• Title/Summary/Keyword: Medical conflict

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Civil Law Study on the Arbitrary Uninsured Medical Benefits (임의비급여 진료행위에 관한 민사법적 검토)

  • Bae, Byungil
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.75-103
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    • 2017
  • There are three types of benefits in the National Health Insurance Act of Korea. Those are the treatment benefit, statutory uninsured medical benefits and arbitrary uninsured medical benefits. Recently the Korea Supreme Court changed its past legal theory and permitted the arbitrary uninsured medical benefits under the strictly exceptional conditions. According to the Supreme Court's decision, the existence of procedural difficulty, the medical necessity and the patient's consent are necessarily required in order to allow the legal exceptions in arbitrary uninsured medical benefits. Among the three requirements, the doctor's explanation and the patient's fully informed consent are the most important essentials in this legal conflict. The requirement concerning the doctor's explanation and the patient's consent roles like a hole in the ice as a breathing hole in the arbitrary uninsured medical benefits. The most cases dismissed after Supreme Court Decision 2010DU27639, 27646 Decided June 18, 2012. were due to the defect of three requirements.

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A Study on Occupational Stress and Coping, Turnover, Knowledge and Practice of Infection Control in Dental Hygienists of COVID-19

  • Kwon, Hye-Rin;Gil, A-Young;Kim, Ji-Min;No, Ji-Seon;Park, Ga-Bin;Oh, Ji-Yune;Lee, Na-Kyung;Kim, Seol-Hee
    • Journal of dental hygiene science
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    • v.21 no.4
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    • pp.233-242
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    • 2021
  • Background: The importance of infection with COVID-19 is being emphasized in dentistry with high risks such as aerosols. The purpose of this study is to investigate the knowledge and practice of infection control, stress and coping, and turnover of dental hygienists. Methods: Questionnaire was conducted knowledge and practice of infection control, occupational stress and coping, turnover. Survey data was investigated about 149 dental hygienists from February to March 2021 Data were analyzed t-test, ANOVA, Pearson's correlation using statistical programs of PASW Statistics ver. 21.0. Results: Regarding occupational stress, relationship conflict was higher in the group with less than 2 years of experience (p<0.05). Job anxiety, organizational system, inadequate compensation, and workplace culture were highly surveyed in the 3 to 5 year of experience. The group with more than 6 years of experience had the highest perception of lack of job autonomy (p<0.05). The group with higher knowledge of infection control had lower mean inappropriate rewards and stress (p<0.05). The group with high infection control performance had a lower average in items such as job instability, organizational system, inadequate compensation, workplace culture, and stress. And problem-focused coping ability was found to be high (p<0.05). Infection control knowledge and performance were positively correlated (r=0.251, p<0.01), infection control practice and stress were negatively correlated (r=-0.264, p<0.01), and stress and emotional coping were positively correlated (r=0.367, p<0.01). Stress was positively correlated with turnover rate (r=0.549, p<0.01). Conclusion: Infection control training was required to reduce occupational stress. Occupational stress was highly correlated with turnover, a holistic and systemic organizational operation and improvement of the quality of medical care were required to reduce stress.

Ethnography of Caring Experience for the Senile Dementia (노인성 치매 환자의 돌봄경험에 대한 문화기술지)

  • 김귀분;이경희
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.1047-1059
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    • 1998
  • Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

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A Study on the Uterus in Korean Medical Literature based on its Meaning and Function (한의학(韓醫學) 문헌(文獻)에 나타난 자궁(子宮)에 대(對)한 고찰(考察) - 자궁(子宮)의 개념(槪念)과 기능(機能)을 중심(中心)으로 -)

  • Yoon, Eunkyung;Baik, Yousang
    • Journal of Korean Medical classics
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    • v.29 no.4
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    • pp.75-94
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    • 2016
  • Objectives : The uterus plays an important role in the woman's body. In Korean Medical literature, the uterus is mentioned in various contexts according to different perspectives on its meaning and function. An examination of these various contexts is crucial in understanding the meaning of the uterus and to better understand and approach woman's body. Methods : Aside from the most widely used term Jagung(子宮), there were various terms used to refer to the uterus. Based on a list of these terms, the Siku Qianshu collection of medical literatures was investigated. Contents related to the definition, shape, location, function were extracted and examined. Results : Among the findings, first, there were various terms referring to the uterus similar to contemporary understanding. Some of them referred to the uterus as a whole, while others referred to specific parts, one of which is the placenta. Some reflected a broader perspective on the meaning of the uterus. Second, the functions of the uterus could be summarized as gate keeping, and the maintenance of uterine environment that is related to menstruation, pregnancy, and childbirth. Third, based on the examination of the meaning of the uterus and its functions, perspectives on the uterus in Korean Medicine could be summarized into two. Conclusions : One viewed uterus as an organ dedicated to reproduction, similar to today's common understanding. According to this view, uterus is a special organ specific to women, which functions as an incubator for the fetus. The other viewed the uterus as an intangible source of life in the woman's body. As a general source of life to all human beings, it is not a passive organ but functions as an active source in woman's life phenomena. The two perspectives are not in conflict, but rather reflect the broad range of thought on the concept of the uterus in Korean Medicine. In today's biomedical society, the diversity and flexibility of these perspectives could shed light on medical practices that have resulted from extreme views on the woman's body.

A Study of King Kyung-jong's strange diseases according to Medical records from 『The Daily Records of Royal Secretariat of Chosun Dynasty』 (『승정원일기(承政院日記)』의안(醫案)을 통해 살펴본 경종(景宗)의 기질(奇疾)에 대한 이해)

  • Kim, Dong-Ryul;Kim, Namil;Cha, Wung-Seok
    • The Journal of Korean Medical History
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    • v.26 no.1
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    • pp.41-53
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    • 2013
  • In this paper, King Kyung-Jong's strange diseases which had been exacerbated by the Sinim-Sahwa(辛壬士禍) are researched and discussed. The subject will be described mostly based on health and medical records from "The Daily Records of Royal Secretariat of Chosun Dynasty(承政院日記)" and "The Annals of the Choson Dynasty(朝鮮王朝實錄)". Sinim-Sahwa had occurred for two years. It is thought that the beginning of it was 'a controversy on a proclamation of a crown prince, Yeon Ing Goon'. At the first year of Kyung-Jong's ruling, August 21, the No-Ron demanded a king's heir be decided as soon as possible, the king asked Yeon Ing Goon as his successor because of his 'strange diseases'. In October of the same year, the conflict between No-Ron and So-Ron parties reached its peak after a dispute about 'regency from behind the veil for the crown prince' at that time. Kyung-jong added that he had a mysterious and heavy disease and there was little hope to recover from it. Some opposing courtiers emphasized the king was in his good health and there weren't any actual diseases he suffered. But Kyung-Jong stubbornly persisted the diseases he had were so heavy that he couldn't get well readily. In detail, he announced his disease had so deeply rooted in internal organs that he could feel some kind of heat and fire arousal form his heart, then rage and resent soaring. Eventually, on 16th, the No-Ron party followed the king's demand, thus the king's health and illness condition itself was gradually getting off the subject. It seems that Kyung-jong's strange diseases was hwa-byung(火病). His symtoms are similar to the symtoms of hwa-byung. Environment he lived, was enough to cause hwa-byung. as a result, Sinim-Sahwa was the event what his hwa(火) was erupted.

Domestic and Foreign Case Studies on ICT Convergence for Mental Heath Improvement and Suicide Prevention (정신건강 증진과 자살예방을 위한 ICT 융합 국내외 사례 연구)

  • Kim, Ho-Kyung;Shin, Dong-Hee
    • The Journal of the Korea Contents Association
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    • v.15 no.5
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    • pp.592-606
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    • 2015
  • Depression and mental illness across all age groups, and steady increasing in suicide rate are our major social problems which cause dramatically decreasing government competitiveness. While Korean government has implemented various policies to improve mental health and prevent suicide, it faces revealing issues in progress on implementation and referral management systems. The current research examined domestic and foreign cases to understand the actual status and directivity of ICT convergence plan in terms of mental health. The United States and the United Kingdom have provided convergent ICT service, telepsychiatric care to senior citizens in rural areas, children and adolescents, socially disadvantaged class, etc. In Korea, emergency-notice devices are installed to prevent suicide for single elderly people, and diverse mobile health devices are developing to cure depression and Alzheimer's disease. ICT convergent mental health care service is needed to save socioeconomic costs and realize universal welfare for an aging society. Social consensus on sharply conflict issues, medical law and medical devices about telepsychiatry service, effectiveness studies on users' unique psychiatric characteristics by life cycle, and region-specialized strategies for the least densely populated rural regions with lower access to medical care should be considered.

A Study on the Evaluation of Electronic Medical Record Systems using the AHP (AHP를 이용한 전자의무기록시스템 선정 평가에 관한 연구)

  • Park, Cheol-Soo;Lee, Jung Seung
    • Journal of Information Technology Applications and Management
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    • v.20 no.4
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    • pp.235-247
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    • 2013
  • The evolution of information technology and proliferation of hospital management and managerial applications of computing has led to change in the characteristics, uses and evaluations of software for the hospital management. With the growing proliferation of microcomputer use and the value-added for management strategies, more and more software has been massively developed, produced and distributed for the hospital industry. The user is faced with an increasingly difficult choice in the evaluation and selection of software. For many reasons, users frequently must rely on expert evaluations of the technical functions and quality of software. The objectives of this study are to provide selection criteria for an Electronic Medical Record (EMR) and to develop an evaluation framework for the Hospital Information Systems. The major findings of our study are as follows (1) the identification of EMR evaluation characteristics (2) the design and development of EMR selection model and (3) the evaluation of the importance for EMR characteristics using Analytic Hierarchy Process (AHP). We identify 6 characteristics and 22 sub-characteristics of the EMR, calculate their weights, and decide the best configuration. Especially, the AHP methodology can be applied to gather knowledge from multiple experts. Because AHP can 1) facilitate the participation of multiple experts 2) increase group productivity and therefore result in both quantitatively and qualitatively superior outcomes than that of a single individual's work 3) provide a mechanism for reconciling conflict from multiple expert 4) validate the acquired knowledge, providing consistency of facts, and 5) enhance the accuracy reliability of the acquired knowledge increase through of the reliability provided by consensus across multiple experts. Although some further research is required, the proposed model can be regarded as a basis for the selection of EMR.

Analysis of the Relationship between the Drinking Status and Job Stress of Firefighters (소방공무원의 음주 실태와 직무스트레스 관계 분석)

  • Shim, Gyu-Sik;Bang, Sung-Hwan;Ahn, Hee-Jeong
    • Fire Science and Engineering
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    • v.33 no.2
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    • pp.132-138
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    • 2019
  • This study examined the drinking status to determine the relationship between the AUDIT-K (Alcohol Use Disorders Identification Test-Korean) and job stress of firefighters. The study subject was 267 firefighters in areas C, K, and P, who were surveyed to investigate their drinking status and job stress. According to the study, the AUDIT-K was 152 people (56.9%) in the normal drinking group and 115 people (43.1%) in the problem drinking group. The most frequent answer of the frequency of drinking was 83 people (31.1%) in the 2-4 times of a month; the amount of drinking was 10 cups or more by 101 people (37.8%) in one sitting; the frequency of heavy drinking was every day in 77 people (28.8%). High group of job stress showed a significantly higher odds ratio with the problem drinking group (OR = 5.458, 95% CI = 1.108-26.886). Among them, the interpersonal relation conflict was found to be a major factor affecting AUDIT-K (OR = .332, 95% CI = .134 - .820). Therefore, their AUDIT-K scores can be lowered by reducing the job stress and interpersonal relation conflicts.

Trends in Research on Patients With COVID-19 in Korean Medical Journals

  • Heejeong Choi;Seunggwan Song;Heesang Ahn;Hyobean Yang;Hyeonseong Lim;Yohan Park;Juhyun Kim;Hongju Yong;Minseok Yoon;Mi Ah Han
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.1
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    • pp.47-54
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    • 2024
  • Objectives: This study was conducted to systematically summarize trends in research concerning patients with coronavirus disease 2019 (COVID-19) as reported in Korean medical journals. Methods: We performed a literature search of KoreaMed from January 2020 to September 2022. We included only primary studies of patients with COVID-19. Two reviewers screened titles and abstracts, then performed full-text screening, both independently and in duplicate. We first identified the 5 journals with the greatest numbers of eligible publications, then extracted data pertaining to the general characteristics, study population attributes, and research features of papers published in these journals. Results: Our analysis encompassed 142 primary studies. Of these, approximately 41.0% reported a funding source, while 3.5% disclosed a conflict of interest. In 2020, 42.9% of studies included fewer than 10 participants; however, by 2022, the proportion of studies with over 200 participants had increased to 40.6%. The most common design was the cohort study (48.6%), followed by case reports/series (35.2%). Only 3 randomized controlled trials were identified. Studies most frequently focused on prognosis (58.5%), followed by therapy/intervention (20.4%). Regarding the type of intervention/exposure, therapeutic clinical interventions comprised 26.1%, while studies of morbidity accounted for 13.4%. As for the outcomes measured, 50.7% of studies assessed symptoms/clinical status/improvement, and 14.1% evaluated mortality. Conclusions: Employing a systematic approach, we examined the characteristics of research involving patients with COVID-19 that was published in Korean medical journals from 2020 onward. Subsequent research should assess not only publication trends over a longer timeframe but also the quality of evidence provided.

The Thoughts of Patients on Medical Accidents and Disputes in Korea (의료사고와 의료분쟁에 대한 의료이용자들의 의식 조사)

  • Rhee, Hyun-Sill;Lee, Jun-Hyup;Rhim, Kook-Hwan;Choi, Man-Kyu
    • Korea Journal of Hospital Management
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    • v.11 no.1
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    • pp.1-30
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    • 2006
  • According to the available data, in these days, the number of medical accidents and disputes have significantly increased since 1990 in Korea. From this aspect, a variety of approaches and efforts to solve these problems is needed before it is too late. This study intended to identify the thoughts of patients who are directly connected with medical accidents and disputes and then to consider reasonable settlement methods of the increasing disputes. For achieving the purpose of this study, the self-administerd questionnaire was conducted with 450 out-patients who visited three university hospitals, five small and medium-sized hospitals, and ten clinics in Seoul from June 13 to 17, 2005. Incomplete questionnaires were omitted and 410 respondents(91%) were included for the analysis of this study. Each section of the survey was composed of six categories such as the recognition of malpractice, a compensation system about no-fault medical accidents, the recognition of the judgement of medical accidents in court, reasonable settlement of medical accidents, reasons of lawsuit, and the need of the medical dispute settlement organization. The major results of this study were as follows. First, more than half of the respondents, 51.9 percent, worry about malpractice. And many respondents think malpractice causes their symptoms to persist or become worse, and also some respondents think that the doctor's prescription changed too frequently. Second, as for a compensation system about no-fault medical accident, 55.7 percent of the respondents insist that a proper compensation for suffering patients or their families should be provided. And also as for the responsibility of compensation, respondents think joint compensation of both the medical institution and the government is needed foremost, followed by the medical insurance company and finally by the medical institution. The government as well as the related institutions should take responsibility for malpractice accidents for which the doctor is not responsible. Third, as for the acknowledgment of medical accident judgements by the court, 32.8 percent of respondents think that it is best to compromise with a medical institution, followed by lawsuit(26.2%), the assistance of civil organization(23.2%), and a powerful physical protest(7.6%). Fourth, as for the lawsuit of medical accidents, 62.9 percent of respondents think that patients and their families would be in a disadvantageous position in relation to medical institutions and doctors mentioning the lack of professional medical and lawful knowledge, experience and know-how as the reason. So many people have given up appeals owing to the difficulties involved in defending themselves through evidence. Fifth, about a half share of the respondents indicated that the medical institution's neglect of the responsibility of medical accidents is one of the most important reasons of lawsuit. And next respondents mentioned the lack of the medical dispute settlement organization and a general distrust of medical institutions and doctors. Sixth, a majority of respondents consented to the introduction of the need of the medical dispute settlement organization, And about a half of the respondents mentioned a readiness to accept the mediation of the organization, but the rest did not express a clear opinion. It seems that conflict among the parties concerned have existed in relation to the medical dispute settlement organization and related legislation for many years. But as this study has shown, the needs of the medical dispute settlement organization is in desperate demand. Therefore, more negotiation efforts from all interest groups should be considered for the birth of the medical dispute settlement organization and related legislation.

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