• 한국병원경영학회지
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• 제28권4호
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• pp.1-22
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• 2023

Purposes: The purpose of this study is to identify and analyze the factors that affect patients reusing non-face-to-face treatments at tertiary general hospitals. Methodology: We retrospectively analyzed a patient's reuse of non-face-to-face treatment from February 1, 2020, to December 31, 2021, at a tertiary general hospital in Seoul within one year of the first non-face-to-face treatment. A frequency analysis was conducted to identify the study subjects' demographic characteristics, treatment type characteristics, disease characteristics, and hospital use type characteristics. Also, across-analysis was conducted to verify the difference in non-face-to-face treatment reuse according to the characteristics a multiple logistic regression analysis was conducted to identify the factors affecting the reuse of non-face-to-face treatment by non-face-to-face treatment patients. Findings: The results of this study can be interpreted as indicating that the following groups are more likely tore use the non-face-to-face treatment: women, children, the elderly, Patients living far from the hospital, psychiatric patients, pediatric patients, medical benefits recipients, chronic patients, patients with mobility difficulties, and patients with high loyalty to hospitals. Practical Implications: When developing a non-face-to-face treatment system in the future, based on the results of this study, it is possible to target patients who prefer non-face-to-face treatment. And this study will be research material for vitalizing non-face-to-face treatment. In addition, the activation of the non-face-to-face treatment system will be an effective means for improving the quality of medical services and generating profits in hospitals in the future.

• 의료법학
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• 제23권3호
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• pp.47-87
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• 2022

코로나19 감염병 확산으로 인해 비대면진료가 일시적으로 허용되었고 지속 필요성에 대한 공감대가 커지고 있다. 그러나 현행 「의료법」은 의사와 의료인 간의 원격의료만 허용하고 있다. 비록 법률해석을 통해 의사와 환자 간의 비대면진료가 허용된다는 의견도 있지만 전체적인 법률체계를 고려할 때 허용되지 않는 것으로 보는 것이 타당하다. 그럼에도 불구하고 과학기술의 발달과 감염병 출현 시기의 단축 등을 종합적으로 고려할 때 앞으로 대면진료만을 고집하는 것은 바람직하지 않다. 따라서 안전하고 효과적인 비대면진료가 이뤄질 수 있는 방안을 고민하고 제도화하는 것이 전략적으로 필요하며, 또 중요하다. 이를 위해 앞으로 논의되어야 할 법률적 쟁점들을 미리 살펴보는 것이 이 글의 목적이다. 비대면진료를 구체적으로 규율하기 위해서는 우선 비대면진료의 범위와 대상 질환 그리고 시행 주체가 명확해야 한다. 또한 비대면진료가 시행되기 위해서는 구조적으로 시설과 장비 기준이 마련되어야 하고 기능적으로는 해당 시설과 장비를 통해 의사와 환자가 적극적으로 소통하고 정보를 실시간 교환할 수 있어야 하고 비대면진료 과정에서 발생하는 정보를 보호하기 위한 관리체계가 구체적으로 마련되어야 한다. 이처럼 비대면진료를 시행하기 위해 새롭게 정비되어야 할 내용뿐만 아니라 비대면진료를 통해 발생할 수 있는 책임의 문제와 비용의 문제도 구체적으로 정리될 필요가 있는 법적 쟁점이다.

• 한국정보통신학회논문지
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• 제26권11호
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• pp.1751-1754
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• 2022

The news articles collected with keyword "non face-to-face" were analyzed through topic modeling applied with LDA algorithm. In this study, collected articles were divided into two periods, period 1(the beginning of COVID-19 spread) and period 2(the end of COVID-19 spread), according to issued date of the articles. The articles of period 1 showed support for non-face-to-face treatment, smart library, the beginning of the online financial era, non-face-to-face entrance exam and employment, stock investment for main topic words. And the articles of period 2 showed conversion to non face-to-face classes, increasing unmanned stores, online finance, education industry, home treatment for main topic words. Also, further issues were discussed through visualization of topic words. These results provide evidence that education and unmanned business in non-face-to-face industries are growing.

• 한국의료질향상학회지
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• 제30권1호
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• pp.55-75
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• 2024

Purpose: This study aimed to elucidate the intention to use non-face-to-face treatment, which was temporarily allowed during the coronavirus disease 2019 pandemic. Based on the social cognitive theory, individual behavioral changes occur through the dynamic interaction of individual, environmental, and behavioral factors. Thus, we investigated the impact of personal, environmental, and behavioral factors on the acceptance of non-face-to-face treatment. Methods: A Web survey was conducted using Korea Research Panel between December 26 and 29, 2022, to examine the conceptual framework. The survey targeted adults aged 19 and older, regardless of whether they had used non-face-to-face treatment. A total of 502 responses were collected. Further, a three-step hierarchical regression analysis was conducted using SPSS Windows software version 25.0. Results: The study showed that 131 out of 502 respondents had experience using non-face-to-face treatment, while 371 did not. The factors that influenced the intention to accept non-face-to-face treatment included the general characteristics of the participants (women, underlying disease), personal factors (usefulness, cost savings, knowledge), and environmental factors (social norms, trust, perceived risk). The model demonstrated an explanatory power of 65%. Conclusion: The results of this study directly show that intention is linked to behavior through the interaction between personal and environmental factors. Further research is needed to explore additional factors influencing the intention to accept non-face-to-face treatment, enabling its effective use in preventing and treating various diseases, including infectious diseases.

• 의료법학
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• 제24권4호
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• pp.131-160
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• 2023

상시적 대면진료를 허용하는 것을 내용으로 하는 의료법 개정안이 제21대 국회에서 5건이 발의되었으나 각 개정안마다 중점적으로 다루는 내용에 차이가 있고, 비대면진료에 대한 의료계의 반대 입장, 정치적 상황 등이 맞물려 현재 '계속 심사' 안건으로 계류되어 있는 상태이다. 그러나 비대면진료의 안전성 확보의 첫 단계로서 의료법 개정이 반드시 필요하다는 공감대를 형성하였고, 비대면진료에 대한 정부의 추진 의지가 강한 상황이므로 머지않아 의료법은 개정될 가능성이 높다. 다만, 비대면진료 도입은 환자의 안전성 확보를 최우선으로 하는 방향으로 제도화, 입법 되어야 한다는 관점에서, 비대면진료의 대상 환자는 재진 환자 중심, 대상 질환은 만성질환 중심, 시행기관은 의원급 의료기관 중심, 비대면진료 수단은 최소한 화상시스템으로 제한, 의료인의 법적 책임은 의료인의 통제 범위 밖의 요인에 의한 사고에 대해서는 책임면제, 대면진료 요구권 마련 등의 방향성을 제안하였다. 최소한의 안전성을 확보할 수 있는 기준을 우선 입법하고, 향후 연구와 평가 등을 통해 비대면진료의 범위를 확대하는 것과 같이 단계적으로 접근하는 것이 바람직하다.

• 한국전문물리치료학회지
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• 제30권1호
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• pp.50-58
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• 2023

Background: This study was carried out to determine whether non-face-to-face physical therapy would have similar exercise effects to face-to-face physical therapy. Hence, we developed an approach for patients, unable to visit hospitals due to circumstances such as the COVID-19 pandemic, to conduct physical therapy comfortably at home. Objects: This study aimed to compare the effects of a face-to-face and a non-face-to-face physical therapy treatment on improving a rounded shoulder posture. Methods: The participants with rounded shoulders were randomly divided into a face-toface group (n = 15) and a non-face-to-face group (n = 15), and each group performed exercises for four weeks. The exercise program consisted of the bare hands exercise, Thera-Band exercise, and foam roller exercise. The participants in the face-to-face group came to a designated place to perform their exercises, and those in the non-face-to-face group performed the exercises at their own home using Google Meet (Google). Acromial height, total scapular distance (TSD), shoulder pain and dysfunction index (SPADI), and pectoralis minor thickness were measured. Data analysis was performed using the R Statistical Software (R Core Team), and a normality test was performed using the Shapiro-Wilk test. Results: There were no significant differences between the face-to-face and the non-face-toface groups (p > 0.05). When comparing the differences before and after the exercises, both the face-to-face and the non-face-to-face groups showed significant differences in acromial height, SPADI, and pectoralis minor thickness (p < 0.05), and both groups showed no significant difference in TSD before and after the exercises (p > 0.05). Conclusion: The results of this study support the results of previous studies reporting that shoulder stabilization exercise and pectoralis minor stretching training improves round shoulders. In addition, this study revealed that both the face-to-face and the non-face-to-face physical therapy treatments had therapeutic effects.

• 대한한의학회지
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• 제43권3호
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• pp.65-78
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• 2022

Objectives: The purpose of this study is to analyze the weight loss and the adverse events of overweight and obese adults on weight loss program with face-to-face treatment (FTF) and non-face-to-face treatment (NFTF) in 6 Korean Medicine obesity clinics. Methods: From March 2nd to March 10th, 2021, we collected data with a retrospective way from overweight and obese adults (body mass index, BMI≥23 kg/m²) who registered for a 12-week Gamitaeeumjowi-tang prescription program. After matching initial information of the FTF group and the NFTF group using propensity matching score, weight loss and BMI change were analyzed, and adverse events were evaluated in terms of causality, severity and system-organ classes. Results: Weight and BMI change from baseline to 12 weeks was -7.98±3.09kg (10.41±3.57%), -3.03±1.14kg/m² and -7.30±3.11kg (9.59±3.45%), -2.76±1.15kg/m² for FTF group and NFTF group, respectively. Body weight and BMI significantly decreased before and after treatment in both groups, and there was no significant difference in weight loss and BMI change between the two groups. No serious adverse events were reported. Conclusions: This study showed the potential that NFTF weight management treatment could be a good alternative way to FTF weight management treatment without serious adverse events.

• 대한통합의학회지
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• 제9권4호
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• pp.225-235
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• 2021

Purpose: Since coronavirus disease 2019 (COVID-19) spread around the world, non-face-to-face services have emerged as the new normal. The functioning of children with developmental disabilities and cerebral palsy improves when parents, therapists, and institutions cooperate. We aimed to investigate the difficult environment of pediatric physical therapy caused by COVID-19, and grasp parents' perceptions of home exercise programs. We intend to design home exercise programs for pediatric treatment in the future and create a non-face-to-face pediatric rehabilitation service system based on our findings. Methods: The first survey was conducted on 30 parents who had children with cerebral palsy and developmental disabilities. It was produced after consultation with relevant experts and discussion with the research team, based on a survey conducted in a previous study. The second survey was produced by revising and supplementing the opinions of parents who completed the first survey and consulting experts. Thereafter, an online survey was conducted on 118 parents who had children with cerebral palsy and developmental disabilities. Results: 61.01 % of the parents reported that they were anxious or afraid for their children to be treated for infectious diseases. 83.90 % of the parents reported that the role of parents had increased. 50.00 % of the parents complained of a lack of skill. 85.59 % of the parents reported that they needed a home exercise program provided by the organization. As a non-face-to-face exercise management method, 35.59 % of the parents wanted a real-time video recording electronically mailed to them, and 34.75 % wanted real-time education using video conferencing programs such as zoom. Conclusion: The threat of COVID-19 has further emphasized the importance of social cooperation and management, leading organizations to enter a new era of non-face-to-face rehabilitation services. It is necessary to collect and systematize related studies to reflect more diverse opinions and improve the perceptions of therapists and parents.

• 의료법학
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• 제25권1호
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• pp.149-192
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• 2024

정신질환자는 대체로 병식이 전혀 없거나 자발적 치료의지가 없는데, 그에 따라 치료가 어렵고 그 고통은 주로 가족에게 전가된다. 그에 따라 환자를 직접 대면하여 진료하지 않고 가족과의 면담을 통해 예후를 관찰하여 진단하는 비대면진료 및 가족을 통해 몰래 투약이 이루어지는 비고지투약이 이루어질 수 있고, 이는 필요악으로 여겨지기도 했다. 이러한 정신건강의학과 진료의 특수성이나 가족들이 받는 고통 등 현실적인 측면을 고려하더라도 환자 몰래 약을 투약하는 등 동의 없는 치료는 의료법 위반은 물론 강제입원처럼 정신질환자에 대한 인권침해의 소지가 크다. 무엇보다도 이를 뒤늦게 환자가 알게 되는 경우에는 환자와 가족, 의사 사이의 신뢰가 완전히 깨지고 치료를 절대적으로 거부하는 상황이 발생한다. 여러 사정을 고려하여 그 예외적 허용요건을 제시한 일본의 치바(千葉)판결은 구체적 타당성을 도모하는 하나의 해결책이 될 수도 있다. 그러나 비고지투약을 예외적으로 허용하고 이를 일시적인 조치로서 허용하려는 의도와 달리 이는 현실적으로 장기적인 비고지투약으로 이어지고 치료적 대화를 통한 치료 및 투약은 완전히 단절될 수 있다는 점을 감안할 때 올바른 해결책이 아니다. 결국, 치료적 대화의 복원을 통해 이 문제를 근본적으로 접근하고 대안을 모색할 필요가 있다.

• Radiation Oncology Journal
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• 제37권2호
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• pp.143-148
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• 2019

Although surgery is the mainstay of local treatment for skin cancer, definitive radiation therapy (RT) has been also applied for patients who are unable to tolerate surgery. Definitive RT regimens usually consist of daily treatment for 4-7 weeks. Such protracted daily RT regimens, however, would not be feasible for non-compliant patients or patients who are unable to make multiple daily trips for weeks. Without treatment, however, skin cancers can continuously progress and cause distressing symptoms. A cyclical hypofractionated RT (QUAD Shot: 14 Gy in 4 fractions, twice-daily treatments with 6 hours interval on 2 consecutive days) can be a practical RT regimen for those patients. In this report, we present the successful treatment course of repeated QUAD Shots in a 79-year-old patient with neglected skin cancer that was disfiguring his face yet declined definitive surgery and protracted RT. We also evaluated and compared biologically equivalent doses between QUAD Shots and conventionally fractionated protracted RT regimens.