• Title/Summary/Keyword: Long-term care hospitals

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A Study on Medical Tourism Evaluation and Institutional Challenges (의료관광 시행 이후에 나타난 성과와 향후의 과제)

  • Moon, Seong-Jea
    • The Korean Society of Law and Medicine
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    • v.11 no.2
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    • pp.275-307
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    • 2010
  • In the presidential new-year address in January 2, 2009, the President declared that 17 kinds of new driving force of growth that could create high-added value be selected to step up job creation and an increase in national wealth. The Ministry of Strategy & Finance announced plans for the 17 kinds of new driving force of growth after the presidential address. Specifically, that ministry announced an ambitious plan to select health care service named 'Global Health Care' as one of the five service industries that could create high-added value in a move to provide jobs to approximately 7,000 people and produce pervasive economic effects coming up to a trillion and 10 billion won. To attain the goal, several action plans were mapped out to globalize domestic medical institutions, to rearrange the relevant law and system for the purposes of raising awareness of domestic medical institutions among foreign patients and improving their accessibility and post-satisfaction level, and to lure lots of foreign patients through financial assistance. At the same time, the government announced plans to lure severe patients such as those in want of surgery or organ transplant, cancer patients or patients with heart diseases to create high-added value on a long-term basis. Thus, the government announced that it planned to formulate such strategies and to enter an agreement with foreign governments to attract plenty of foreign patients. In fact, however, there are little full-scale evaluation of medical tourism though it's been a year since it was introduced, and there are few actual efforts to implement what the government announced, either. According to the results of the evaluation of medical tourism, domestic hospitals are said to undergo little significant changes after the introduction of medical tourism, which shows that they take a dim view of medical tourism instead of having expectations for that. The medical tourism industries in major Asian countries have been dynamized, and there are several factors of their success. First of all, they are successful in creating new market opportunities by incorporating related industries such as medicine, tourism and IT and in developing medical tourism products and differentiated marketing by taking advantage of their competitive edge. They have offered full-fledged assistance to this sector, and another reason is the improved international credibility of their medical service. If our country fails to pinpoint our problems in consideration of the cases of the Asian countries or to provide appropriate financial aid, our country is bound to lag behind them. Given this reality, how to assess medical tourism and what challenges this sector is confronted with are discussed.

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PRESENT STATE AND PROSPECT OF PUBLIC DENTAL HEALTH SERVICE FOR CHILDREN AND ADOLESCENTS IN KOREA (우리나라 어린이와 청소년의 구강건강을 위한 공공서비스의 현황과 전망)

  • Lee, Kwang-Hee;Kim, Jee-Young;Song, Ji-Hyon;Kim, Yun-Hee;Im, Kyeong-Uk;Jeong, Seung-Yeol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.3
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    • pp.578-588
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    • 2008
  • To achieve the dental health of children and adolescents which is the objective of the pediatric dentistry, the role of the public service should be increased. The basis of the public service is established by many laws of which the Dental Health Law is most important. The percentages of primary schools that had the school dental health clinic, that implemented the fluoride rinsing program, and that implemented the group toothbrushing after lunch were 7.2%, 57.5%, and 46.9%, respectively, and the percentages of primary school children that received the dental health education and that received the fissure sealing were 48.0% and 12.4%, respectively(2006). About 42% of infants and preschool children from 0 to 6 years received preventive dental care in the last one year, at the nursery or kindergarten(18%) or at the health center(1%)(2005). The percentage of the health centers that implemented water fluoridation was 11.3%, and the percentage of the population who drank the fluoridated water was 5.7%(2006). It was suggested that the school dental health administration should be unified, that dental health teachers should be employed, and that the comprehensive dental health care should be supplied to all the children and adolescents through the circuit school dentists and the school dental hospitals in the long term. Also, the dentist in charge system for the children and adolescent was suggested.

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Analysis of the Health Insurance Costs of Occupational Therapy in Stroke patients (뇌졸중 환자의 작업치료 보험수가 분석)

  • Kim, Hyun-Jin;Kim, Se-Yun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.3
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    • pp.1920-1927
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    • 2015
  • This study examined health insurance costs of occupational therapy in stroke patients. The subjects were stroke patients, who underwent occupational therapy by hospitalization or out-patient centers in 2010. The cost of occupational therapy was analyzed from the insurance claims data of Health Insurance Review and Assessment Service in 2010. The kinds of occupational therapy were divided according to the insurance fee of occupational therapy in 2010. In-patients who received occupational therapy paid the highest rehabilitation treatment fee, whereas outpatients paid the highest nervous system function test fee. The cost of occupational therapy in the special rehabilitation treatment fee was highest by 25.3 billion won. The number of uses of general hospitals was the highest by 180 thousand but the total cost of long-term care hospital was highest by 10.4 billion won. The number of uses and cost by regional groups was highest in Seoul and Gyeonggi-do province. This study is meaningful in that a cost analysis of occupational therapy in stroke patients was performed for the first time using the stroke data from the whole country. The result can be used to provide basic data to improve the insurance fee in the future.

Legislative Study on the Mitigation of the Burden of Proof in Hospital Infection Cases - Focusing on the revised Bürgerliches Gesetzbuch - (병원감염 사건에서 증명책임 완화에 관한 입법적 고찰 - 개정 독일민법을 중심으로 -)

  • Yoo, Hyun Jung
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.159-193
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    • 2015
  • Owing to causes such as population aging, increased use of various medical devices, long-term hospitalization of various patients with reduced immune function such as cancer, diabetes, and organ transplant patients, and the growing size of hospitals, hospital infections are continuing to increase. As seen in the MERS crisis of 2015, hospital infections have become a social and national problem. In order to prevent damage due to such hospital infections, it is necessary to first strictly implement measures to prevent hospital infections, while, on the other hand, providing proper relief of damage suffered due to hospital infections. However, the mainstream attitude of judicial precedents relating to hospital infection cases has been judged to in fact shift responsibility over damages due to hospital infections on the patient. In light of the philosophy of the damage compensation system, whose guiding principle if the fair and proper apportionment of damages, there is a need to seek means of drastically relaxing the burden of proof on the patient's side relative to conventional legal principles for relaxing the burden of proof, or the theory of de facto estimation. In relation to such need, the German civil code (Burgerliches Gesetzbuch), which defines contracts of medical treatment as typical contracts under the civil code, and has presumption of negligence provisions stipulating that, in cases such as hospital infections which were completely under the control of the medical care providers, if risks in general medical treatment have been realized which cause violations of the life, body, or health of patients, error on the part of the person providing medical care is presumed, was examined. Contracts of medical treatment are entered into very frequently and broadly in the everyday lives of the general public, with various disputes owing thereto arising. Therefore, it is necessary to, by defining contracts of medical treatment as typical contracts under the civil code, regulate the content of said contracts, as well as the proof of burden when disputes arise. If stipulations in the civil code are premature as of yet, an option may be to regulate through a special act, as is the case with France. In the case of hospital infection cases, it is thought that 'legal presumption of negligence' relating to 'negligence in the occurrence of hospital infections,' which will create a state close to equality of arms, will aid the resolution of the realistic issue of the de facto impossibility of remedying damages occurring due to negligence in the process of occurrence of hospital infections. Also, even if negligence is presumed by law, as the patient side is burdened with proving the causal relationships, such drastic confusion as would occur if the medical care provider side is found fully liable if a hospital infection occurs may be avoided. It is thought that, alongside such efforts, social insurance policy must be improved so as to cover the expenses of medical institutions having strictly implemented efforts to prevent hospital infections in the event that they have suffered damages due to a hospital infection accident, and that close future research and examination into this matter will be required.

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The Present State and Curriculum Implementation Overview of the Nursing-Specialized Vocational High Schools (특성화고등학교 간호과 운영 현황 및 교육과정 운영실태 분석)

  • Yoon, In-Kyung;Jang, Myung-Hee;Lee, Hyun-Young
    • Journal of vocational education research
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    • v.35 no.4
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    • pp.19-46
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    • 2016
  • The purpose of this study is to analyze the curriculum implementation of the Nursing-Specialized Vocational High School by researching on operation, organization and environment of the program of Nursing. This study aims to improve the curriculum of the Nursing-Specialized Vocational High School. This study has analyzed previous existing studies, Link of School info, Educational Statistics and data indicating establishment, operation and curriculum of the department of Nursing which have been collected from web sites of institutions and associations relevant to Nurse Education. The major results of this study are as follows: 1) As of the first semester of the year 2016, out of a total of thirty eight Specialized Vocational High Schools and Meister High Schools in the country, 6.4% of the schools have nursing educational programs. These schools have established the programs under various names, such as Health Nursing, Dental Health Nursing, Nursing, Nursing and Medical Tourism, Accounting in Nursing and Nursing Management, etc. Since 2012, enrollment rates have increased while post-graduation employment rates have decreased, with the average employment rate of Specialized Vocational High School graduates having reached up to 46% by 2015. 2) The Nursing-Specialized Vocational High School aims to create skilled Nurses Assistant such as Nurse Aide and Care giver. The program is successful in providing necessary courses to acquire required certification and proficient field experience but requires revisional changes in order to create a long-term program of sufficient qualification. The official requirement of 780 hours of field practice was completed during the three educational breaks from the first year of high school to the second year, while the curriculum was conducted separately in the field hospitals. 3) An average of two laboratory classrooms were available based on the facility requirement standard of Cities and Provinces Educational Policies. In order to secure proficient instructors of Nursing education, establishment of specific indicated subjects, regional placement, in-service education, research and supervision are essential for establishing excellence and continual improvement.

Effects of Market Orientation and Relationship Orientation with Suppliers on Business Performance in Animal Clinic Industry: Moderating Effects of Entrepreneur's Characteristics and Clinic Location (동물병원의 시장지향성과 공급업체와의 관계지향성이 동물병원 성과에 미치는 영향: 경영자의 특성과 동물병원 입지에 따른 조절효과)

  • Yoo, Dong-Keun;Suh, Seung-Won;Lee, Yong-Ki
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.2
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    • pp.189-222
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    • 2008
  • This study developed a model to empirically investigate the effects of market orientation and relationship orientation with suppliers on business performance and examine the moderating effects of entrepreneur's characteristics (working tenure) and clinic's location. The data was collected from 200 animal clinics which belong to Korean Animal Hospital Association (KAHA)'s national conference in April, 2007. Descriptive statistic, factor analysis, reliability analysis, and regression analysis were conducted to analyze the data using SPSS/PC+ 12.0. The findings are as follows. First, the market orientation of animal clinics influences significantly both financial and non-financial performance. When the moderating effect of entrepreneur's working tenure is considered, market orientation has significant effect on animal clinic's financial and non-financial performance. However, when the moderating effect of animal clinic's location is considered, market orientation has not significant effect on animal clinic's financial and non-financial performance. Second, animal clinic's relationship orientation with suppliers mostly affects the financial and non-financial performance significantly. When entrepreneur's working tenure in the clinic is longer (above 4 years group), relationship orientation with suppliers significantly affects both financial and non-financial performance. Meanwhile, when the entrepreneur's working tenure in the clinic is shorter (less than 3 years group), relationship orientation with suppliers doesn't affect clinic's financial performance but affect non-financial performance partially. In other words, when entrepreneur's working tenure is shorter (less than 3 years group), market orientation more influences on clinic's financial and non-financial performance while relationship orientation with suppliers does less. It is thought that their relation with suppliers and relationship orientation activities with suppliers are less strongly established and maintained yet. So, they primarily focus on market orientation strategy when entrepreneur's working tenure is shorter. Third, when animal clinics are located in non-metropolitan area, relationship orientation with suppliers significantly affects financial and non-financial performance. However, when animal clinics are located in metropolitan area, it doesn't affect financial and non-financial performance either. It is thought that animal clinics which are located in non-metropolitan area need stronger relationship with suppliers and need support more from them as most of suppliers actively work in metropolitan area not in the non-metropolitan area and animal clinics in metropolitan area can easily get better market information than animal clinics in non-metropolitan area. Lastly, while the effect of the market orientation significantly influences animal clinic's business performance continuously, the effect of the relationship orientation differently influences business performance as it is moderated by entrepreneur's working tenure and animal clinic's location. So, relationship orientation with suppliers can be selectively applied to improve the clinic's financial and no-financial performance. In summary, both of animal clinic's marketing orientation and animal clinic's relationship orientation with suppliers positively influence their business performance. However, entrepreneur's working tenure and animal clinic location moderate the relationship between market orientation and relationship orientation and their business performance differently. This study is quite meaningful to empirically investigate the effects of both of market orientation and relationship orientation with suppliers on business performance and examine the moderating effects of entrepreneur's characteristics (working tenure) and clinic's location. And, as this kind of study has been very few in the context of animal clinic industry, it helps practically understand the effects of market orientation and relationship orientation with suppliers on the financial and non-financial performance in animal clinic industry. Furthermore, as the market conditions in animal clinic industry have been in difficulty for a few years, this study can help improve animal clinic's financial and non-financial business performance together with their suppliers as business partners. Lastly, this study can help find mid-term and long-term cooperation between animal clinics and their suppliers. This study has some limitations. So, care should be taken when generalizing the results of the study. First, our samples were collected from only the animal clinics industry. However, a comparison of the results presented here with those form other marketing contexts (e.g., general hospitals) would be worthwhile. Future comparative research will enhance the generality of our contingency theory cross industry context. Second, this study found that market orientation and relationship orientation affect business performance. However, there may be other antecedents, such as internal market orientation and relationship orientation with customers. Also, this research did not consider other moderators, such as overall market conditions, competitive situations, and power/conflict between suppliers and buyers in the relationship between market and relationship orientation and business performance.

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National Survey of Mycobacterial Diseases Other Than Tuberculosis in Korea (비결핵항산균증 전국 실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.277-294
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    • 1995
  • Background: The prevalence of tuberculosis in Korea decreased remarkably for the past 30 years, while the incidence of disease caused by mycobacteria other than tuberculosis is unknown. Korean Academy of Tuberculosis and Respiratory Diseases performed national survey to estimate the incidence of mycobacterial diseases other than tuberculosis in Korea. We analyzed the clinical data of confirmed cases for the practice of primary care physicians and pulmonary specialists. Methods: The period of study was from January 1981 to October 1994. We collected the data retrospectively by correspondence with physicians in the hospitals that referred the specimens to Korean Institute of Tuberculosis, The Korean National Tuberculosis Association for the detection of mycobacteria other than tuberculosis. In confirmed cases, we obtained the records for clinical, laboratory and radiological findings in detail using protocols. Results: 1) Mycobacterial diseases other than tuberculosis were confirmed that 1 case was in 1981, 2 cases in 1982, 4 cases in 1983, 2 cases in 1984, 5 cases in 1985, 1 case in 1986, 3 cases in 1987, 1 case in 1988, 6 cases in 1989, 9 cases in 1990, 14 cases in 1990, 10 cases in 1992, 4 cases in 1993, and 96 cases in 1994. Cases since 1990 were 133 cases(84.2%) of a total. 2) Fifty seven percent of patients were in the age group of over 60 years. The ratio of male to female patients was 2.6:1. 3) The distribution of hospitals in Korea showed that 61 cases(38.6%) were referred from Double Cross Clinic, 42 cases(26.6%) from health centers, 21 cases(13.3%) from tertiary referral hospitals, 15 cases(9.5%) from secondary referral hospitals, and 10 cases(6.3%) from primary care hospitals. The area distribution in Korea revealed that 98 cases(62%) were in Seoul, 17 cases(10.8%) in Gyeongsangbuk-do, 12 cases(7.6%) in Kyongki-do, 8 cases(5.1%) in Chungchongnam-do, each 5 cases(3.2%) in Gyeongsangnam-do and Chungchongbuk-do, 6 cases(3.8%) in other areas. 4) In the species of isolated mycobacteria other than tuberculosis, M. avium-intracellulare was found in 104 cases(65.2%), M. fortuitum in 20 cases(12.7%), M. chelonae in 15 cases(9.5%), M. gordonae in 7 cases(4.4%), M. terrae in 5 cases(3.2%), M. scrofulaceum in 3 cases(1.9%), M. kansasii and M. szulgai in each 2 cases(1.3%), and M. avium-intracellulare coexisting with M. terrae in 1 case(0.6%). 5) In pre-existing pulmonary diseases, pulmonary tuberculosis was 113 cases(71.5%), bronchiectasis 6 cases(3.8%), chronic bronchitis 10 cases(6.3%), and pulmonary fibrosis 6 cases(3.8%). The timing of diagnosis as having pulmonary tuberculosis was within 1 year in 7 cases(6.2%), 2~5 years ago in 32 cases(28.3%), 6~10 years ago in 29 cases(25.7%), 11~15 years ago in 16 cases(14.2%), 16~20 years ago in 15 cases (13.3%), and 20 years ago in 14 cases(12.4%). Duration of anti-tuberculous treatment was within 3 months in 6 cases(5.3%), 4~6 months in 17 cases(15%), 7~9 months in 16 cases(14.2%), 10~12 months in 11 cases(9.7%), 1~2 years in 21 cases(18.6%), and over 2 years in 8 cases(7.1%). The results of treatment were cure in 44 cases(27.9%) and failure in 25 cases(15.8%). 6) Associated extra-pulmonary diseases were chronic liver disease coexisting with chronic renal failure in 1 case(0.6%), diabetes mellitus in 9 cases(5.7%), cardiovascular diseases in 2 cases(1.3%), long-term therapy with steroid in 2 cases(1.3%) and chronic liver disease, chronic renal failure, colitis and pneumoconiosis in each 1 case(0.6%). 7) The clinical presentations of mycobacterial diseases other than tuberculosis were 86 cases (54.4%) of chronic pulmonary infections, 1 case(0.6%) of cervical or other site lymphadenitis, 3 cases(1.9%) of endobronchial tuberculosis, and 1 case(0.6%) of intestinal tuberculosis. 8) The symptoms of patients were cough(62%), sputum(61.4%), dyspnea(30.4%), hemoptysis or blood-tinged sputum(20.9%), weight loss(13.3%), fever(6.3%), and others(4.4%). 9) Smear negative with culture negative cases were 24 cases(15.2%) in first examination, 27 cases(17.1%) in second one, 22 cases(13.9%) in third one, and 17 cases(10.8%) in fourth one. Smear negative with culture positive cases were 59 cases(37.3%) in first examination, 36 cases (22.8%) in second one, 24 cases(15.2%) in third one, and 23 cases(14.6%) in fourth one. Smear positive with culture negative cases were 1 case(0.6%) in first examination, 4 cases(2.5%) in second one, 1 case (0.6%) in third one, and 2 cases(1.3%) in fourth one. Smear positive with culture positive cases were 48 cases(30.4%) in first examination, 34 cases(21.5%) in second one, 34 cases(21.5%) in third one, and 22 cases(13.9%) in fourth one. 10) The specimens isolated mycobacteria other than tuberculosis were sputum in 143 cases (90.5%), sputum and bronchial washing in 4 cases(2.5%), bronchial washing in 1 case(0.6%). 11) Drug resistance against all species of mycobacteria other than tuberculosis were that INH was 62%, EMB 55.7%, RMP 52.5%, PZA 34.8%, OFX 29.1%, SM 36.7%, KM 27.2%, TUM 24.1%, CS 23.4%, TH 34.2%, and PAS 44.9%. Drug resistance against M. avium-intracellulare were that INH was 62.5%, EMB 59.6%, RMP 51.9%, PZA 29.8%, OFX 33.7%, SM 30.8%, KM 20.2%, TUM 17.3%, CS 14.4%, TH 31.7%, and PAS 38.5%. Drug resistance against M. chelonae were that INH was 66.7%, EMB 66.7%, RMP 66.7%, PZA 40%, OFX 26.7%, SM 66.7%, KM 53.3%, TUM 53.3%, CS 60%, TH 53.3%, and PAS 66.7%. Drug resistance against M. fortuitum were that INH was 65%, EMB 55%, RMP 65%, PZA 50%, OFX 25%, SM 55%, KM 45%, TUM 55%, CS 65%, TH 45%, and PAS 60%. 12) The activities of disease on chest roentgenogram showed that no active disease was 7 cases(4.4%), mild 20 cases(12.7%), moderate 67 cases(42.4%), and severe 47 cases(29.8%). Cavities were found in 43 cases(27.2%) and pleurisy in 18 cases(11.4%). 13) Treatment of mycobacterial diseases other than tuberculosis was done in 129 cases(81.7%). In cases treated with the first line anti-tuberculous drugs, combination chemotherapy including INH and RMP was done in 86 cases(66.7%), INH or RMP in 30 cases(23.3%), and not including INH and RMP in 9 cases(7%). In 65 cases treated with the second line anti-tuberculous drugs, combination chemotherapy including below 2 drugs were in 2 cases(3.1%), 3 drugs in 15 cases(23.1%), 4 drugs in 20 cases(30.8%), 5 drugs in 9 cases(13.8%), and over 6 drugs in 19 cases (29.2%). The results of treatment were improvement in 36 cases(27.9%), no interval changes in 65 cases(50.4%), aggravation in 4 cases(3.1%), and death in 4 cases(3.1%). In improved 36 cases, 34 cases(94.4%) attained negative conversion of mycobacteria other than tuberculosis on cultures. The timing in attaining negative conversion on cultures was within 1 month in 2 cases(1.3%), within 3 months in 11 cases(7%), within 6 months in 14 eases(8.9%), within 1 year in 2 cases(1.3%) and over 1 year in 1 case(0.6%). Conclusion: Clinical, laboratory and radiological findings of mycobacterial diseases other than tuberculosis were summarized. This collected datas will assist in the more detection of mycobacterial diseases other than tuberculosis in Korea in near future.

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