• The Korean Society of Law and Medicine
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• v.14 no.2
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• pp.119-142
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• 2013

It is not easy to regulate the amount of radiation used for the medical purpose as there usually is more good than harm to the patient's health and life caused by the medical exposure to the radiation. However, the rapid increase of the use of diagnostic radiation involves a high possibility of increasing the radiation hazard exposure. Therefore, it is imperative to implement effective regulations in order to secure the safety of diagnostic radiation. The one and only rule we currently have for the diagnostic radiation is "Medicine Act" with only one clause dedicated to regulate the safety management that does not include any rules for the medical radiation. A set of inclusive rules for the whole medical radiation inclusive of diagnostic radiation and therapeutic radiation need to be based on the "Medicine Act" rather than "Nuclear Safety Act" in order to protect the medical professionals, patients and the guardians of patients from the hazards of diagnostic and/or therapeutic radiation that was not used the purpose of medical treatment. If there is an administrative measure to be imposed to secure the safety of diagnostic radiation, it is considered as exertion of governmental authority of administrative agency. There must be clear and realistic legal guidelines for in-fringe on people's interests. The administrative measures for the safety management of the diagnostic radiation must be clearly and specifically based on the law and the detailed standards for the administrative measures must be dele-gated by the presidential decree or departmental ordinance. Accordingly, the restrictions imposed by the administrative measures to the "Safety Inspection Institute of Radiation along with Radiation Exposure Measuring Institutes" should have clear legal basis as well and the detailed standards for the administrative measures should be regulated by the Ministry of Health and Welfare decree instead of the notification by the Director of Korean Centers for Disease Control and Prevention. While securing the safety of radiation on one side, careful review and up-grade on our legal system for the safety management of the diagnostic radiation is required on the other side to guarantee the legality, interest balance and reliability of the administrative measures.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.11
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• pp.746-754
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• 2016

Smart healthcare systems, a convergent industry based on information and communications technologies (ICT), has emerged from personal health management to remote medical treatment as a distinguished industry. The smart healthcare environment provides technology to deliver vital information, such as pulse rate, body temperature, health status, and so on, from wearable devices to the hospital network where the physician is located. However, since it deals with the patient's personal medical information, there is a security issue for personal information management, and the system may be vulnerable to cyber-attacks in wireless networks. Therefore, this study focuses on a key-development and device-management system to generate keys in the smart environment to safely manage devices. The protocol is designed to provide safe communications with the generated key and to manage the devices, as well as the generated key. The security level is analyzed against attack methods that may occur in a healthcare environment, and it was compared with existing key methods and coding capabilities. In the performance evaluation, we analyze the security against attacks occurring in a smart healthcare environment, and the security and efficiency of the existing key encryption method, and we confirmed an improvement of about 15%, compared to the existing cipher systems.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.347-357
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• 1996

Although occupational low back pain accounts for $20\sim40%$ of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and funcional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. We estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson (1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of $30\sim45%$, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.

• Journal of the Korean Society of Radiology
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• v.5 no.2
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• pp.73-80
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• 2011

Questionnaires were distributed to Radiology departments at hospitals with 300 sickbeds throughout the Pohang region of North Gyeongsang Province concerning awareness and performance levels of infection control. The investigation included measurements of the pollution levels of imaging equipment and assistive apparatuses in order to prepare a plan for the activation of prevention and management of hospital infections. The survey was designed to question respondents in regards to personal data, infection management prevention education, and infection management guidelines. The ATP Public Heath Monitering System was used to measure seven items for pollution levels of imaging equipment and assistive apparatuses in the Radiology Department. Data was analysed using SPSS version 12.0 for paired t-test and Pearson coefficient with a statistically significant level of 0.05. The results of the survey showed a total awareness level of infection management prevention education averaged at $3.73{\pm}0.64$ and performance levels resulted at $3.39{\pm}0.83$ which were statistically significant (p = 0.01). Also the measurements of pollution levels for equipment with high patient contact showed a Pearson Coefficient of over 0.5 implying a focus on pathogenic bacterium. There was no statistical significance with the frequency of imaging (p < 0.05). Therefore for general hospitals with high patient contact, there is a need to supply analyzing equipment for real time monitoring and the implementation of disinfection management that uses a Ministry of Health and Welfare approved antiseptic solution twice every minute.

• Journal of Korean Academy of Nursing
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• v.23 no.1
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• pp.68-89
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• 1993

This study was conducted to develop a model of a fee schedule for nursing services.'Regardless of the demand for skilled and professional nursing service today, the Korean health insurance system does not furnish a chapter for the nursing service fee schedule. A nation-wide survey of hospital nursing service fee schedules was to provide practical and realistic data about how the variety of nursing services are being charged. From September 1990 to April 1991, data from the fee schedule used by twenty hospitals located in eight large cities which are designated large medical regions in the Korea Health Care and Patient Referral System were collected. Nursing services and the fees charged for them were analyzed. The nursing services were subjected to a secondary analysis with referrence to reports on “nursing services to be charged in Korea”. The total number of nursing services recommended by the literatures was 177 : finally 141 types of nursing services were selected by investigator as chargable nursing services. In addition, data on managerial characteristics of the hospitals were collected to discover influential variables for a nursing fee schedule model. Under the assumption that all the managerial characteristics of the hospitals influenced the fee schedule, the following model was tested : Fee of nursing services (C) = f(A₁, A₂, A₃, A₄, A/sub 5/, A/sub 6/, A/sub 7/, A/sub 8/,) When, A₁ = number of nurses A₂ = the first salary of a nurse educated in a four year A₃ = scale of nursing management division A₄ = location of the hospital A/sub 5/ = the type of hospital management (profit / non-profit) A/sub 6/ = number of hospital beds A/sub 7/ = years of hospital operation A/sub 8/ = number and kinds of clinical divisions The results showed that the model should be built as follows : C = f (A₁, A/sub 4/, A/sub 5/) Each nursing service was applied to the fee schedule with consideration for the professional level and time-taken to provide the services. Detailed fee schedules were presented in the related tables. Of the 141 kinds of nursing services, 24.8% were chargeble to the Korea Health Insurance, 32.6％ of the nursing services were being paid directly by the patienty. The rest of nursing services (42.6％) were not being charged to any source. It was recommened that the Korea Health Insurance Reimbursement system should add a classification system for nursing services that can be used in the national health care program. Further study is needed about how to include 32.6% of the nursing services now being paid for directly by the patients in the health insurance system.

• Korea Journal of Hospital Management
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• v.20 no.3
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• pp.45-55
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• 2015

While the influence of healthcare accreditation system to the quality improvement of hospitals has more increased, regarding the preparation costs for healthcare accreditation, it has never been empirically studied about the costs that are actually invested by hospitals. This study is going to determine the difficulties in the preparation process of accreditation and details of accreditation preparation costs for hospitals that participated in the healthcare accreditation system and acquired accreditation. The survey was performed in a self-reported form from February 28 to March 21 2014 for 189 acute hospitals accredited as a hospital from 2011 to February 2014. Of all questionaries of survey participants, 98 were recovered; the response rate was 51.9%. A total of 40 questionnaires were used except for 58 containing insincere answers. Main findings are followings: Firstly, findings showed that advanced general hospitals spent the most statistically significantly highest in terms of equipments and total costs among cost items for accreditation preparation. When accreditation preparation costs items were classified according to classification of hospitals, advanced general hospitals spent the most statistically significantly highest in the equipments and total costs. Also in terms of regional, Gyeonggi, Incheon regions were found to spend statistically significantly higher costs in the equipments costs. Secondly, as a result of the survey in the distribution of the total accreditation preparation costs, advanced general hospitals have disbursed the most out of all. However, the result in hospitals does not show significant difference to the expense of advanced general hospitals and that especially other regional hospitals spent higher costs. As such, all hospitals are under a heavy burden of higher costs on accreditation preparation, especially hospitals. The build-up of infrastructures by hospitals through an accreditation system consequently led to a higher initial investment; if the accreditation system is effective in improving the quality of health care and patient safety, appropriate responses are needed. In other words, financial support for investment costs needs to be given to allow hospitals to actively participate in the accreditation system.

• Journal of Biomedical Engineering Research
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• v.20 no.1
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• pp.81-90
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• 1999

This paper describes an EEG(electroencephalogram) software for two-channel cerebral function monitoring system to detect the cerebral ischemia. In the software, two-channel bipolar analog EEG signals are digitized and from the signals various EEG parameters are extracted and displayed on a monitor in real-time. Digitized EEG signal is transformed by FFT(Fast Fourier transform) and represented as CSA(compressed spectral array) and DSA(density spectral array). Additional 5 parameters, such as alpha ratio, percent delta, spectral edge frequency, total power, and difference in total power, are estimated using the FFT spectra. All of these are effectively merged in a monitor and displayed in real-time. Through animal experiments and clinical trials on men, the software is modified and enhanced. Since the software provides raw EEG, CSA, DSA, simultaneously with additional 5 parameters in a monitor, it is possible to observe patients multilaterally. For easy comparison of patient's status, reference patterns of CSA, DSA can be captured and displayed on top of the monitor. And user can mark events of surgical operation and patient's conditions on the software, this allow him jump to the points of events directly, when reviewing the recorded EEG file afterwards. Other functions, such as forward/backward jump, gain control, file management are equipped and these are operated by simple mouse click. Clinical tests in a university hospital show that the software responds accurately according to the conditions of patients and medical doctors can use the software easily.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.497-501
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• 2009

Background: Prolonged air leakage and pleural fluid drainage from a chest tube may delay removing the chest tube after a patient undergoes video-assisted thoracoscopic wedge resection and the patient is otherwise ready for discharge. We reviewed 37 outpatients patients who were being managed with a postoperative chest tube (a Panda Pneumothorax set with a Heimlich valve). Material and Method: From January 2005 to December 2007, 294 patients underwent video-assisted thoracoscopic wedge resections & pleurodesis. Of them, 37 patients met the criteria for outpatient chest drainage management with using a Panda Pneumothorax set with a Heimlich valve. The patients received written instructions, and they demonstrated competence with using the Panda system. The patients returned for chest tube removal after satisfactory resolution of their air leak and pleural fluid drainage. Result: The patients discharged with a Panda pneumothorax set had a longer duration of hospital stay (mean: 10.3$\pm$1.7 days, range: 11 to 17 days) as compared with the patients without a Panda pneumothorax set (mean: 6.2$\pm$1.5 days, range: 4 to 7 days). The chest tube was removed successfully from the patients with a Panda pneumothorax set at an average of 9.8$\pm$1.6 days (range: 9$\sim$18 days) after discharge. There were no major complications. Four patients experienced minor complications. Thirty six patients (97.3%) experienced uneventful and successful outpatient chest tube management. Conclusion: Successful postoperative outpatient chest tube management with using the Panda set was accomplished in 36 selected patients. This program resulted in a substantially reduced hospital cost and enhanced patient satisfaction by allowing earlier discharge.

• The Korean Society of Law and Medicine
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• v.9 no.2
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• pp.209-229
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• 2008

When we are totalizing the lawsrelated to the medical, as the Laboratory medical testing is a kind of the medical act, it is the regulation that the medical technologist can analyze the specimen using in vitro diagnostic devices and diagnosticdrugs under the guidance of doctor or dentist from a corresponding medical institution and can report through verification and interpretation. However, in real medical fields, 'the guidance of doctor' is seriously in-sufficient or even the person who is not the medical technologist is executing. Furthermore the cases that produce inspection results with devices or reagents which are not validated nor approved have been frequently occurred. The result of Laboratory medical testing derived from this procedure can become the important information for the disease control of a country, and also can be decisive to the definite diagnosis and the prognostic monitoring about the patient disease. In spite of its significant medical act to be applicable to an unique proof with the related expert appraisal result in the medical mal-practice lawsuit, our reality in which the quality control is not properly working due by the costs and the labor shortage related to the Laboratory medical testing is quietly in bad condition. Even from now, the government should recognize the significance of the Laboratory medical testing and must achieve more strict administrative management as well as the law maintenance.

• Journal of Korean Academy of Nursing Administration
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• v.13 no.4
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• pp.407-420
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• 2007

Purpose: The objective of this literature review study was to identify research's trends and methodological issues of cost analysis on nursing services. Methods: Researches which analyzed nursing services cost, were selected from journal articles and master or doctoral dissertation studies. The total numbers of the collected studies were 23. Results: The number of studies on nursing services cost has been increased rapidly since middle-1990. The 5 methodological frameworks to classify the cost analysis researches was found. 4 researches were using the traditional costing method. 6 researches were using the clinical patient classification systems. 4 researches were using the Korean Diagnosis Related Group (KDRG). 5 researches were using the Resource Based Relative Value Scale (RBRVS). 4 researches were using the Activity Based Costing (ABC). Conclusion: These results will be used to provide the basic data for developing a more refined cost analysis method on nursing services. For further studies, we will suggest that the consent criteria of cost items need to measure nursing services be developed and the conducting cost analysis on nursing services be networked a hospital's cost management system.