• Korea Journal of Hospital Management
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• v.18 no.3
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• pp.106-125
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• 2013

Medical litigation, as a method of resolving medical disputes, has been a huge burden on both the patient and medical institution as it is both costly and time-consuming. The Korea Medical Dispute Mediation and Arbitration Agency has created a dispute mediation process as a method of alternative dispute resolution(ADR). Being in its early stage of implementation, there are still areas requiring improvement as some functions overlap with the Korea Consumer Agency's damage redress and mediation process. This study examines the problems of existing practices in medical litigation while reviewing the mediation process of the two agencies from legal/administrative aspects, and provides an in-depth analysis of the situation through case studies and interviews. While the Korea Medical Dispute Mediation and Arbitration Agency offers many advantages in resolving medical disputes, there must be a distinct division of roles and mutual cooperation with the Korea Consumer Agency. Considering the increasing amount of compensation in medical disputes, medical professionals are being requested to carry medical malpractice insurance. However, this has yet to become a general trend in the medical field despite the growing social demand. As such, the coverage of medical malpractice insurance should be expanded to prevent medical accidents from escalating into medical disputes, thus acting as a social safety net. This study seeks to examine the methods of medical dispute resolution and to allow institutional provisions to reduce the social costs arising from such disputes.

• Convergence Security Journal
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• v.9 no.2
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• pp.49-58
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• 2009

In medical Institution, Electronic Health Record (EHR) is "must access information" to medical staff considering it as medical information. However, this unnecessary exploration of personal information must be treated confidentially because the information is highly related to other's private concerns. It is necessary that medical workers should be also restricted to their access to EHR depending on their roles and duties. As the result, this article explains that "EHR access control will be executed by differentiating authorized medical staff from non medical-related staff as well as EHR access will be only permitted to authorized medical staff depending on their work status conditions. By using Advanced RBAC model on medical situation, we expect to minimize unnecessary leak of EHR information; especially, emergency medical care is needed, access control is highly required depending on a person in charge of the cases or not, and restricted medical information defined by the patient one-self is only allowed to be accessed.

• Korea Journal of Hospital Management
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• v.8 no.1
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• pp.1-23
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• 2003

General drug prices involve three stages: shipment stage, wholesaler stage and retail stage. Policies on drug price differ from country to country. Shipment stage prices are tightly regulated in countries like France and Netherlands. They are free in only a minority of advanced countries, even if these include some major players such as the US, Germany and, in a very limited sense, Japan. The situation in the UK is very complex with a semi-free system, where drug companies are free to set their own prices but cannot exceed a predetermined profit ceiling. Mark-up at both wholesaler and retail stages is formally admitted in most countries observed. Apart from the general drug prices, reimbursement price of insured drugs has been major policy concerns. Most countries reviewed in this study has exerted some control over reimbursement prices, but differ both in the way how and in the extent to which prices are admitted or fixed. Price fixing has been used in France and Japan. Some countries have transformed their system over time, particularly to move to reference pricing in the last decade. This mechanism has empowered the customer, and improved price competition on the market. Referring to the drug price policies in the advanced countries, this study makes some suggestions for the redirection of Korean price policy for reimbursement drug in health insurance as follows: to match appropriate policy tools to each policy goal; to maximize market mechanism through effective reimbursement price fixing which admits mark-ups in wholesaler and retail prices; to introduce reference pricing system in order to redirect patient's demand with a financial incentive to choose the best-priced drugs and to save the finance of health insurance; and to strengthen surveillance and monitoring mechanism in the drug market.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.16 no.5
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• pp.117-123
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• 2016

In recent years, Personal Health Record (PHR) has emerged as a patient-centric model of health information exchange. The Personal Health Record (PHR) owners enjoy the full right of accessing their records anywhere and anytime making storage and retrieval more efficient. Due to the sensitivity and confidential nature of the PHR, however, the PHR is maintained in a secure and private environment with the individual determining rights of access. In this paper, we propose a system which enables access to the user's PHR in the event of emergency. In emergency situation where the user is unconscious, the emergency staff can use the PHR information to request a emergency access to the PHR server based on the predefined rights of access for PHR. Under the proposed system, the PHR owner can specify a fine grain access control policy during emergency situations.

• Journal of Korean Critical Care Nursing
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• v.2 no.1
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• pp.58-68
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• 2009

Purpose: The treatment effects and operation status of continuous renal replacement therapy (CRRT) for acute renal failure patients have been investigated. Method: Two expert nurses reviewed the records of 731 patients undergoing CRRT in an intensive care unit of a general hospital from Jan. 2002 to Dec. 2006 with the CRRT assessment sheet and situation sheet developed for this study. Results: The number of patients received CRRT increased from 90 in 2002 to 194 in 2006. The most common indication for CRRT was azotemia (40.0%). Before CRRT treatment, patients were 78.6 ($\pm55.5$) of BUN value and 5.0 ($\pm3.2$) of Cr. value. The standard values of BUN and Cr. were lowered. Compared the survival group with the death group, there were significant differences among the medical departments and the main diagnosis group. Their BUN and creatinine value, APACHE II score, mean blood pressure, and oliguria were significantly different (p<0.05). Conclusion: This survey demonstrates a trend that patients receiving CRRT has been increased. We suggest further studies are needed in some hospitals in order to generalize the results and to find how CRRT treatment affects patient’s survival and death rate.

• Korea Journal of Hospital Management
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• v.5 no.2
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• pp.40-58
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• 2000

Nurses are medical personnel, who play a key role in supporting patient care, so it is important to supply them adequately in balance with ever increasing medical demand. But there appears severe shortage of nurses in some hospitals because of their uneven distribution, especially in small sized-hospitals and rural-hospitals. As nationwide distorted distribution of nurses in Korea is just like what monopsony model(a kind of market structure model) tells us, it is attempted to explain this situation of nurse labor market in Korea on the basis of monopsony model and presented in this paper. Specifically, determinants of nurse wage and the level of their relative employment were examined, and monopsony impact on their wage and the level of relative employment controlling those determinants were studied. Major results of this study arc as follows. The most important determinant of nurse wage level in this study was the wage level of a local community where each hospital located Hospital owner's characteristics an educational function of each hospital were also important factors. With these factor controlled, it was found that monopsony power of each hospital was negativel associated with nurse wage level as expected. 1% increase in monopsony power of hospital(measured by Herfindah-Hirschman Index) reduced nurse wage by $5,674{\sim}19,19$ won(in Korean currency). With regard to the level of relative employment, the most important determinant wa the capacity for supplying nurses of the local community. Again, hospital owner characteristics and educational function of each hospital were also important. With these factors controlled, it was found that monopsony power of each hospital was negative associated with the number of nurses per bed, as expected. 1% increase in monopsony power of each hospital(again measured by Herfindah-Hirschman Index) reduced the number of nurses per 100 bed as much as $0.46{\sim}0.67$. In conclusion. structural factors of nurse labor market influence the instability of nurse labor supply in Korea. Further consideration for these market structural characteristics needed for policy making related to nurse resource allocation.

• Korean Journal of Digital Imaging in Medicine
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• v.5 no.1
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• pp.86-92
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• 2002

Information concerning a patient visit is to be sent from the OCS(Order Communication System) to the PACS(Picture archiving and Communication System) and when the image acquisition is completed, information regarding the procedures also actually preformed should be sent back to the OCS. It should be possible to present related medical information from the OCS at the same image workstation in a coherent way with the images in the PACS, Examples of the related medical information are: the report of a diagnostic image procedure, data on medication, laboratory results, admission and discharge letters, and surgery reports, because we could maximize the efficiency of Radiological Work, like decrease examination time and human mistakes, though the integration of PACS and OCS, Therefore, We research some hospitals to find integral lists of PACS and OCS but there are no sufficient ingredients. Further, the percentage of Integral lists of PACS and OCS is different in all hospitals because there is no such standard yet like HL7(Healthcare Level 7) and DICOM(Digital Imaging and Communications in Medicine). Accordingly, if all hospital would follow national standard like HL7 and DICOM, the integration of OCS and PACS would be efficient but in this situation radiological technician should take part in construction integration system of PACS and OCS positively, so we could improve efficiency of radiological work and our status.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.62 no.6
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• pp.833-839
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• 2013

Cardiopulmonary resuscitation (CPR) is performed by thoracic compression and artificial ventilation for the patient under emergent situation to maintain at least the minimum level of respiration and blood circulation for life survival. Good quality CPR requires monitoring respiration, however, traditional respiratory air flow transducers cannot be used because the transducer elements are facing the whole area perpendicular to the flow axis. The present study developed a new air flow transducer conveniently applicable to CPR. Specially designed "sensing rod" samples the air velocity at 3 different locations of the flow cross-section, then transforms into average dynamic pressure by the Bernoulli's law. The symmetric structure of the sensing holes of the sensing rod enables bi-directional measurement simply by taking the difference in pressure by a commercial differential pressure transducer. Both inspiratory and expiratory flows were obtained with symmetric measurement characteristics. Quadratic curve fitting provided excellent calibration formula with a correlation coefficient>0.999 (P<0.0001) and the mean relative error<1%. The present results can be usefully applied to accurately monitor the air flow rate during CPR.

• Journal of Korean Academy of Nursing
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• v.25 no.3
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• pp.457-471
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• 1995

This research was done to promote improvement of practical application of nursing diagnoses and to improve the quality of nursing. The subjects of this research were 156 second year students of C junior nursing college who were giving adult patient care. The nursing diagnoses of 312 reports were analyzed using NANDA. In these case reports only nursing diagnoses were considered, of which there were a total of 982. In the data analysis the 9H of the nursing students' nursing diagnoses matched with 105 NANDA nursing diagnoses, Of these, the most frequent diagnoses were pain(165, 17.48%), anxiety(101, 10.70%), alteration in nutrition(83, 8.79%) , sleep disturbance (67, 7.10%), in activity intolerance (67, 7.10%), ineffective breathing pattern(51,5.40%). The etiology for the students' nursing diagnoses were compared with NANDA's nursing diagnoses by frequency. The most frequent etiology for the nursing diagnoses of pain was a biological etiology(50, 31%), for anxiety, situation crisis(58, 57.43%), for alteration in nutrition, indigesion(23, 27.71%), for sleep disturbance, external etiology(25, 37.32%), for activity intolerance, immobile position(22, 32.84%), for ineffective breathing pattern, pain(35, 68.63%), and for ,impaired physical mobility, pain(31, 65.96%). The most frequent etiology for constipation was inadquate digestion of water and cellulose (16, 34.78%), for fluid volume felicity, loss of body fluid (21, 52.50%), for impaired skin integrity, external etilogy(16, 43.24%), for impaired physical mobility, pain(22, 62.86%) , for knowledge deficits, cognition disturbance(9, 27.27％), for ineffective air way clearance, secretion obstruction(14, 48.27%) , for impaired gas exchange, loss of transport ability of blood oxygen(9, 37.50%) , and for powerlessness, therapy environment (5, 22.73%). The number of nursing diagnoses by pattern was exchange(16), moving(6), feeling(4), choosing(4), relating(3), communication(1), perceiving(1), knowing(1), valuing(1).

• Journal of Biomedical Engineering Research
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• v.19 no.4
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• pp.351-360
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• 1998

Digital gamma camera has many advantages over analog gamma camera. These include convenient quality control, easy calibration and operation, and possible image quantitation which results in improving diagnostic accuracies. The digital data can also be utilized for telemedicine and picture archiving and communication system. However, many hospitals still operate analog cameras and have difficult situation to replace them with digital cameras. We have studied a feasibility of digitalizing an analog gamma camera into a digital camera using Gamma-PF interface board. The physical characteristics that we have measured are spatial resolution, sensitivity, uniformity, and image contrast. The patient's data obtained for both analog and digital camera showed very similar image quality. The results suggest that it may be feasible to upgrade an analog camera into a digital gamma camera in clinical environments.