• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.88-104
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• 2017

The purpose of this study explains how service characteristics such as service competence, service customization, interpersonal communication and image affect service trust and affective commitments and how service trust, affective commitment play a role in affecting risk-taking and service loyalty in specialty hospital. and then confirm the mediating role of relationship quality components such as service trust and affective commitment in the above path relation. For this purpose, the research hypothesis was verified by structural equation model analysis(SEM) using SPSS 21.0 and AMOS 20.0 statistical package. The results of the study are as follows. First, interpersonal communication influenced service trust, image influenced affective commitment, service ability influenced service trust and emotional commitment, while service customization did not affect any factor. Second, service trust and affective commitment did not effect each other. Third, service trust and affective commitment were more powerful in risk-taking than the influence on service loyalty. Fourth, Risk takings affected service loyalty. Therefore, marketers of special hospitals not only medical services by providing medical service with superior service ability, but also by always strengthening interpersonal communication at the time of providing services. This will enable consumers to overcome the avoidance in the service decision process and implement a specific service marketing strategy that can continuously use the hospital service.

• Anxiety and mood
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• v.9 no.2
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• pp.121-127
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• 2013

Objective : Several studies have reported the association between posttraumatic stress disorder (PTSD) and hypertension (HTN). The aim of this study was to evaluate the impact of PTSD symptoms on blood pressure. Methods : Korean veterans of the Vietnam War with (n=62) or without PTSD (n=87) participated in this study. The clinician administered PTSD scale (CAPS) and alcohol use disorder identification test (AUDIT) were applied. Blood pressure, pulse rate, risk factors of HTN and demographic data of the subjects were collected. Effects of potential explanatory variables on HTN were analyzed with logistic regression. Results : Diastolic blood pressure was significantly higher in PTSD group (p=0.015). However, PTSD subjects showed significantly lower pulse rate than non-PTSD subjects (p=0.004). Logistic regression analysis showed that avoidance symptom might be a predictor for hypertension (OR=1.065, p=0.030). Conclusion : These results suggest that PTSD, especially avoidance symptom, might be a risk factor on HTN in the elderly with PTSD. Further studies are needed to evaluate the change of blood pressure according to the clinical improvement of PTSD.

• The Korean Journal of Emergency Medical Services
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• v.7 no.1
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• pp.135-146
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• 2003

The purpose of this study was to improve EMS-System in Korea through the research in EMS-System of advanced country. The response time is defined as the interval from the time of call receipt to the time of scene arrival. The important factor was to shorten moving distance of ambulance. It should be considered to accomplish this factor that the vehicle must be increased and the convenient location chosen for optimizing of service area. The transport of emergency patients carried out almost by 119 Emergency Medical Service but out of all the employees at 119 EMS only 11.3% have own qualified EMT degree. They should be employed more and more specially at 119 EMS for a superior level of emergency medical care for civilian. In America, EMT can take care of emergency patients following the order from medical Director at the scene of accident. But in Germany, prehospital care was emphasized from the beginning and, in those days, a medical doctor was sent for treatment of emergency patients at the scene, the so-called a Rendezvous system. Hierby this study makes the suggestion to improve the EMS-System, it is effective to use the medical Director system in America and furthermore a Rendezvous system in Germany. The functional integratin and unification of the report system as well as enough personal and equipmental elements saved together invaluable lives.

• The Journal of the Korea Contents Association
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• v.17 no.11
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• pp.435-445
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• 2017

This study was conducted to overcome the limitations of prior research on the equity of medical care performed by identifying simple differences in the use of medical care or using limited medical needs and medical utilization indicators. Specifically, we used activity limits, chronic diseases, and subjective health status as medical needs, and used outpatient, inpatient, and emergency services as medical uses. In addition, we used concentration index, concentration curve, and Le Grand factor to analyze the equity of medical use considering medical needs. The main results are as follows. First, the amount of medical care for the low-income class is higher than that of the high-income class when considering the concentration of medical use. In particular, the number of hospitalization days for low-income households and hospitalization fees were higher than the fees of outpatient medical consultation and emergency room usage. Second, medical needs were concentrated in the low income class. In other words, low-income group is not as healthy as the high-income group. Third, the Le Grand factor was calculated in order to confirm the fairness of the medical uses considering the medical needs. Even if medical needs are taken into consideration, the high-income earners will have a large amount of medical care. In addition, when considering the limitation of activity and the number of chronic diseases, the medical use of the high income class was more frequent. However, when the subjective health condition and the chronic illness were considered, medical use of the low income class was more frequent. This may be due to the underestimation of the medical needs of the low-income earners by neglecting their own health status and perception of chronic diseases.

• Journal of Internet Computing and Services
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• v.18 no.6
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• pp.75-84
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• 2017

As there has been growing interests in PHR-based personalized health management project, various institutions recently explore safe methods of recording personal medical and health information. In particular, innovative medical solution can be realized when medical researchers and medical service institutes can generally get access to patient data. As EMR data is extremely sensitive, there has been no progress in clinical information exchange. Moreover, patients cannot get access to their own health data and exchange it with researchers or service institutions. It can be operated in terms of technology, yet policy environment are affected by state laws as well as Privacy and Security Policy. Blockchain technology-independent, in transaction, and under test-is introduced in the medical industry in order to settle these problems. In other words, medical organizations can grant preliminary approval on patient information exchange by using the safely encrypted and distributed Blockchain ledger and can be managed independently and completely by individuals. More apparently, medical researchers can gain access to information, thereby contributing to the scientific advance in rare diseases or minor groups in the world. In this paper, we focused on how to manage personal medical information and its protective use and proposes medical treatment exchange system for patients based on a permissioned Blockchain network for the safe PHR operation. Trusted Model for Sharing Medical Data (TMSMD), that is proposed model, is based on exchanging information as patients rely on hospitals as well as among hospitals. And introduce medical treatment exchange system for patients based on a permissioned Blockchain network. This system is a model that encrypts and records patients' medical information by using this permissioned Blockchain and further enhances the security due to its restricted counterfeit. This provides service to share medical information uploaded on the permissioned Blockchain to approved users through role-based access control. In addition, this paper presents methods with smart contracts if medical institutions request patient information complying with domestic laws by using the distributed Blockchain ledger and eventually granting preliminary approval for sharing information. This service will provide an independent information transaction and the Blockchain technology under test will be adopted in the medical industry.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10683-10690
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• 2015

The big gap between efficacy of population level prevention and expectations due to heterogeneity and complexity of cancer etiologic factors calls for selective yet personalized interventions based on effective risk assessment. This paper documents our research protocol aimed at refining and validating a two-stage and web-based cancer risk assessment tool, from a tentative one in use by an ongoing project, capable of identifying individuals at elevated risk for one or more types of the 80% leading cancers in rural China with adequate sensitivity and specificity and featuring low cost, easy application and cultural and technical sensitivity for farmers and village doctors. The protocol adopted a modified population-based case control design using 72, 000 non-patients as controls, 2, 200 cancer patients as cases, and another 600 patients as cases for external validation. Factors taken into account comprised 8 domains including diet and nutrition, risk behaviors, family history, precancerous diseases, related medical procedures, exposure to environment hazards, mood and feelings, physical activities and anthropologic and biologic factors. Modeling stresses explored various methodologies like empirical analysis, logistic regression, neuro-network analysis, decision theory and both internal and external validation using concordance statistics, predictive values, etc..

• Korean Medical Education Review
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• v.21 no.2
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• pp.92-99
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• 2019

The aim of this study was to use narrative inquiry to explore the experiences of medical students who faced expulsion, military service, and readmission, and their journeys of identity formation. Three medical students were recruited via snowball sampling, and each participant was interviewed twice. According to the sequence of experiences, their stories were summarized as follows: the process of being expelled, the military service experience and readmission process, and the present. Before all three students were expelled, they lived dissolute lives free of concern from the entrance examination and failed to cope well with dropping out. They felt that military experience had helped them develop interpersonal skills in the clinical setting and the strength to withstand a difficult crisis. Two students were motivated to become doctors after military service, but the other was not. They had reflected deeply over their unique experiences. The scars imprinted from their experiences became a means of stimulation, and they ultimately acquired the resilience and ability to accommodate for and counteract their weaknesses. This appears to have been an important influence on their identity formation. The narrations of their rare experiences can help medical educators more fully understand and support medical students through difficulties, specifically with regard to academic failure or expulsion. These findings may prompt medical professors to think about the kind of guidance or motivation that could help students before expulsion, rather than assuming that they are simply lacking academic ability.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.7 no.5
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• pp.1058-1076
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• 2013

The WBAN(Wireless Body Area Network) supplies mobile convenience to our medical services. But if we have few effective control variables across this service deployment, the hidden distortions or defects of the system might threaten the lives and rights of the stakeholders. Therefore we need to increase the service credibility, to get WBAN effective. This study proposes a governance mechanism using feasible variables that are currently in use in practices in WBAN environments against medical incidents. Control variables were tested in Seoul National University hospital and related medical industries of South Korea. We assume that WBAN systems would be open based on integrating patients, medical employees and law enforcements to get smart theater operations against medical incidents by implementing proposed MJA(Multilateral Joint Analysis) model. MJA model also contributes to the convergence of computer systems and medical services by demonstrating flexible SOA(Service Oriented Architecture) dashboard of healthcare services with credibility factors in medicine. The important components in MJA model across WBAN, were found to be "Safety, Accuracy and Reliability" in priority order. Factor analysis, correlations and ANOVA were used to evaluate this model and an IT dashboard with a realization of mobile application, was used to support participants' decision-making.

• Journal of Korean Academy of Nursing Administration
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• v.14 no.4
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• pp.396-403
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• 2008

Purpose: The purpose of this study was to identify experiences when Koreans who reside in Thailand visit Thai health facilities. Methods: The data were collected via direct interview from 36 Korean residents of Thailand. Collected data were analyzed by content analysis. Result: 1) 162 content analysis data were collected from the participants' statements. These data were categorized into 70 attributes and 9 higher attributes. 2) Out of the 70 attributes, the 3 attributes which were most commonly mentioned by the participants were the following: medical expense for foreigners were expensive(66.7%), difficulties in communication with health care providers(36.1%), kindness of nurses(33.3%). 3) The 9 higher attributes were 1) high medical expense to foreigner, 2) difficulties in communication, 3) distrust about medical service, 4) excessive prescription in oral medicine, 5) kindness, 6) good service, 7) difference in medical environment according hospital type, 8) irrational process in medical treatment for out patients, 9) cultural difference in postpartum care. Conclusion: When Korean residents in Thailand use Thailand health facilities, they experience high medical expense, difficulties in communication, low quality in medical service and kindness of the medical staff.

• The Korean Society of Law and Medicine
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• v.8 no.1
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• pp.137-177
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• 2007

The medical expenses review system in Korea has developed under fee-for-service system with its own unique structure. The importance of reviewing medical expenses has been emphasized, as the size of medical expenditures moving through the health insurance legal context and its weight in the national economy have increased very rapidly. It is, however, analyzed that the feuds and arguments continue among the stakeholders for the lack of laws supporting the medical expenses review system. The medical expenses review is a series of administrative procedures, deciding whether claims from medical care institutions to the insurer are legal and valid or not. It mainly controls the increase of unnecessarily excessive health insurance claim and prevents fraudulent claim and abuse and checks the less use or unsuitable use of medical resources. It also works a function guarantees medical benefits for the appropriate treatment according to the object of health insurance system as a social insurance scheme. The dispute on legal base of the medical expenses review is about the source of law in the medical expenses review. There are the Health Insurance Act and administrative laws as jus scriptum and the guidelines of review as administrative orders. The medical expenses review should reflect various factors, such as the development of medical healthcare technologies, the health expenditures distribution, the financial situation of the health insurance, and the evaluation on the level of appropriate benefits. It is also likely to adapt to the traits of characters of medicine, and trends and transition, Besides it should judge the legality and the validity of medical benefits expenditures by synthesizing these all factors. And the evaluation system of appropriateness of medical benefits was administrative procedure which was consecutive with reviewing the medical expenses system and it was intended to make up for the result of reviewing the medical expenses in more comprehensive levels.