• Journal of Nutrition and Health
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• 제13권1호
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• pp.9-14
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• 1980

A total of 35 hospitals throughout Korea were surveyed for the assessment of the educational function of dietitians. The current situation and the depth of practices were diagnosed in such areas as: 1. The continuing education for the hospital dietitians 2. The characteristics of patient consultation performed by the hospital dietitians 3. Systems and methods of patient instruction practiced by the dietitians, and 4. Prospectives in establishing the nutrition education center for the in-and out-patients. The major findings are: 1. Approximately half of the hospital dietitians feel positive about the practicality of their college education for the job. Extremely small number of them are on any kind of continuing education program 2) The monthly average of only 20 patients at one hospital receive diet consultation or nutrition education service from dietitians. The 50% of the consultation cases is taken up by the patients with diabetes and various circulartory diseases followed by the tube feedings, liver and renal diseases with less frequencies 3) Not even a single hospital has an office for the diet consultation and nutrition education for the in-or out-patients. Very few hospital dietetics have educational aids and/or any feedback system to evaluate the effect of the consultation. Charting is not practiced by most dietitians leaving no record of their contributions to the patient care. 4) Although the necessity of the nutrition education center in the hospital is strong1y recognized among dietitians the progress has been blocked by such obstacles as the poor system in the hospital administration in general, short in funds, lack of preparation in the dietetics and the lack of recognition both by the hospital administration and by the dietitian themselves.

• 한국응급구조학회지
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• 제5권1호
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• pp.177-198
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• 2001

The purpose of this research which was conducted by surveying the transfer consultation records from 360 medical institutions such as general hospitals, hospitals, clinics to the Emergency Medical Center at E University Hospital for six months(Jan. 1, 2000 - Jun. 30, 2000) are to standardize & complete transfer consultation record of hospitals at the 1st & 2nd referral level and to give patients transferred emergency medical center medical information services on a better quality. The conclusions and suggestions from this study were summarized as follows; (1) Examing the distribution of the referral medical consultation(transfer) sheet type, surgery part local clinic sheet types were 34.4%, medical part local clinic sheet types were 26.7%, undifferentiated local clinic sheet types were 23.9% and hospital level sheet types were 15.0%. (2) The items of the transfer consultation records had been standardized more than 75% in the order of patient's name, date, doctor's name, diagnosis, patient's status, impressions. (3) That the degree of recording completion on these items is in the order of patient's name, date, diagnosis, impressions was revealed. (4) Because the standardization and the degree of recording completion are very low in the patient's gender, age, address, electronic recording system was needed for more perfect input of initial patient informations. (5) This standardizing & complete recording on examination and medication will prevent re-examination and abuse of medication for patients transferred emergency medical center. (6) EMT Transfer System should be fixed in all medical institute for the standardizing & complete recording on care period and departure time will give many emergency patients the proper treatments at the proper time. (7) It was revealed that developing new standardized transfer consultation record & using electronic recording system are needed. (8) The complete recording & Fast Track System were needed for higher rate of bed operation at emergency medical center and more hospital profit.

• 약학회지
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• 제52권3호
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• pp.201-211
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• 2008

All pharmacists must provide the drug consultation whenever dispense drugs to patients by the Korean Pharmacy Law. Drug consultation is very important procedure for increasing pharmacotherapy. Because it maximizes the therapeutic effects or/and minimizes adverse drug reaction during the drug therapy. However, it is not easy to do because of the dynamic and hectic pharmacy environment. Especially, if someone has a disabling body function, they required more time and efforts to perform consultation by pharmacist. Currently several auxiliary labels for helping drug consultation are using in pharmacy practice but not for disabling patients. Therefore we developed the total 53 auxiliary labels with size of 0.7 cm (width) and 1 cm (length) by Braillewriter letters for blind patients. This research has been performed for total 12 months (Mar. 15ts, 2007$\sim$Feb. 25th, 2008) and the developing methods are consisted of 4 steps: 1) selection of essential informations, 2) simplification of information, 3) changing for Braillewriter letters, 4) application and revising by blindness patients. Also the labels are consisted of 12 for adverse reactions and precautions, 8 for directions, 2 for storages, 9 for duration, 9 for dosage forms, and 12 for common names. After developed those labels, we revised those labels by discussion with 2 blind people. In conclusion, the new auxiliary labels for blind patients can increase therapeutic effects and decrease risks from pharmacotherapy besides decreasing of pharmacist's work load in the future.

• 한국해양환경ㆍ에너지학회지
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• 제19권3호
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• pp.211-217
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• 2016

어항시설에 대한 해역이용협의 시 계류시설이 협의대상에서 정확히 규정되어 있지 않고, 항만시설과 규모에서 차이가 있으나 협의대상 규모를 동일하게 적용하고 있어 문제점이 나타나고 있다. 본 연구에서는 이러한 사항을 분석하기 위해 최근 2년간(2013-2014) 해역이용영향검토기관에서 검토된 어항관련 일반해역이용협의서 17건을 분석 후 세 가지 개선방안을 제시하였다. 첫째, 해역이용협의 대상사업 범위에 대한 재평가가 필요하다. 어항개발은 외곽시설을 포함한 계류시설 등 다양한 시설설치가 동시에 진행되기 때문에 기본시설, 기능시설 등을 모두 고려하는 등 해역이용협의 대상을 보다 명확히 해야 할 것이다. 둘째, 시설규모에 대한 조정이 필요하다. 그 밖의 어항시설의 경우는 공유수면 점용 사용 면적이 $50,000m^2$일 경우 일반해역이용협의 대상이나, 대부분 소규모 어항의 경우 항계를 초과하는 경우가 많아 대상사업의 범위가 과대하게 설정되어 있어 조정이 필요하다. 셋째, 해역이용협의에 대한 근거의 혼선을 해소하기 위해 협의대상을 명확히 할 필요가 있다. 공유수면 점 사용 허가 및 적용배제의 근거인 "공유수면 관리 및 매립에 관한 법률"과 "해양환경관리법"에 따른 공유수면 점용 사용과 관련된 협의대상 사이에서 나오는 불명확성과 혼란을 제거하기 위해 협의대상의 근거를 명확히 설정하는 규정이 마련되어야 할 것이다.

• 대한심미치과학회지
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• 제22권1호
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• pp.74-82
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• 2013

현대사회는 TV나 인터넷 등 대중매체의 노출과 스마트 폰 보급으로 급성장한 SNS 등을 통해 이미지에 대한 지각이 신체관련 소비행동에까지 영향을 미치고 있으며 그로 인해 본인이 가지고 있는 콤플렉스에 대한 개선을 원하는 심미 증례 환자의 수요 역시 증가하고 있습니다. 심미적인 치료를 희망하는 환자군은 일반진료를 받는 환자군에 비해 더욱 적극적인 성향을 보이며, 이미지 개선에 대한 기대와 함께 기능적인 문제, 결과에 대한 만족도 등의 두려움을 가지고 있습니다. 심미 증례 환자의 상담에 있어서 가장 기본은 환자본인이 심미치료를 통해 개선하고 싶은 포인트가 어떤 것인지를 술자와 상담자가 정확하게 인지하는 것에서부터 출발합니다. 환자의 관점에서 시작되는 상담은 의학적인 분야의 접근을 통해 합의 즉 이상적인 것과 자연스러움의 균형점을 찾는 방식으로 진행됩니다. 초기 상담부터 각 진료단계별 상담 process를 구축하고 단계별 상담 내용을 정확하게 기재하여 술자 및 진료staff이 공유하며, 초기상담부터 Maintenance care까지 일관성 있는 정책을 운영하여 환자에게 무리한 기대를 주고 공감하지 못하는 결과로 실망을 초래하는 상담이 아닌 진정한 소통이 바탕이 되어 환자, 술자, 진료staff이 만족할 수 있는 결과를 이끄는 상담이 가능해 집니다. 심미 증례의 유형별 case를 통해 환자와의 공감을 바탕으로 한 심미 증례 환자의 효과적인 상담전략을 소개합니다.

• 한국병원경영학회지
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• 제27권4호
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• pp.22-35
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• 2022

Purpose: Physician's occupational burnout has been a very important issue that can cause negative consequences not only for individual's physical and mental health, but also for patient's health and the overall national healthcare system. For the reason, this study confirmed how consultation length and the number of outpatients affect physician's occupational burnout in the medical environment. Methodology: In the study, the data of '2020 Korean Physician Survey' conducted by Korean Medical Association(KMA) was used for the analysis, and a total of 4,215 physicians were selected as study samples. The differences in the degree of occupational burnout according to the physicians' general characteristics were confirmed through uni-variate analysis, and also a regression analysis was conducted to confirm the effects of consultation length and the number of outpatients on physician's occupational burnout. Findings: As a result. the overall degree of physician's occupational burnout decreased(𝛽=-0.051, p<0.01) as the consultation length increased. Specifically, the physician's emotional exhaustion increased(𝛽=0.051, p<0.01), while the reduction of accomplishment decreased(𝛽=-0.131, p<0.001). Furthermore, the overall occupational burnout decreased(𝛽=-0.047, p<0.01) as a proportion of advice and education during the consultation increased, and it had an effect on the decrease in depersonalization(𝛽=-0.045, p<0.01) and the reduction of accomplishment(𝛽=-0.065, p<0.001). At last, as the number of outpatients increased, the overall occupational burnout increased(𝛽=0.041, p<0.05) with more emotional exhaustion(𝛽=0.095, p<0.001), depersonalization(𝛽=0.065, p<0.001), and less reduction of personal achievement(𝛽=-0.081, p<0.001). Practical implication: Consequently, it is necessary to prevent physician's occupational burnout by ensuring sufficient consultation length and providing a medical environment to treat an appropriate number of patients. Therefore, national policies should expand health insurance coverage and compensate medical fees for sufficient consultation length that both patients and physicians can satisfy. It will ultimately contribute to ensuring the patients' health and improving the quality of national healthcare services.

• 한국산학기술학회논문지
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• 제21권6호
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• pp.461-467
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• 2020

산업자문은 교원이 경영 또는 기술적으로 산업체 등을 컨설팅 하는 일종의 인적용역으로, 통상 산학협력단이 주체가 되어 계약을 하고 교원이 책임자로 자문을 수행한다. 산학협력단이 자문의 대가로 교원에게 지급하는 산업자문료의 소득세 과세가 최근 논란이 되는바, 세무 전문 인력이 부족한 상황에서 동일한 성격의 금원에 대해 대학별로 다르게 원천징수하고 있어 합리적인 과세 기준 제시를 통해 대학의 혼란을 방지할 필요가 있다. 본 연구에서는 산업자문의 속성을 살펴본 후, 우리나라 법령과 과세 사례를 중심으로 논의하고 비판적 고찰을 통해 대학 현장에서 용인될 수 있는 과세 기준을 제시하고자 하였다. 교원에게 지급하는 산업자문료는 산학협력단과 교원 간에 실질적인 고용관계가 없다는 점을 감안할 때 일반 과세 이론상 근로소득으로 취급하기는 어렵다. 다만, 산학협력법 및 회계 관행 상 자문료의 지급 근거가 직무발명 보상금과 동일하고, 통상 산업자문 과정에서 직무발명이 자연스럽게 도출되는바, 현행 법 하에서 교원의 산업 자문료는 직무발명 보상금과 동일하게 취급해 소득세법 제20조제1항제5호에 따른 근로소득으로 보는 것이 타당할 것이다. 산업자문을 연구용역과 유사하다고 보아 연구수당처럼 기타소득으로 과세해야 한다는 견해는 산업자문에 대해 별도의 관리규정을 두어 엄밀하게 관리·감독하는 것은 아니어서 소득세법 상 인정되기는 어렵다. 산업자문료의 근로소득 과세는 높은 세율로 인해 산학협력 활동의 위축으로 이어질 수 있는바, 정책 당국의 조속한 과세 체계 정비가 요구되며, 소득세법 시행령 개정을 통해 산업자문을 연구용역과 동일하게 산학협력 유형의 일종으로 규정함으로써 기타소득으로 과세하는 방안이 타당하다.

• 보건행정학회지
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• 제27권1호
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• pp.39-46
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• 2017

Background: We evaluated new patient's satisfactory consultation time (SCT) and their willingness to pay additional costs (WPAC) for their SCT. Methods: We surveyed medical service satisfaction, SCT, WPAC for their SCT, and payable amount to 612 new patients of single general hospital and measured their real consultation time (RCT). To compare WPAC and payable amount, we divided RCT into 4 groups (${\leq}3$ minutes, 3-5 minutes, 5-10 minutes, and > 10 minutes), and SCT into 3 groups (${\leq}5$ minutes, 5-10 minutes, and > 10 minutes). On the basis of WPAC, we estimated new patient's SCT. Results: RCT was 6.2 minutes, SCT was 8.9 minutes, and medical service satisfaction score was 4.3 (out of 5). The number of patients having WPAC (payable group) was 381 (62.3%) and the amount was 5,853 Korean won. Their RCT and SCT were longer than non-payable group (6.4 minutes vs. 5.7 minutes, 9.3 minutes vs. 8.2 minutes). From multiple logistic regression analysis, WPAC of RCT 5-10 minutes was higher than that RCT ${\leq}3$ minutes (odds ratio= 1.78). Payable amount was highest in RCT > 10 minutes (6,950 Korea won) and SCT > 10 minutes (7,458 Korean won). Intuitively we suggest 10 minutes as SCT, based on payable group's SCT (9.3 minutes) and cut-off time differentiating payable group with non-payable group (10 minutes). Conclusion: We found that new patient had WPAC for their SCT and the longer the SCT, the greater the amount. From this, we hope that current simplified new patient consultation fee calculating system should be modified combining the consultation time factor.

• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2861-2866
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• 2012

Background: The aim of our study was to assess the practical utility of the palliative prognostic index (PPI) as a prognostic tool used by nurse specialists in a hospice consultation setting in Taiwan. Methods: In total, 623 terminal cancer patients under hospice consultation care from one medical center in northern Taiwan were enrolled between January 1 and June 30, 2011. PPI was assessed by a nurse specialist at first hospice consultation and patients categorized into groups by prognosis (good, intermediate, poor). Patient survival was analyzed retrospectively to determine significance of between-group differences. Results: By PPI sum score, 37.2% of patients were in the good prognosis group, 18% in the intermediate prognosis group and 44.8% in the poor prognosis group. The death rates were 56%, 81.2% and 89.6% and median survivals were 76, 18 and 7 days, respectively. The hazard ratio was 0.19 (95% confidence interval [CI] 0.10-0.24, p<0.001) for the poor versus good prognosis group and 0.54 (95% CI 0.43-0.69, p<0.001) for the poor versus intermediate prognosis group. The sensitivity and specificity for the poor prognosis group was 66% and 71%; the positive predictive value and negative predictive value were 81% and 52%, respectively, to predict patient death within 21 days (area under the curve of the receiver operating characteristic was 0.68). Conclusions: Assessment by PPI can accurately predict survival of terminal cancer patients receiving hospice consultation care. PPI is a simple tool and can be administered by nurse members of hospice consultation teams.

• 정신신체의학
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• 제21권2호
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• pp.114-121
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• 2013

연구목적 타과 입원 중 정신건강의학과에 자문 의뢰된 초로기와 노년기 환자의 특징에는 어떠한 차이가 있는지 알아보기 위하여 연구를 실시하였다. 방 법 일 대학병원 정신건강의학과에 자문 의뢰된 타과 입원환자 중 50세부터 64세 범위의 초로기 환자(N=162)와 65세 이상의 노년기 환자(N=171)의 자문기록지를 비교분석하였다. 결 과 1) 정신건강의학과 자문의 주소는 초로기에 신체증상, 불안, 수면장애 순, 노년기에 인지저하, 의식혼탁, 우울한 기분 순으로 많았다. 2) 자문 결과에 의한 정신의학적 진단명은 초로기에 섬망, 기분장애, 물질사용장애순, 노년기에 섬망, 기분장애, 주요 신경인지장애 순으로 많았다. 3) 신체질환 치료제의 수는 초로기보다 노년기에 더 많았다. 결 론 정신건강의학과 자문의 특성은 초로기와 노년기 환자에서 차이가 있었으므로, 노인정신의학 자문 활동에 있어서 더욱 세분화된 노인 연령층별 접근이 필요하다고 제시된다.