• 의료법학
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• 제9권1호
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• pp.385-411
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• 2008

The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3639-3644
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• 2015

Oral, cervical and breast cancers, which are either preventable and/or amenable to early detection and treatment, are the leading causes of cancer-related morbidity and mortality in India. In this paper, we describe implementation science research priorities to catalyze the prevention and control of these cancers in India. Research priorities were organized using a framework based on the implementation science literature and the World Health Organization's definition of health systems. They addressed both community-level as well as health systems-level issues. Community-level or "pull" priorities included the need to identify effective strategies to raise public awareness and understanding of cancer prevention, monitor knowledge levels, and address fear and stigma. Health systems-level or "push" and "infrastructure" priorities included dissemination of evidence-based practices, testing of point-of-care technologies for screening and diagnosis, identification of appropriate service delivery and financing models, and assessment of strategies to enhance the health workforce. Given the extent of available evidence, it is critical that cancer prevention and treatment efforts in India are accelerated. Implementation science research can generate critical insights and evidence to inform this acceleration.

• 한국병원경영학회지
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• 제14권1호
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• pp.123-144
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• 2009

Recently, a long strike by hospital labor union emerged as a serious social issue. During the Worldcup Games in June, 2002, labor strikes broke up at 'C', 'K' and other hospitals, and in 2007, 'Y' hospital suffered much from a strike. Such series of extreme labor disputes have awakened people of importance of a more stable labor-management relationship for the medical institutions responsible for people's health than any other business organization. The purpose of this study was to examine the labor-management disputes at 'Y' hospital in 2007 and 'C' and 'K' hospitals in 2002. The results of this study can be summarized as follows; First, requests of the labor union such as pay raise, reemployment of the irregular workers as regular employees and participation of the labor union in personnel affairs are the long-held or core issues suffered by the medical institutions. Such issues are not independent from each other but complicated with each other surrounding the pay raise. Accordingly, it is not easy to determine the genuine bone of issue for labor-management disputes. Second, the model type of disputes between labor and management at medical institutions may be strike. However, it is conceived that the type of disputes would be subject to change as the essential medical service area system began to be operated since 2008. Third, the common characteristic of the labor strike among the 3 sample hospitals was occupation of the hospital lobby for a sit-in strike to maximize the negative effects of strike. Article 42 (Prohibition of Violence) of Labor Union and Labor Relation Coordination Act prohibits occupation of production or other important business facilities. In addition, since Ministry of Labor interprets that the hospital lobby belongs to the important business facilities enumerated by Article 42 of the above act, occupation of the hospital lobby for a sit-in strike may be too controversial to be admitted as a fair act of labor dispute when its legitimacy should be judged. Fourth, the counter-measures taken by the hospitals against the strike were observance of the principle 'no labor no pay,' closure, legal action, accusation, claim for recovery of damage, provisional seizure, disciplinary punishment, etc., but the principle of 'no labor, no pay' was not applied in a fair manner by 'C' and 'K' hospitals. However, 'Y' hospital applied this principle thoroughly to the strike; the hospital conduced to correction of the wrong labor-management relationship by refusing inclusion in the labor collective agreement of a provision about payment of wage during the period of strike or labor union's request to that effect during a strike. In addition, 'Y' hospital took an effective measure to end the strike earlier by notifying the labor union of cancellation of the collective agreement and banning the unionists from entering the hospital.

• 경영과정보연구
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• 제39권2호
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• pp.127-143
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• 2020

최근 무례한 고객에 의한 비이성적인 행동이 언론으로부터 자주 노출되면서 그 심각성이 사회적으로 이슈가 되고 있다. 서비스업의 경우 직무의 특성상 무례한 행동을 하는 고객과 자주 대면하여야 하며 상호작용하여야 하기에 이로 인한 종사원들의 스트레스는 매우 심각한 수준이다. 고객무례행동으로 인하여 종사원은 불쾌함, 우울함 등 부정적 감정을 느끼고 본인의 직업에 회의를 느껴 조직을 떠나려는 생각도 하게 된다. 이처럼 종사원의 서비스 제공에 직접적인 영향을 미친다는 점을 고려하면 고객무례에 관한 올바른 대처방안이 필요하다고 볼 수 있다. 이에 본 연구에서는 고객무례행동이 종사자의 감정부조화에 미치는 영향을 살펴보고 감정부조화가 직무스트레스에 미치는 영향과 직무스트레스가 조직일탈행동, 생활침해행동, 창의성에 미치는 영향을 살펴보았다. 또한, 직무스트레스를 보다 긍정적으로 관리할 방안을 마련하기 위하여 감정부조화와 직무스트레스의 관계에서 스트레스관리 교육의 조절효과를 살펴보았다. 자료 수집을 위해서 부산시 소재 종합병원, 중소병원의 고객 접점에서 업무를 수행하고 있는 의료서비스 종사자들을 대상으로 설문 조사를 시행하였으며 결과는 다음과 같다. 첫째, 무례행동은 감정부조화에 정(+)의 유의적 영향을 미치는 것으로 나타났다. 둘째, 감정부조화는 직무스트레스에 정(+)의 유의적 영향을 미치며 셋째, 직무스트레스는 조직일탈행동과 생활침해행동에 모두 정(+)의 유의적 영향을 미치는 것으로 나타났다. 넷째, 직무스트레스는 창의성에 부(-)의 유의적 영향을 미치는 것으로 나타났다. 다섯째, 감정부조화와 직무스트레스 간의 관계에서 스트레스관리 교육의 조절효과는 나타나지 않았다.

• 수산해양교육연구
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• 제26권6호
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• pp.1278-1295
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• 2014

The Sixteenth Meeting of the Conferences of Parties of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES), which was held in March 2013 in Bangkok, Thailand, listed five shark species and one genus, and uplisted one sawfish species. All new species listings will be come into force of the eighteen months delay, on the fourteenth of September, 2014. The purpose of the delay is to support the preparation of the domestic measures on shark trade by the parties, as there has been no previous experience in trading the commercially exploited aquatic species in the CITES. The CITES Secretary-General has visited several potential shark trade countries to encourage and facilitate the implementation of the new CITES listings. The newly listed sharks have been caught as a target or non-target species by Korean distant water fisheries and introduced into Korea. So the establishment or change of the domestic laws, regulations, and measures for the implementation of the new CITES species must be prepared before the effective entry date. This paper is prepared to assess the effects of the trade of the CITES listed shark species, and to suggest effective government service measures for the management of Korean distant water fisheries. The Ministry of Environment (MOE) is the general Management Authority of the CITES, and the Ministry of Food and Drug Safety (MFDS) is in charge of the medical trade of CITES listed species in Korea. By law, all imported medicines and medical materials must be inspected by the MFDS during the customs examination; this kind of authority sharing is reasonable and effective way of providing government service. Similarly, the designation of new CITES Management Authority for the trade of commercially exploited aquatic CITES species is critical and the Ministry of Oceans and Fisheries (MOF), which is now in charge of the trade of fisheries products, is the most appropriate governing body for this purpose in Korea. The revision of the National Plan of Action for Conservation and Management of Sharks, initially submitted to the Food and Agriculture Organization (FAO) of the United Nations in 2011 as a practical guideline for shark conservation in all Korean fisheries, could be a effective measure to achieve unification of conservation of endangered species and sustainable use of fisheries stocks. The proper CITES measures for the trade of listed species, such as the establishment of the documenting system for Non-detriment Findings, domestic measures suitable for the "Introduction from the Sea" clause, species specific Harmonized System Codes for the customs service, and an effective shark catch data reporting system should be in place prior to the fourteenth of September 2014.

• 보건행정학회지
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• 제27권4호
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• pp.273-275
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• 2017

It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

• 무역상무연구
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• 제45권
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• pp.191-238
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• 2010

The purpose of this paper is to make research on the trend of the worldwide medical device market, the trend of the medical device market in the major foreign countries, the present status of the medical device industry in Korea and Gangwon area, the present status of export competitive power and the SWOT analysis of competitive power of the medical device industry in Gangwon area, and the strengthening methods of export competitive power of the medical device industry in Gangwon area. As the research method, the questionaire for the strengthening of export competitive power of the medical device industry in Gangwon area was carried out from August 13 to Otober 22, 2009. The worldwide medical device market in 2008 is estimated at USD 210.2 billion, with the United States being the largest market, followed closely by Japan and Western Europe. In 2006, the worldwide export amount of medical devices recorded USD 121.1 billion and the worldwide import amount of medical devices recorded USD 126.3 billion. As of the end of 2008, the number of Korea's medical device manufacturers expanded to 1,726. The production amount of Korea's medical device industry in 2008 recorded 2,525 billion won, and the domestic market volume of medical devices in 2008 recorded 3,618 billion won. Korea's export amount of medical devices in 2008 recorded USD 1,132 million and recorded a 9.67% growth compared to the previous year, and the import amount of medical devices recorded USD 2,123 million and recorded a 1.43% reduction compared to the previous year. As of the end of 2008, the number of Gangwon area's medical device manufacturers expanded to 81. The production amount of Gangwon area's medical industry in 2008 recorded 380 billion won, and Gangwon area's export amount of medical devices recorded USD 269 million and recorded a 0.25% reduction compared to the previous year, and the import amount of medical devices recorded USD 3 million and recorded a 39.63% reduction compared to the previous year. According to the result analysis of the questionaire for the strengthening of export competitive power of medical device industry in Gangwon area(August 13~October 22, 2009), the competing country of the export medical device is the United States being the highest ranking. Comparing to the collective competitive power level 100 of the competing country, the collective competitive level of the export medical device is 60 below and 70-80 below being the highest ranking. Comparing to the quality level 100 of the United States, EU and Japan, the quality level of the export medical device is 80-90 below being the highest ranking. Comparing to the design level 100 of the United States, EU and Japan, the design level of the export medical device is 90-100 below being the highest ranking. Comparing to the technology level 100 of the United States, EU and Japan, the technology level of the export medical device is 80-90 below being the highest ranking. According to the SWOT analysis of competitive power of medical device industry in Gangwon area, the strength is the abundant expert manpower of the medical device in Wonju area. The weakness is the fragility of the brand recognition of the medical device industry. The opportunity is the demand increase of the new medical device owing to the advanced age of population. The threat is the difficulty of entry into overseas market owing to the request of the new specification certification of the medical device. In order to strengthen the export competitive power of the medical device industry in Gangwon area, the following measures should be taken by the government, local self-government body, related organization and medical device industry : the development of new technology and design, the enhancement of brand recognition. the acquisition of the foreign specification certification, the building of overseas distribution channel and after sales service channel, the positive participation in overseas medical device exhibition and opening of medical device exhibition, the training of expert manpower, the strengthening of overseas marketing, and the application of FTA and the establishment of counter measures against FTA. In conclusion, the medical device industry in Gangwon area has the difficulty in the entry into the overseas market owing to the shortage of overseas marketing capability. Therefore, the government and local self-government body should make the intensive and systematical support for overseas marketing of the medical device industry. For the support of overseas marketing, the government and local self-government body should provide positively the support of expenses for the acquisition of foreign specification certification, the support of participation in the overseas medical device exhibition, the despatch of market development mission, the increase of the support amount for R&D investment fund, and the training of expert manpower of medical devices.

• 보건의료산업학회지
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• 제8권3호
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• pp.27-38
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• 2014

The purpose of this study is proving the effects of the internal customer satisfaction management on worker's job satisfaction at general hospital. In the relationship between the management and the satisfaction, the study also finds the moderating effect of the organizational support awareness and the organizational justice. For this study, it was surveyed targeting 270 employees who work in seven general hospitals in Busan. As the result, 246 questionnaires returned. All of these questionnaires were used in the final analysis. The method of analysis is descriptive statistics using SPSS VER. 18.0, correlation analysis, regression analysis, factor analysis and reliability analysis. The main results of empirical analysis were as follows: First, in the effect of the internal customer satisfaction management to worker's job satisfaction, it has positive effect to internal communication and the commission of authority and it has positive effect to worker's job satisfaction. Second, the organizational support awareness & the organizational justice have moderating effect on the relationship between the internal customer satisfaction management and worker's job satisfaction. Third, the study proves that supporting management hierarchy shows positive effects for all socio-demographic characteristics in the organizational support awareness and the organizational justice.

• 지역사회간호학회지
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• 제14권2호
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• pp.179-189
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• 2003

Objectives: This study described the features of home-bound industrial accident victims and their needs for rehabilitation services. This study was also aimed to find a future direction of development of community rehabilitation programs that are suitable for their needs demands. Methods: This study is a descriptive study, were collected through two phases using structured questionnaire. In the first stage, su were performed via telephone interviews. In the se stage, surveys were performed via home visit Subjects in the first stage included 2203 indu injured victims staying at home, of whom. individuals complaining of post-traumatic complic became the subjects of the second stage. Results: This study showed that the home-bound industrial accident patients were complaining of complications from the injury even after receiving treatment by IACI. However, they were neglecting their health problems without any intervention. Even if they use health care services. the treatment is mainly focused on acute medical care, which may not effective for them. Furthermore, they had unstable employment status and suffered from financial burden for health care costs. The Labor Welfare Organization has established a plan to remove barriers of industrial accident victims in reinstatement, and has been preparing various programs in order to establish an all-embracing service system for industrial accident victims from accident occurrence to reinstatement. However, these rehabilitation services can be truly helpful only when the injured are able to obtain enough information about them. The current restrictive system is also not appropriate for solving health problems of the industrial accident victims. Therefore, it is necessary to develop a plan that can provide industrial accident victims high-quality rehabilitation services so that they can use those services in the community without being dependent on hospitals. This study proposes visit nursing services as a way to provide various health services within community for the industrial accident victims.

• 보건의료산업학회지
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• 제1권1호
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• pp.31-44
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• 2007

The purpose of this study is to shed light on the effect of work-family conflict on organizational effectiveness, focusing on the moderating effect of organizational support among married working women of health services organizations. Data were collected from 149 married working women of health services organizations located in Busan Metropolitan areas by structured self-administered questionnaire. Main results of this study is as the following: First, based on the type of work-household conflicts, namely time-based conflict(2.82 points), strain-based conflict(2.81 points) and behavior-based conflict(2.69 points), working women mainly experienced time and strain-based conflicts. The level of work-household conflicts was significantly higher among younger groups, highly educated, nurses, and regular workers. Second, the perceived organizational effectiveness found to be an above-average. Especially scores were high in the subcategories of customer orientation(3.84), followed by organizational commitment (3.42) and job satisfaction(3.19). The level of organizational effectiveness was significantly higher among older groups, medical technician and administrative job holders, day-time workers, and higher income groups. Third, the results of the regression analysis on the effects of work-household conflicts on organizational effectiveness showed that strain-based conflicts have a significant negative effect on organizational effectiveness such as job satisfaction and organizational commitment. Fourth, organizational support found to have a strong controlling effect for strain-based conflicts on organizational effectiveness. Above results imply that practical family-supportive policies for lessening the work-household conflicts is crucial for enhancing organizational effectiveness in health services organization.