• Title/Summary/Keyword: Medical practice support

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Strategies for Appropriate Patient-centered Care to Decrease the Nationwide Cost of Cancers in Korea (국가 암 비용 감소를 위한 환자중심 진료의 적정성 확보 전략)

  • Bae, Jong-Myon
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.4
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    • pp.217-227
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    • 2017
  • In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.

A Study for Diagnostic Agreement between Web-based Diagnosis Support System and Korean Medical Doctors' Diagnosis (웹기반 진단 보조 시스템의 진단 일치도 연구)

  • Seungyob Yi;Minji Kang;Hyun Jung Lim;WM Yang
    • Journal of Convergence Korean Medicine
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    • v.6 no.1
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    • pp.37-42
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    • 2024
  • Objectives: This study aims to evaluate the clinical validity of the system by conducting a clinical study to assess the diagnostic agreement between the system and Korean medical doctors. Methods: This study was conducted from September 7, 2023, to December 7, 2023, across five Korean medicine institutions, involving 100 adult participants aged 20-64 who consented to participate. Participants first entered their symptoms into a web-based program, which utilized an AI-based algorithm to diagnose 36 types of pattern differentiation. Subsequently, Korean medical doctors conducted face-to-face diagnoses using the same 36 types. The diagnostic agreement between the system and the doctors' diagnoses was analyzed using descriptive statistical analysis, and the results were expressed as a percentage agreement. Results: Analysis of the diagnostic data from 100 participants revealed that the web-based diagnosis support system identified an average of 7.76±0.79 patterns per patient, while Korean medical doctors identified an average of 7.99±0.10 patterns per patient. The diagnostic agreement between the system and the doctors showed an average of 7.08±1.08 patterns per patient, with an overall diagnostic agreement rate of 88.57±13.31%. Conclusion: This study developed a web-based diagnosis support system for traditional Korean medicine and evaluated its clinical validity by assessing diagnostic agreement. Comparing the diagnoses of the system with those of Korean medical doctors for 100 patients, the system showed an approximately 89% agreement rate with the clinical diagnoses. The system holds potential for aiding Korean medical doctors in pattern differentiation diagnosis in clinical practice.

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The Current Status of Professional Medical Support Staffs in Medical Institutions with over 500 Beds (500병상 이상 의료기관에서의 전문지원인력 운영실태)

  • Kim, Min Young;Choi, Su Jung;Seol, Miee;Kim, Jeong Hye;Kim, Hee Young;Byun, Sook Jin
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.2
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    • pp.131-141
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    • 2017
  • Purpose: This study was to investigate the nationwide operational status of the professional medical support staffs (PMSS) who practice the expanded roles in the hospital setting. Methods: The data were obtained through survey from 36 hospitals with over 500 beds from 25th May to 12th July 2016. Data from 1,666 PMSS were analyzed. Results: Since the job titles varied, we classified them into 5 groups according to their roles; advanced practice nurse, clinical nurse expert, PA (physician assistant), coordinator, and others. There were differences in the operation status of PMSSs depending on the region, nurse staffing grade and number of hospital beds. Qualification criteria varied from hospital to hospital, and almost half of the hospitals didn't have any qualification standards for them. There were differences in age, educational level, clinical careers, rewards, and job satisfaction in 5 groups. Especially PA group had low salary, poorer working conditions, more difficulties in performing their work, and lower job satisfaction than other groups. Most PMSS (99.5%) were using a delegated prescription authority, however only 68.3% had job description and 19.9% had documented delegated role. Conclusion: Adequate training curriculum, documented delegated roles, and the protocols for legal protection and efficient medical services are needed.

Career Guidance to Help Medical School Students Choose a Specialty after Graduation (의과대학생의 졸업 후 전공선택을 위한 진로지도)

  • Sun Woo Lee
    • Korean Medical Education Review
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    • v.26 no.1
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    • pp.5-18
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    • 2024
  • The author recommends the creation of a nationwide career guidance program at the national level through the establishment of a long-term cohort, involving collaboration among medical schools nationwide. This cohort would be constructed for the purpose of analyzing correlations from admission to medical school to post-graduate education, facilitating the development of a career guidance program. This will aid in career development through students' self-analysis and competency building. Each medical school should operate a systematic career guidance program. Career guidance for post-graduate major selection should be included in the regular curriculum. Schools are advised to operate student counseling rooms for various career guidance services. For example, medical schools can operate 1:1 career counseling, academic counseling, career guidance surveys, psychological tests, and counseling. It is advisable to establish a mentor-professor system, connect mentor professors, and build a network of experts related to majors to provide immediate support according to students' needs. Professional mentor training should be provided to mentor professors. To provide opportunities for students to experience their career paths in advance, early clinical exposure, long-term integrated clinical practice, community-based clinical practice, participation in student research programs, career fairs, and student internship programs are recommended. In South Korea, it is necessary to systematically operate the internship system and make improvements to facilitate optical career choices. Additionally, considering the significant influence of social factors on students' career choices in South Korea, efforts should be made to identify and address the issues related to these social factors.

The Korean Practice Parameter for the Treatment of Pervasive Developmental Disorders : Non-Pharmacological Treatment (전반적 발달장애의 한국형 치료 권고안 : 비약물적 치료)

  • Koo, Young-Jin;Cho, In-Hee;Yoo, Hee-Jeong;Yoo, Han-Ik K.;Son, Jung-Woo;Chung, Un-Sun;Ahn, Dong-Hyun;Ahn, Joung-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.2
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    • pp.117-122
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    • 2007
  • Practice parameters for non-pharmacological treatment of children and adolescents with pervasive developmental disorders are based on the scientific literature for evidence-based practices. Appropriate educational and behavioral interventions are important in improving the long-term outcome in pervasive developmental disorders. Early and sustained intervention appears to be particularly important. The goal for interventions is to gain pragmatic skills for verbal communication, playing with peers, daily living routines, self-management, and social adaptation. Appropriate involvement and collaboration with parents and family are essential for well-functioning intervention programs. The life-long nature of autism implies that the clinician should maintain an active role in long-term treatment planning and family support. Vocational training and training for more independent living are important for adolescents with autism. Professionals should be knowledgeable about local and national resources and opportunities for family support as well as support of the individual.

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The Frequency of Job Performance of the Korean Professional Medical Support Staff at Medical Institutions over 500 Beds (500병상 이상 의료기관에서의 전문지원인력의 직군별 업무 수행빈도 분석)

  • Kim, Min Young;Choi, Su Jung;Seol, Miee;Kim, Jeong;Kim, Hee Young;Byun, Sook Jin
    • Journal of Korean Critical Care Nursing
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    • v.11 no.1
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    • pp.15-27
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    • 2018
  • Purpose : This study was intended to investigate the frequency of job performance of the Korean professional medical support staffs (PMSS). Method : The data of 1,666 PMSS from 36 hospitals and over 500 beds were analyzed. The participants were divided into 5 groups: advanced practice nurses (APN), clinical nurse experts, physician assistants (PA), coordinators, and others. Results : Among the 5 main domains of job performance, advanced clinical practice has the highest frequency (111.36 d/y), followed by consultation/collaboration (75.66 d/y), education/counseling (53.54 d/y), leadership (23.90 d/y), and research (19.14 d/y). There was a significant difference in the frequency of job performance between the 5 groups of participants. The invasive activities were more frequent in the PA group. In the education and counseling domain, APNs had a higher level of job frequency than others (p < .001). In the research and leadership domains, APNs and coordinators had more prominent performance frequency than other groups (p < .01). However, there are some ambiguities in the job performance of the 5 groups depending on institutional characteristics. Conclusion : To establish the scope of work of PMSS, organizational and individual efforts are needed to promote and expand the leadership and research domains. To resolve the ambiguities of PMSS' roles, it is necessary to reorganize their titles.

Midwife's role for mother and infant wellbeing (태아의 안녕과 안전한 출산 : 조산사의 역할)

  • Lee, Kyung-Hye
    • Korean Parent-Child Health Journal
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    • v.3 no.2
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    • pp.67-80
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    • 2000
  • This study was described as midwife's role and obstacle of midwife's role expansion. Midwife as primary medical personal who practices for a mother and infant health care and promotion of mother infant interaction. As the trend of increasing natural childbirth, midwifery has to provide childbearing care those who want delivery in a midwifery center. This study conducted to survey for 44 midwives who work at the midwifery center. The results of the study as fellows. 1. Most of the midwives role was care of pregnancy, delivery, postpartum women and babies. Another role was conducted educational classes childbirth, breast feeding, contraception and sexual education. 2. Some midwives role perform breech, vaccum delivery, episiotomy and suture, pitocin induction and augmentation, ultrasonogram, giving medication, anesthesia, collecting specimen from Pap smear and vaginal discharge. Midwife perform these roles without medical law support. 3. Most of the obstacles of the midwife role was the medical law limitation. Midwives want revise medical law to perform simple treatment for childbearing women and babies. 4. Half of the midwives refer cases to medical doctor in case of complication of women and newborns. 5. Current frequency of home birth rate is slightly higher than before and me cases like to have delivery under water. Finally, midwife and midwifery have to prepare to meet childbearing woman, baby and family's need. For activation and expansion of midwife's role, every midwife has to be aware of medical law accurately and they must know what practice they can do and what practice they can not do.

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Personal Accountability of Medical Students in Medical Education (의학교육에서 의과대학생들의 개인 책무성)

  • Lee, Young Hwan
    • Korean Medical Education Review
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    • v.21 no.3
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    • pp.137-142
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    • 2019
  • Producing graduates with sufficient practical competency is the main mission of every educational institution. Following the accreditation of the Korean Institute of Medical Education and Evaluation, medical schools have been stepping up efforts to establish curriculum that reflects the practical value of medical education and the importance of adapting to the practice of graduates in order to increase the accountability of medical education in Korea each year. To this end, all medical schools have recently made efforts to develop diverse policies to strengthen the social accountability of medical education along with the transition to a competency-based curriculum. In line with this trend, the institutional accountability of medical education as well as the personal accountability of students, the main subjects of learning, should be highlighted, and educational activities to foster accountability need to be specified. Personal accountability in medical students involves recognizing their social accountability as future doctors and understanding and practicing student accountability. To achieve this, medical schools should provide programs that support and teach practical application of skills, and students need to define and attempt specific activities to strengthen their accountability.

Middle East respiratory syndrome clinical practice guideline for hemodialysis facilities

  • Park, Hayne Cho;Lee, Young-Ki;Lee, Sang-Ho;Yoo, Kyung Don;Jeon, Hee Jung;Ryu, Dong-Ryeol;Kim, Seong Nam;Sohn, Seung Hwan;Chun, Rho Won;Choi, Kyu Bok;The Korean Society of Nephrology MERS-CoV Task Force Team
    • Kidney Research and Clinical Practice
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    • v.36 no.2
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    • pp.111-116
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    • 2017
  • The Korean Society of Nephrology participated in the task force team consisting of government authorities and civilian experts to prevent and control the spread of Middle East respiratory syndrome (MERS) in 2015. The Korean Society of Nephrology MERS Task Force Team took an immediate action and drafted 'the clinical recommendation for hemodialysis facilities' to follow when the first and the only confirmed case was reported in the hemodialysis unit. Owing to the dedicated support from medical doctors, dialysis nurses, and related medical companies, we could prevent further transmission of MERS infection successfully in hemodialysis units. This special report describes the experience of infection control during MERS outbreak in 2015 and summarizes the contents of 'the clinical practice guideline for hemodialysis facilities dealing with MERS patients' built upon our previous experience.

Medical Data Base Controlled By Medical Knowledge Base

  • Chernyakhovskaya, Mery Y.;Gribova, Valeriya V.;Kleshchev, Alexander S.
    • Proceedings of the Korea Inteligent Information System Society Conference
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    • 2001.01a
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    • pp.343-351
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    • 2001
  • World practice is evidence of that computer systems of an intellectual support of medical activities bound up with examination of patients, their diagnosis, therapy and so on are the most effective means for attainment of a high level of physician\`s qualification. Such systems must contain large knowledge bases consistent with the modern level of science and practice. To from large knowledge bases for such systems it is necessary to have a medical ontology model reflecting contemporary notions of medicine. This paper presents a description of an observation ontology, knowledge base for the physician of general tipe, architecture, functions and implementation of problem independent shell of the system for intellectual supporting patient examination and mathematical model of the dialog. The system can be used by the following specialist: therapeutist, surgeon, gynecologist, urologist, otolaryngologist, ophthalmologist, endocrinologist, neuropathologist and immunologist. The system supports a high level of examination of patients, delivers doctors from routine work upon filling in case records and also automatically forms a computer archives of case records. The archives can be used for any statistical data processing, for producing accounts and also for debugging of knowledge bases of expert systems. Besides that, the system can be used for rise of medical education level of students, doctors in internship, staff physicians and postgraduate students.

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