• Journal of Preventive Medicine and Public Health
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• 제54권6호
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• pp.385-394
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• 2021

Objectives: This study aimed to explore the status of regional variations in acute ischemic stroke (AIS) treatment and investigate the association between the presence of a thrombectomy-capable stroke center (TSC) and the case fatality rate (CFR) of AIS within hospital service areas (HSAs). Methods: This observational cross-sectional study analyzed acute stroke quality assessment program data from 262 hospitals between 2013 and 2016. TSCs were defined according to the criteria of the Joint Commission. In total, 64 HSAs were identified based on the addresses of hospitals. We analyzed the effects of structure factors, process factors, and the presence of a TSC on the CFR of AIS using multivariate logistic regression. Results: Among 262 hospitals, 31 hospitals met the definition of a TSC. Of the 64 HSAs, only 20 had a TSC. At hospitals, the presence of a stroke unit, the presence of stroke specialists, and the rate of endovascular thrombectomy (EVT) treatment were associated with reductions in the CFR. In HSAs, the rate of EVT treatment (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99) and the presence of a TSC (OR, 0.93; 95% CI, 0.88 to 0.99) significantly reduced the CFR of AIS. Conclusions: The presence of a TSC within an HSA, corresponding to structure and process factors related to the quality of care, contributed significantly to lowering the CFR of AIS. The CFR also declined as the rate of treatment increased. This study highlights the importance of TSCs in the development of an acute stroke care system in Korea.

• 한국융합학회논문지
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• 제8권10호
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• pp.9-17
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• 2017

이 연구는 클라우드 컴퓨팅과 인공지능의 융합기술을 적용하여 운동처방전문가시스템을 개발하고, 운동 건강관리 전문가들이 인터넷 환경에서 사용할 수 있도록 구현하고자 한다. 최근 우리사회는 의료기술의 발전으로 평균 수명이 늘어나고, 웰빙과 함께 근육질 몸매 가꾸기 붐이 일면서 사람들의 건강에 대한 관심이 높아지고 있다. 이러한 사회적 현상에 따라 건강관리를 전문적으로 하는 퍼스널 트레이너 및 운동 건강관리 전문가의 수요가 증가하고 있다. 하지만, 현재 오프라인 위주의 운동 교육으로 인하여 전문가가 많이 부족한 실정이다. 따라서 이 논문에서는 운동처방전문가 시스템을 개발하여 분산된 데이터를 모으고, 이를 바탕으로 인공지능 룰을 생성하여, 퍼스널 트레이너 및 운동건강관리 전문가들이 사용하는 시스템과 교육시스템을 구현하고자 한다. 또한 이 시스템은 오프라인 위주의 운동 교육시스템을 온라인에서 할 수 있도록 하여 많은 운동처방 전문가 육성에 기여 할 것이다. 향후 연구로는 다양한 IoT 기기의 연동을 통해 수집한 빅데이터를 바탕으로 현재 시스템의 기능을 더 발전시킬 것이다.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1998년도 제50차 추계 학술대회 연제집
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• pp.36-37
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• 1998

• 한국콘텐츠학회논문지
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• 제12권12호
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• pp.282-290
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• 2012

현재 우리나라의 재가간호서비스는 보건소의 맞춤형 방문건강관리사업과 의료기관 가정간호사업, 그리고 노인장기요양보험의 방문간호서비스의 독립성과 전문성을 인정하면서, 각 영역간의 연계를 통해 사업의 중복성을 최소화하는 연계방안이 필요한 상황이다. 이에 본 연구는 재가간호서비스의 연계방안을 도출하기 위해 전문가들의 의견을 바탕으로 합의를 이끌어내는 델파이 기법을 활용하였다. 그 결과 제도적 차원의 연계와 의료적 차원의 연계라는 두 영역 안의 총 24개 항목이 연계방안으로 도출되었다. 재가간호서비스의 연계방안으로 도출된 24개의 항목은 재가간호사업 체계의 개선과 제공되는 서비스 질의 향상, 대상자의 만족도 증대 효과를 가져 올 수 있을 것으로 기대되며, 서비스의 중복을 최소화할 수 있는 방안을 모색함으로서 국가적 차원에서 복지 및 국민 건강관리의 효율성을 증대할 것으로 보인다. 이를 통해 궁극적으로 국민의료비의 절감과 더불어 재가간호서비스 증진에 기여할 것으로 여겨진다.

• 한국비블리아학회지
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• 제30권3호
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• pp.195-221
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• 2019

본 연구는 국외 병원도서관 환자대상 건강정보서비스 사례조사를 통한 시사점을 제시하고자 함이 목적이다. 총 89개의 국외 병원도서관을 대상으로 하였으며 여기에는 종합병원, 전문병원, 여성병원, 어린이병원, 재향군인병원 등이 포함되어 있다. 89개 병원도서관에서 일반적이면서 공통적으로 제공하고 있는 건강정보서비스를 조사하였으며 다음으로 차별화된 건강정보서비스를 조사하였다. 조사결과, 첫째, 국외에서는 병원도서관의 설치와 건강정보서비스 제공이 일반화되어 있음을 알 수 있다. 둘째, 건강정보서비스 제공을 위해 사서, 건강정보전문가, 의학전문사서, 사회복지사, 임상사서, 건강교육전문가, 자원봉사자 등의 다양한 인적자원을 활용하고 있다. 셋째, 인쇄자료뿐 만 아니라 전자자료, 웹사이트, 팸플릿, 브로우셔 등의 다양한 정보원을 제공하고 있으며 다양한 언어로도 건강정보를 제공하고 있다. 넷째, 건강(정보활용)교육 및 프로그램 제공에 있어 병원, 지역공공도서관, 지역공동체 등과의 연계를 통한 서비스가 제공되고 있다. 이를 통한 국내 병원도서관을 위한 시사점으로는 첫째, 병원도서관 설치 및 건강정보서비스 제공에 대한 인식의 전환, 둘째, 인적자원 양성을 위한 교육과정 및 협회의 지원과 계속교육의 필요성, 셋째, 병원도서관에서의 건강정보서비스 의무화 및 다양화를 위한 관련 기관과의 연계 등이 필요하다.

• 의학교육논단
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• 제20권2호
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• pp.72-77
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• 2018

Observation of the current Korean medical education and training system shows that certain negative traits of unchangeable solidification engraft themselves so deeply into the overarching system that they are now hampering the state of the national health welfare. Focusing only on undergraduate medical education, we can point out some glaring side-effects that should be of concern to any stakeholder. For instance, a graduate can legally begin his career as an independent practitioner immediately after passing the licensing exam and return to the old stuck school-year system of 2-year-premedical and 4-year-medical programs where outcome-based and integrated curricula are incomplete and unsatisfactory. In terms of learning opportunities, the balance between patient care and public health, as well as that between in-hospital highly specialized practice and community-based general practice, has worsened. Every stakeholder should be aware of these considerations in order to obtain the insight to forge a new direction. Moreover, our medical schools must prepare our students to take on the global roles of patient care within the Fourth Industrial Revolution, health advocacy for the imminent super-aged society, and education and research in the bio-health industry, by building and applying the concept of academic medicine. We will need to invest more resources, including educational specialists, into the current undergraduate medical education system in order to produce proper outcomes, smart curriculum, innovative methods of teaching and learning, and valid and reliable monitoring and evaluation. The improved quality of undergraduate medical education is the starting point for the success of the national system for public health and medical care as a whole, and therefore its urgency and significance should be emphasized to the public. The medical society should go beyond fixing what is broken and usher in a new era of cooperation and collaboration that invites other health professionals, governmental partners, law-makers, opinion leaders, and the general public in its steps toward the future.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9411-9416
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• 2014

Background: Cancer registration data is used to understand the nation's cancer burden, and to provide significant baseline data for cancer control efforts, as well as, research on cancer incidence, mortality, survival, and prevalence. A system that approves, assesses, and manages the qualification of specialists, responsible for performing cancer registration, has not been developed in Korea. This study presents ways to implement a certification system designed for the qualification of tumor registrars in Korea. Materials and Methods: Requirements for implementing a certified tumor registrar qualification system were determined by reviewing the system for establishing qualifications in Korea and the American qualification system via the National Cancer Registrars Association (NCRA). Moreover, a survey was conducted on Korean medical records administrators, who had taken the U.S. Certified Tumor Registrar (CTR) examination, in order to review their opinions regarding these requirements. Results: This study verified the feasibility of a qualification examination based on the opinions of CTR specialists by determining the following: items, and the associated ratings, of the qualifications necessary to register individuals as certified tumor registrars in a private qualification system; status of human resources required for the examination or training processes; plans regarding the organization needed for management, and operation of qualifications, examination standards, subject areas, examination methods, examination qualifications, or education and training programs. Conclusions: The implementation of a certified tumor registrar qualification system will lead to enhanced job competency for specialists and a qualitative improvement of cancer registration data. It will also reliably foster human resources that will lay the groundwork needed to establish scientific and reasonable national cancer management policies.

• International Journal of Advanced Culture Technology
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• 제8권2호
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• pp.1-5
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• 2020

As the world gradually advances to an aging society, the quality of human life is valued. Among them, 'quality of sleep' is very closely related to quality of life. Recently, Korea expanded health insurance coverage for "sleep disorders". Particularly, as the number of sleep multiple tests and prescriptions for sleep aids has increased rapidly, much attention has been focused on the related medical service environment. Therefore, this study looked at an in-depth interview of 11 hospitals to see what treatment delivery system is being established when the government applies health insurance for 'sleep disorders'. In conclusion, the organizations with the most average number of sleep polyp tests per day were found to have more sleep polyp labs (hardware) and more full-time specialists. Also, the polysomnography lab (hardware) and the specialist's full-time status (software) did not necessarily result in a "positive pressure regulator prescription" that can solve "sleep apnea" caused by "sleep ailments". Rather, it was found that the number of days of sleep multiple laboratories (hardware), the number of full-time specialists (software) or the specialty majors (software) had a greater impact. In particular, the higher the specialist's full-time personnel (software) index (=6.000), the higher the sleep-inducing agent prescription rate(=1.000), and the lower the specialist's full-time personnel (software) index (=1.000), the higher the sleep-inducer's prescription rate(= 0.010) Was low. In addition, even if the professional full-time personnel(software) index was the same (=1.000), the hospital type was lower as it was closer to the public hospital(=0.067) and higher at the specialized hospital (= 0.933). In the case of university hospitals, when the full-time specialists (software) are in the same condition (= 1.000), the frequency of use of the sleep laboratory (=1.000) and the sleep test rate (= 1.000) were all the same.

• 보건행정학회지
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• 제25권1호
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• pp.40-52
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• 2015

Background: The purpose of this study was to analyze the increase in Grade of Nursing Management Fee of medical institutions and establish a reasonable government policy by examining which factors affect the increase of nurse staffing. Methods: Analyzing data collected from the Health Insurance Review & Assessment Service resource management department with targets of 1,104 medical institutions. The study period was 5 years from June 30, 2008 to June 30, 2013. SAS ver. 9.2 (SAS Institute Inc., Cary, NC, USA) was used for statistical analysis. The data was analyzed by a chi-square test and also conducted muiltivariate logistic regression analyses for variables of basic characteristics, human resource characteristics, and material resources. Results: Adjusted odds ratio (AOR) of the rise in Grade of Nursing Management Fee among other hospitals compared to hospitals owned by government or universities was 0.264. The AOR in hospitals established after November 2006 compared to those before June 1995 was 2.383. The AOR in Gangwon, Chungcheng South, and Jeolla South Provinces compared to Seoul was 0.084, 0.036, and 0.194, respectively. The AOR in hospitals with more than 6.75 specialists per 100 beds compared to those with less than 6.75 specialists per 100 beds was 7.514. The AOR in hospitals with more than 17.48 nurse per 100 beds compared to those with less than 17.48 nurse per 100 beds was 3.300. The AOR in hospitals with 50% to 75% bed utilization, 75% to 90% bed utilization and more than 90% bed utilization compared to those with less than 50% bed utilization was 5.428, 9.884, and 10.699, respectively. The AOR in hospitals with one magnetic resonance imaging (MRI) and more than two MRI compared to those with no MRI was 2.018 and 2.942, respectively. Conclusion: This result has showed policies to induce the rise in Grade of Nursing Management Fee among old hospitals and the incentive system for local medical institutions are needed. Also we need to develop a governmental policy for medium-small hospitals with low operation rate of beds and insufficient medical personnel and number of equipment in hospitals.

• 대한간호학회지
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• 제25권4호
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• pp.774-789
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• 1995

Due to the rapid socioeconomic development and the introduction of the national health insurance system the general population's need for health care and utilization of health care services have increased dramatically. As a result of this change. Korea is experiencing a shortage of health care facilities and health manpower, and this leads long wailing line at doctor's offices. One of the solutions of this problem could be home health care system for those who have minor health related problems. With this background, this study was conducted to look at the feasibility of a home-based prenatal care system using information superhighway and nursing informatics specialists. With the home-based prenatal care system, the pregnant woman checks her blood pressure, tests her urine for sugar and protein, and measures her body weight at home and sends the information to a hospital computer via the information networks such as public telephone line and information superhighway. Nursing informatics specialist at the hospital will go through each patient record and screen those who have abnormal values and notify them to see a doctor as soon as possible. Besides telemonitoring features, the proposed system will include tole-education capabilities for the patients so that patient can learn whatever they need to know ragarding the prenatal care via information networks. If this system develops and operates, patient can save time in terms of travel to and from the hospital and waiting time in the hospital. And the health care institute can utilize its resource more efficiently.