• 농촌의학ㆍ지역보건
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• 제8권1호
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• pp.35-43
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• 1983

Health institutions in Korea include a wide range of traditions, most notable of which are hospitals, clinics, pharmacies and health centers as foci for the dispension of western medicine care ; and herb clinics and shamans acting as centers for traditional medicine. Health consumers have pluralistic conceptions of illness(or disease) and act accordingly, using what they consider as appropriate medical practices. The research conducted surveyed residents of Jeomdong-Myon(a rural farming district), Guro 6-Dong(an urban district) and the Banwol(a semiurban district) area on attitudes about health institutions and their utilization of them. The results indicate that the hospital is considered the most reliable health institution, however, the most widely known and commonly used institution was the pharmacy. Hospitals and clinics were found to be utilized more frequently by those residents who were familiar with them than by others less familiar with them. In addition respondents with higher education, those with medical insurance, and those living in urban areas tended to utilize hospitals and clinics more frequently than their less educated, uninsured, or rural counterparts. Converse to the ranking of western medical institutions, traditional health institutions were rated low with regards to reliability, familiarity and utilization. This indicates that western medical care has pervaded the Korean medical system.

• 대한한방부인과학회지
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• 제19권4호
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• pp.131-147
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• 2006

Purpose : This study was carried out to analyze the cognition and realities of postpartum care and to aid the spread of oriental medicine in postpartum care and to get a basic guideline of postpartum care home and Korean Medicine Doctor(K.M.D.)'s role model of postpartum care. Methods : We has made questions about the cognition and realities of postpartum care to 2 groups they are workers with postpartum care Home at Gangdong-gu or Songpa-gu puerperants and K.M. doctors working at Gangdong-gu from December 2005 to April 2006. And then we analyzed collected data by using statistics analysis program, SPSS. Results : Almost of 2 group felt sympathy for importance of postpartum care. 5.9% of workers with postpartum care home had maternity nurse licence, 67.6% of them had nurse license and 26.5% of them had nurse's aide qualification. 97.1% of them had experience at medical institution. Most of K.M.D. used Herb-medication for postpartum care with acupuncture and Moxibustion additionally. Conclusion : Workers with postpartum care home had a comparatively good record of medical care or postpartum care. There was difference between 2 groups about proper management model of postpartum care home.

• Journal of Chest Surgery
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• 제52권6호
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• pp.409-415
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• 2019

Background: Postoperative chylothorax may be caused by iatrogenic injury of the collateral lymphatic ducts after thoracic surgery. Although traditional treatment could be considered in most cases, resolution may be slow. Radiological interventions have recently been developed to manage postoperative chylothorax. This study aimed to compare radiological interventions and conservative management in patients with postoperative chylothorax. Methods: We retrospectively reviewed periprocedural drainage time, length of hospital stay, and nil per os (NPO) duration in 7 patients who received radiological interventions (intervention group [IG]) and in 9 patients who received conservative management (non-intervention group [NG]). Results: The baseline characteristics of the patients in the IG and NG were comparable; however, the median drainage time and median length of hospital stay after detection of chylothorax were significantly shorter in the IG than in the NG (6 vs. 10 days, p=0.036 and 10 vs. 20 days, p=0.025, respectively). NPO duration after chylothorax detection and total drainage duration were somewhat shorter in the IG than in the NG (5 vs. 7 days and 8 vs. 14 days, respectively). Conclusion: This study showed that radiological interventions reduced the duration of drainage and the length of hospital stay, allowing an earlier return to normal life. To overcome several limitations of this study, a prospective, randomized controlled trial with a larger number of patients is recommended.

• 의료법학
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• 제15권2호
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• pp.345-366
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• 2014

Because the health care or medical sector has such characteristics as publicity, professionality, and exclusivity, it cannot be left to the free market system. As a consequence, the state has restricted the establishment of medical institutions in order to protect the life and health of people. Also, the medical law has regulated to permit the establishment of medical institutions by only medical personnel and a few corporate bodies and to ban the establishment of medical institutions under disguised ownership as well as double opening of medical institutions by medical personnel. Nevertheless, there are still many cases that non-medical personnel have dominantly established medical institutions under disguised ownership of other medical personnel or nonprofit corporation. Because they are willing to recover their investment costs as soon as possible, these illegally established medical institutions are likely to make patients undergo unnecessary tests or to perform the excessive treatments and, as a result, are likely to cause infringement on the health and lives of the people. In addition, even if the misconduct is uncovered, the rate at which the costs already paid is very low and, as a result, the damages are straightly connected to the people's loss. On the other hand, there are also increasing number of cases that medical personnel or nonprofit corporations are establishing medical institutions against the medical law regulations. The examples of this illegality are also the double opening of medical institutions and the establishment of medical institutions under disguised ownership by medical personnel or nonprofit corporations. And the damages in these cases may not differ from those in the above cases. In this study, regarding medical law regulations restricting opening a medical institution, I will review the intent of those regulations, the type of violations and criminal punishments, and the possibility of recovery from unlawful profit by the National Health Insurance Act. And then, I would like to find a way for rational improvement of each.

• 농촌의학ㆍ지역보건
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• 제22권1호
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• pp.75-83
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• 1997

The medical insurance system has been adopted in 1989. Since then, the utilization of medical care services has increased rapidly. It appears that the medical institution needs more nursing manpower such as nurses and nurse aides to meet an increased demand for medical care for the residents. However, the medical care clinics run by a medical practitioners has a more shortage of nursing manpower than hospitals. The purpose of this survey was to analyze the current employment status and to obtain an opinion on the improvement of utilization such as recruitment and retention of nursing manpower. The questionnaire sent to the private physician and the response rate was 28.7% ; 87 out of 300 physicians. 82.6% of the respondents employed nurses aides rather than nurses and an average number of employees per clinic was 2.5 persons. Most physicians had difficulties in recruiting nursing manpower. It took more than one month for replacement on average, therefore, they were suffering from giving good continual care for the patient and also high resignation of nursing personnel. The low wage, long working hours, hard work and lack of incentives are the biggest reasons for the difficulty in recruiting and retaining of the nursing personnel obtained for the clinics survey. The above mentioned problems would be solved in the near future by changing those difficulties. In the meantime, the private physicians are marking an effort to retain the nursing personnel by keeping a relationship of the private physician's cooperatives.

• 대한방사선기술학회지:방사선기술과학
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• 제37권4호
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• pp.315-322
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• 2014

본 연구에서는 CT 장비의 국내에서의 보급률과 이용률이 증가되고 있는 흐름과 증가의 변화와 장치의 변화가 검사부위에 나타나는 빈도 등을 정량적으로 파악하기 위하여 현재 우리나라의 의료기관 종별 및 시기별의 의료영상 진단 장비인 CT장치의 보유현황, 검사료 등을 조사하였다. 최근 10년간의 우리나라 의료기관 종별(상급종합병원, 종합병원, 병원, 의원, 치과병원, 보건의료원, 한방병원) 및 연도별(2003~2012)에 따른 CT장치 보유현황, 연도별 CT검사료를 의료기관 종별의 분포를 조사하였다. 우리나라 CT장치는 상급종합병원과 종합병원급 의료기관에서 보유한 총 비율은 2003년에 25.6%, 2011년에 32.5%정도인 반면, 병원과 의원급 의료기관에서 보유한 비율은 2003년에 73.5%와 2009년에 67.5%로 약 70%를 차지하고 있는 것으로 나타났다. 2011년도를 기준으로 하였을 때 상급종합병원과 종합병원에서 총 검사료의 82.4% 정도인 반면, 병원과 의원에서는 총 검사료의 17.6%로 나타났다. CT장비는 병원급은 증가하고 있는 추세이나 의원급은 감소하고 있는 것으로 나타났다. CT검사료 대부분은 80% 이상이 상급종합병원과 종합병원에서 청구하는 것으로 나타났다. 의료기관 종별 CT장비 보유현황과 검사료간의 상관관계가 유의미함을 알 수 있다. 그 중에서도 상급종합병원의 CT보유대수와 검사료간의 상관관계가 높았으며(p<.001), CT보유대수가 많아질수록 검사료 청구액도 높아진 것으로 나타났다.

• Korean Circulation Journal
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• 제53권9호
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• pp.594-605
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• 2023

Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in the Asia-Pacific region, and mortality rates differ between countries in the region. Systems of care have been shown to play a major role in determining AMI outcomes, and this review aims to highlight pre-hospital and in-hospital system deficiencies and suggest possible improvements to enhance quality of care, focusing on Korea, Japan, Singapore and Malaysia as representative countries. Time to first medical contact can be shortened by improving patient awareness of AMI symptoms and the need to activate emergency medical services (EMS), as well as by developing robust, well-coordinated and centralized EMS systems. Additionally, performing and transmitting pre-hospital electrocardiograms, algorithmically identifying patients with high risk AMI and developing hospital networks that appropriately divert such patients to percutaneous coronary intervention-capable hospitals have been shown to be beneficial. Within the hospital environment, developing and following clinical practice guidelines ensures that treatment plans can be standardised, whilst integrated care pathways can aid in coordinating care within the healthcare institution and can guide care even after discharge. Prescription of guideline directed medical therapy for secondary prevention and patient compliance to medications can be further optimised. Finally, the authors advocate for the establishment of more regional, national and international AMI registries for the formal collection of data to facilitate audit and clinical improvement.

• 한국임상보건과학회지
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• 제2권2호
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• pp.148-157
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• 2014

Purpose. This study compares and analyzes customer service on customer satisfaction and customer royalty on customer satisfaction targeting the customers visiting a hospital or a clinic which is franchised or not. And it aims at helping business rationalization for a medical institution. Methods. This paper conducts a survey and selects a sample of 670 customers except the missing value targeting the customers of 4 primary health care institutions and 4 bigger health care institutions in Seoul and Gyeonggi province. It conducts frequency analysis for the purpose of investigating the respondents' generic characteristic and factor of their medical institution selection, and factor analysis, reliability analysis and regression analysis for the hypothesis testing. Results. The first hypothesis testing result is significant in level of significance of 0.01. The second one is the same as the first one, but the dummy variable shows a negative regression coefficient(-0.479). The third one is significant in level of significance of 0.01, but the forth one is not significant. And the respondents prioritize website(Home page) and convenience in use of a hospital procedure for selecting a hospital or a clinic. Conclusions. The additional analysis finds that the franchised group has more satisfaction than none franchised group. But in case of their royalty, the average of franchised and none franchised groups are not significantly different. Therefore, the results of this paper reveal to support the results of the advanced researches.

• 보건의료산업학회지
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• 제7권4호
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• pp.179-190
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• 2013

The main purpose of this study was to investigate the effect of the factors which cause the patients to choose hospital from the view of Christian missionary hospital. The subjects were 194 inpatients and 202 outpatients of the K Medical Center in Busan. The research had been conducted from 20 June to 31 July in 2013. The major results demonstrated that the medical and social services image factors strongly affected to the satisfaction and selectivity of patients. Social role image of religious medical institution should be considered important and it seems beneficent in CRM(Customer Relationship Management) based on this results.

• 의료법학
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• 제21권1호
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• pp.33-67
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• 2020

사무장병원은 경제력을 지니고 있으나 의료기관을 개설·운영할 수 없는 비의료인이 의료업계에 첫발을 내딛는 의료인이 경제적으로 자립하기 어려운 상황에서 의료기관 개설 초기에 소요되는 막대한 자본을 감당할 수 없다는 점을 악용하여, 의료인과 공모하여 외형상 요건을 구비한 의료기관을 난립시켜 의료인이 중심이 되어야 하는 의료시장질서를 교란시키고 있다. 또한 사무장병원은 정부로부터 요양급여나 보조금 등 다양한 혜택을 부정하게 수급하여 감으로써 국민건강보험의 막대한 재정 누수를 가져오고 있어 사회적으로 큰 문제를 야기하고 있다. 사무장병원의 개설상의 불법성은 그 개설에 관한 약정을 민사상 무효화하고 의료법상 개설에 관여하는 자 전체에 대하여 형사벌을 가함과 동시에 의료인에게 행정처분을 부과할 정도로 높다. 또한 사무장병원이 개설상의 위법을 인지하고 있음에도 불구하고 이를 묵비한 채 국민건강보험공단에 대하여 요양급여비용을 청구하여 수급하는 행위에 대하여, 국민건강보험법과 의료급여법상의 환수에 더하여 형법상 사기죄, 나아가 이득액에 따라 특정경제범죄 가중처벌등에 관한 법률위반(사기)죄의 처벌, 그리고 민사상 불법행위책임까지 적용하고 있다. 본고에서는 사무장병원에 대한 현행법상 법적 규제와 현재까지의 판례의 태도를 살펴봄으로써, 사무장병원에 대한 규제가 어떻게 이루어지고 있는지 그 현황을 고찰하고, 향후 입법 방향의 토대를 제시하고자 한다.