 'escalation' and 'limits to growth'. This study also finds solution from archetypal structure suggested by Wolstenholme. The inefficient status of healthcare delivery system might be explained by the 'out of control' archetype. In conclusion, the public resources such as the national health insurance need to be acknowledged as the entire achievement. All the participants should cooperate with each other in order to improve the inefficiency of the healthcare delivery system. In addition, the arrangement of incentive system for cooperation, acceleration of health information technology, and development of innovative business models make the sustainable healthcare delivery system.

• 보건행정학회지
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• 제29권3호
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• pp.248-261
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• 2019

Establishing a healthcare delivery system is key to building a cost-effective healthcare system that can prevent the waste of healthcare resources and increase efficiency. Recently, the rapid increase in the national medical expenditures due to the aging of the population and the increase in chronic diseases has raised the question about the sustainability of the healthcare system including the health insurance system. This is why we need to reform the medical delivery system, including the function setting of medical institutions. Accordingly, gradual and practical efforts based on the recognition of reality are needed for solving the problems and improving the medical delivery system. The first effort is to secure policy measures to establish functions and roles of medical institutions which are the basis of the healthcare delivery system, and a systematic medical use system for appropriate medical use. This approach can be achieved through a reasonable health insurance schemes. Without reasonable reform efforts, it will be difficult for Korea's health care system to develop into a system that can provide cost-effective and high-quality medical services that the people want.

• 한국병원경영학회지
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• 제spc호
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• pp.51-60
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• 2016

The forms of healthcare service delivery emerges from the interaction between technological progress and institutional changes. Building a healthcare system which enables effective and efficient patient care is a imperative to a sustainable operation of a society. Identifying of a promising medical technologies and diffusing them consists of the basic tasks of a good healthcare system. Inducing of a promising innovation in healthcare and utilization of the innovation requires a deep understanding of healthcare innovation system and delicate governmental intervention to the effective functioning of the system. Therefore, the support for R&D in healthcare field should be given to social and institutional technologies for the better organization of healthcare delivery and consumption system as well as basic and applied medical sciences.

• 한국병원경영학회지
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• 제spc호
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• pp.39-50
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• 2016

This paper discusses the strategic concepts applied to integrated delivery system(IDS). IDS is rooted in vertical integration(VI) and strategic alliance(SA), but only few knows about the theoretical backbone of the IDS. The paper explains how VI and SA applies to IDS, then provides cases of IDS rooted in strategic concepts; Kaiser Permanante Model, Mayo Clinic Model, and ACO(Accountable Care Organizations). Finally the paper provides the implication of IDS on Korean healthcare delivery system.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제24권1호
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• pp.7-14
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• 2018

Purpose: This study analyzes mental healthcare delivery services and types of facilities, the status of installation and operation, and planning standard. The purpose of the study is to propose a basic data for the performance of related research and work tasks, along with an understanding of the Chinese mental healthcare facility type and support system. Furthermore, it will show a lack of current function management as the changes of mental health concept and demand for services increases, and it is intended to provide implications for the construction of mental health facilities. Methods: This study was conducted by a research on law and regulation of China's mental healthcare delivery service system and mental healthcare facility. The analyzed data are the national standard GB, the optional national standard GB/T, the building construction standard JGJ, and the report issued by the Health Planning and Development Committee. Results: At present mental healthcare facility construction in China is in the period of rapid development and it exposes the layout of medical facilities, which is not currently reasonable and the service does not reach the designated position and so on. Overall, it requires more detailed guidelines to enhance the quality of mental healthcare service. Implications: It is expected that the research of this paper will provide effective reference for future research on Chinese Mental healthcare system and facilities, and can promote construction of Chinese mental healthcare facility theory in perfect condition.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제14권4호
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• pp.47-54
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• 2008

Preconstruction process in a lean project delivery system was studied in one large healthcare project working for a general contractor. Researchers joined a new lean delivery project for approximately six weeks and participated in preconstruction process including design coordination, management coordination, and target costing while concurrently interviewing other project participants and employees, recording activity in meetings, and otherwise observing the process. The preconstruction process in lean project delivery system, called integrated project design, showed many benefits such as brining expertise of downstream players (i.e., mechanical and electrical contractors) into the design phase. However, lack of leadership and lack of design-integrator blocked the successful application of a new concept of design process.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제17권2호
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• pp.27-34
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• 2011

It is very important to justify the reasonable role of healthcare facilities in the law in order to provide considerable medical services to the patient. Defining the right role of healthcare facilities makes it possible to build adequate Health Care Delivery System which might be helpful for the patient. However, the information of healthcare facilities in Korean law is so unclear that people are able to hardly understand what sort of proper medical service is for them. Furthermore, there is not enough regulation to differentiate each type of hospitals in the law. The result of this study is summarized into three points. Firstly, the current medical law does not reflect differences of function which each medical facility has. Secondly, the method of classification of healthcare facilities in the law disagrees with the Health Care Delivery System. Finally, there is no information on the type of sickbed in the law. Therefore, this study intend to analyze cause of problems which the law contains in order to be used for the fundamental resource for the healthcare facility planning.

• Translational and Clinical Pharmacology
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• 제26권3호
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• pp.103-110
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• 2018

The human microbiome is known to play an essential role in influencing host health. Extracellular vesicles (EVs) have also been reported to act on a variety of signaling pathways, distally transport cellular components such as proteins, lipids, and nucleic acid, and have immunomodulatory effects. Here we shall review the current understanding of the intersectionality of the human microbiome and EVs in the emerging field of microbiota-derived EVs and their pharmacological potential. Microbes secrete several classes of EVs: outer membrane vesicles (OMVs), membrane vesicles (MVs), and apoptotic bodies. EV biogenesis is unique to each cell and regulated by sophisticated signaling pathways. EVs are primarily composed of lipids, proteins, nucleic acids, and recent evidence suggests they may also carry metabolites. These components interact with host cells and control various cellular processes by transferring their constituents. The pharmacological potential of microbiome-derived EVs as vaccine candidates, biomarkers, and a smart drug delivery system is a promising area of future research. Therefore, it is necessary to elucidate in detail the mechanisms of microbiome-derived EV action in host health in a multi-disciplinary manner.

• 보건행정학회지
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• 제28권3호
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• pp.280-287
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• 2018

There has been much efforts to facilitate healthcare innovation and many desirable outcomes were produced in Korea. However, some structural deficiencies were found. They are misalignment of research and development (R&D) subjects with healthcare system, lack of flexibility of current healthcare system to accommodate the radically innovative products, and lack of cooperation among innovation agent. Some suggestions to correct these deficiencies are discussed. The suggestions are as follows: relating Korean healthcare R&D to healthcare system, enhancement of institutional flexibility to allow innovative application of new technology, improvement of the R&D process, and reexamination of the role of academic medical centers.

• 한국산학기술학회논문지
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• 제17권12호
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• pp.594-602
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• 2016

이 연구는 국민건강보험 이용자의 입장에서 의료전달체계에 대한 인식에 따른 진료의뢰 개선방안을 제시하기 위해 수행되었다. 국민건강보험 이용자가 1단계 의료기관에서 진료의뢰서를 받아 서울에 소재한 S대학병원(소위 '빅 4병원'중 한곳)을 방문한 207명의 외래환자를 대상으로 설문조사를 하였다. 설문 신뢰도는 Cronbach's ${\alpha}$가 0.7이상 이었고 연구방법은 인구학적인 특성은 pearson카이제곱과 Fisher's exact 검정을, 인식도와 개선요구도 간에는 pearson상관 분석을 실시하였다. 연구결과, 내원환자의 5.9%가 상급종합병원에서 의뢰되어 상급간의 의뢰를 확인하였고, 병원선택요인은 의사의 명성과 신뢰($4.40{\pm}.92$)가 가장 높았다. 진료의뢰제도에 대해 서울의 대형 상급종합병원으로 쏠리는 현상을 가장 높게 인식하였고($4.24{\pm}.97$) 서울의 대형 상급종합병원으로의 집중화현상이 최우선 개선과제로 나타났다($4.05{\pm}1.02$). 의료전달체계의 인식도와 개선요구도의 상관계수가 0.326으로 매우 유의미한 양(+)의 상관관계를 보였다(p<.01). 이번 연구를 통해 향후 의료전달체계 개선 시 공급자나 보험자가 아닌 이용자중심의 제도개선이 이루어지기를 기대해 본다.