• 대한치과기공학회지
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• 제32권4호
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• pp.417-433
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• 2010

Purpose: This study evaluated the manpower planning of dental technicians. Methods: Methods : Survey was conducted regarding subject's general characteristics, characteristics of dental technician's occupational view and working conditions, and reason to enter into branches of the public health enter. The survey sample consisted of 323 dental technicians (221 male/ 102 female). Survey was conducted for one month from August 1 to September 1 in 2010. Following results were obtained. Results: 1. Regarding general characteristics of the subjects, there was a slight male predilection with 68.4%. Subjects in their 40s occupied the highest proportion of 32.2%. Majority of subjects worked in the big cities (71.5%). Favored working places were dental laboratory (57.6%) and dental hospital or dental clinic (19.5%). Although no position is available in the public sector such as public health center or health care civil servant, 9.3% preferred working in the public health center. Public sector is more favored than 2-year technical colleges or dental supply and equipment companies. In respect to education, 57% of the subjects graduated college. 67.8% were married. Subjects who specialize in the porcelain or all-ceramic were 57.9%. With regard to current position, head of the dental laboratory was most common. 2. Following occupation characteristics were found. Economic reason took the highest proportion when deciding their occupation (39.9%) followed by gaining social experience (36.5%). Majority of the subjects (76.5%) wanted to work as dental technicians until their retirement. 71.5% pursuit to become a manager of the dental laboratory. 76.1% agreed on opening a dental technician position in the public health center. Regarding an authority to lead developing the dental technician position in the public sector, majority of the subject chose ministry of health and welfare (35.6%) and Korean dental technologist association (34.7%). Employment (average, 30%) and turnover rate (average, 36.5%) of dental technology college graduates ranged from 40% to 60%. Most important factors for the employment were practical experience (41.2%) and competency (34.4%). With regard to job satisfaction, so-so as 46.7% and satisfactory was 42.7% 3. In respect to the reason for opening a position in the public health center, 'It is needed to continue denture rogram for elderly patients' obtained the highest score (4.14 point). 'Institutional devices are required to open a position for dental technicians as a public healthcare provider' received high score (4.11 point). 4. Concerning the working conditions, 'professional knowledge is required' received the highest score (4.23) followed by 'too short maternity and parental leave' (4.21). 5. Relationship between general characteristics of the subjects and favor of working in the public health center was investigated. Significant differences were found according to the current and favored working area, favored occupation, education level, marital status, and specialty. Working in the public health center was favored by following subjects: working in mid- or small-sized cities (4.16 point, p<0.05); PhD degree-holder (4.59 point, p<0.01). 6. Among general characteristics of the subjects, significant difference of working conditions was found in the following factors: gender; working areas; favored working areas; favored working positions, and education level. Majority of subjects favored working in big cities and currently work in big cities although satisfaction was comparatively low (3.75 score). 7. Future plan to work in public health center was evaluated according to occupational characteristics. Subject's intention to work in the public healthcare center was significantly affected by opening of dental technician position, leading authority, average turnover rate, and factors affecting employment. Working in the public health care center was favored by the following subjects: Dental technicians who actively supported opening of the dental technician position (4.34 point, p<0.001); subjects who thought the Korean dental technologist association is responsible for the opening of positions in the public sector (4.26 point, p<0.001); and subjects who thought that attitude and character are important for the employment (p<0.001). 8. Concerning difference of working conditions according to the occupational characteristics, significant difference was demonstrated by factors such as a reason to choose to be a dental technician, work plan, pursuing position, responsible authority, average employment rate, and job satisfaction. High standard of working conditions was required in subjects who selected to be a dental technician for the leisure time after work (s.05 point, p<0.01), who planted to work until their marriage (4.25 point, p<0.001), and who pursuit to be a manager (3.98, p<0.05). 9. In respect to influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.068 and age affected the working condition with significant difference according to the pvalue. 10. Regarding influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.335 and work plan, opening of dental technician position in the public sector, and responsible authority had significant influence over the subject's intention to work in the public health center according to the p-value. 11. With regard to the influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.091 and reason to choose to be a dental technician, work plan, and responsible authority significantly affected subject's working conditions. Conclusion: Korean society is becoming a super-aged society according to several statistics. As aged population is rapidly increasing, national health insurance plans to cover denture for senior citizen over 75 years old from 2012. Therefore, dental technicians are urgently needed in the public health centers all over the nation. Many subjects in this study planed to work until their retirement and recognized dental technician's expertise. Ministry of health and welfare and Korean dental technologist association should co-operate each other to prepare foundation and institutional devices for dental technicians to advance into the public health center. This will improve oral health of the population. This study showed urgency of medical facilities and services which meets increasing number of aged population and welfare of the population.

• 항공우주정책ㆍ법학회지
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• 제20권1호
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• pp.9-43
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• 2005

우리나라는 2005 년 11월에 한국항공우주연구원이 개발한 다목적실용위성 2호(아리랑 2호)를 발사하게 될 것이고 2006 년 6월에는 한국통신의 통신 방송위성 5호(무궁화 5호)가 발사될 예정이고 2007 년에는 한국항공우주연구원이 한반도의 남해안 외나로도에 건설하고 있는 "우주센타"가 준공되어 자력으로 개발한 우주발사체(KSLV-1 : 로켓)를 이용하여 국산 과학기술위성2호(100kg급의 소형)의 발사 등 우리나라에 본격적인 우주개발시대에 접어들게 된다. 따라서 우리나라의 우주개발중기계획에 따라 2010년까지 13기의 각종위성과 발사체를 개발하여 "우주센타"에서 시험발사와 발사를 자주 하게 될 것이다. 이와 같이 위성발사에 따라 예상할 수 없는 발사사고 발생될 가능성도 있게 된다. 상기위성들을 국내외에서 우주발사체(로켓)를 이용하여 발사하는 과정에서 있을지도 모르는 로켓 발사사고로 인해 지상에 있는 제3자의 인적 손해 또는 물적 손해를 입혔을 때에 선진국의 입법례와 같이 이를 신속히 해결하기 위하여 가해자와 피해자 양자 간의 공정한 책임규명, 책임한계 및 재판의 기준, 손해배상책임 등을 규정하고 우리나라의 우주개발중장기기본계획을 성공적으로 달성시키기 위하여 국내우주법의 제정이 필요로 하게 되었던 것이다. 우리나라는 우주개발을 체계적으로 진흥시키고 우주물체를 효율적으로 이용관리하기 위한 법적 제도적 틀을 마련하고, 우주개발국가로서 국제조약에 규정된 국가의무를 이행하기 위한 법적 근거를 마련하기 위하여 우주개발진흥법을 2005년 5월 31일 정부가 제정 공포하여 동법 부칙에 의거 6개월 후인 2005년 12월 1일부터 시행하게된다. 본 논문에서는 우주개발진흥법의 제정을 계기로 현재 세계도처에서 발생되고 있는 우주사고의 특성과 사례, 우주개발진흥법을 제정하는데 계기가 되었던 4개의 우주관계 국제조약과 세계 각국의 국내우주관계법의 입법례((1)미국,(2)러시아, (3)영국, (4)독일, (5)프랑스, (6)캐나다, (7)일본, (8)스웨덴 (9)오스트레일리아, (10)브라질, (11)노르웨이, (12)남아프리카, (13)아르헨티나, (14)칠레, (15)우크라이나)를 소개한 후 우리나라 우주개발의 실적과 현황 및 전망 및 우주개발진흥법의 입법배경과 경위 및 주된 내용, 2005년 8월 19일 과학기술부가 입법 예고한 우주개발진흥법 시해령 안과 시행규칙안의 주요내용, 앞으로의 과제로서 우리나라 우주관계기구의 개혁 등 순서로 설명하였다. 본 논문의 핵심이 되는 사항인 앞으로의 과제로서 우주관계기구의 개혁의 문제는 필자가 과학기술부의 우주관계 담당부서의 기구개혁과 한국항공우주연구원의 기구를 확대 개편하여 한국항공우주개발공사(가칭)의 설립을 제안하는 이유는 각종위성 및 발사체의 개발지연과 우주센터의 건립이 지연되지 않도록 하고 앞으로 우주개발중기계획에 따라 각종위성 및 발사체의 개발이 2010년까지 당초 정한 목표 년도에 완성시키어 우리나라의 우주산업을 세계10위권 내에 조기에 진입시키고자 하는데 그 목표가 있는 것이다.

• 항공우주정책ㆍ법학회지
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• 제29권2호
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• pp.3-54
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• 2014

오랜 논의와 노력 끝에 우리나라 상법 제6편 항공운송편이 신설되어 2011년 11월부터 시행되었다. 상법 항공운송편은 국내항공운송으로 인해 발생한 항공 운송인의 손해배상책임 문제와 항공기 운항으로 인해 발생한 지상 제3자에 대한 항공기운항자의 손해배상책임 문제 등을 규율하기 위해 제정되었다. 상법 항공운송편은 관련 국제 조약들과 항공선진국들의 국내입법을 충분히 비교 검토하여 우리 법으로 수용하였기 때문에 국제 기준에 부합한다는 장점도 있지만, 항공기운항자의 지상 제3자에 대한 손해배상책임 규정을 중심으로 다음과 같이 개선해야 할 내용들도 포함하고 있다. 첫째, 상법 항공운송편상 항공기운항자의 지상 제3자 손해에 대한 배상책임 한도액은 피해자에 대한 적절한 배상을 하기에는 너무 낮은 수준으로 규정되어 있어 상향될 필요성이 있다. 따라서 독일과 같이 2009년 체결된 일반위험협약 및 불법방해배상협약의 관련 내용을 수용하여 항공기의 중량에 따른 분류기준을 10단계로 세분화하고 총 책임한도액을 최대 7억 SDR까지 상향시키면서, 인적 손해에 대한 배상책임한도액은 기존의 법무부 검토안처럼 최근의 물가상승률을 반영하여 현 규정의 5배 수준인 1인당 62만5천SDR까지 상향 조정하는 방안을 생각해 볼 수 있다. 이 방안이 한 사고당 항공사에게 일반적으로 보험으로서 보장되는 단일배상책임한도액이나 다양화 된 항공기 제원을 반영하면서도 지상 제3자에게 현실에 맞는 적절한 손해배상을 할 수 있다는 점에서 가장 바람직하다고 본다. 둘째, 항공기운항자는 현 상법 항공운송편상 항공기 납치 공격이나 9 11 테러와 같은 항공기를 이용한 공격행위 등과 같은 항공기테러에 의한 지상 제3자의 손해에 대하여도 무과실책임을 부담한다. 이에 관하여는 항공기운항자에게 지나치게 가혹하고 불합리한 입법이라는 견해가 있지만, 항공기운항자에게도 일정 부분 테러를 방지할 법적 의무가 있고 피해를 입은 제3자 구제 측면에서 그것이 항공기운항자에게 지나치게 가혹하거나 불합리하다고 생각되지는 않는다. 그러나 9 11테러와 같이 조직화 된 테러단체에 의해 항공기가 테러에 이용되어 지상 제3자 피해가 발생한 경우에도 항공기운항자가 피해자들에게 무과실책임을 지도록 하는 것은 불합리하며, 이러한 경우에는 항공기운항자의 책임이 면제되는 방향으로 상법 항공운송편 규정은 개정되어야 할 것이다. 셋째, 항공기사고와 같은 항공기 운항으로 인한 피해의 엄청난 규모를 고려해 볼 때, 다수의 피해자들이 경제적 어려움에 직면할 수 있으므로 항공여객의 인적 손해에 대한 항공운송인의 배상책임 발생 시 적용되는 선급금 지급 규정을 항공기운항자의 책임 발생 사례에도 준용할 필요가 있다고 본다. 넷째, 현행 상법 항공운송편상 항공기운항자의 손해배상책임 규정은 항공기 운항으로 인한 피해가 지상 또는 수면 및 수중에서 발생된 경우에만 적용되고 공중에서 발생한 피해에는 적용되지 않는다. 하지만 다른 항공기의 운항으로 인한 공중에서 발생된 항공기 등의 손해가 지상이나 수면 및 수중에서 발생한 손해와 차이가 있다고 볼 수 없다. 그러므로 상법 항공운송편상 '지상 제3자'라는 용어에서 '지상'이란 용어를 삭제하여 다른 항공기 운항으로 인한 공중에서의 항공기 등의 손해에도 상법 항공운송편상 항공기운항자의 지상 제3자 손해 배상책임 관련 규정이 적용될 수 있게 하는 것이 바람직하다고 본다. 위에서 제시된 상법 항공운송편상 항공기운항자의 지상 제3자 손해에 대한 배상책임 관련 규정의 개선방안 검토와 동 규정의 보완을 위한 지속적인 관심과 노력을 통하여, 상법 항공운송편이 피해를 입은 지상 등의 제3자에게 현실에 맞는 적절한 배상을 할 수 있게 하면서도 항공기운항자에게 과도한 부담을 지우지 않는 상호 간의 이익 균형상 더욱 바람직한 방향으로 발전되기를 희망한다.

• 항공우주정책ㆍ법학회지
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• 제24권1호
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• pp.35-58
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• 2009

항공기 운항 중 제3자에 대한 피해를 배상하는 국제 조약은 1933년 로마협약에서 처음 규정하였지만 호응을 얻지 못한 채 1952년 로마 협약으로 개정되면서 배상 금액이 상향 조정되는 등 일부 내용이 개선되었다. 이에 불구하고 2009년 현재 협약 당사국이 49개국에 불과하여 보편적인 국제 조약으로 기능하지 못하고 있는데 동 협약을 개선한 1978년 몬트리올 의정서는 배상 상한을 다시 인상하였음에도 불구하고 미국, 일본, 영국, 독일 등 주요 항공 대국이 참여치 않은 가운데 의정서 당사국이 12개국에 그치면서 명목을 유지하는 형편이다. 이에 따라 제3자에 대한 항공기 피해에 대한 배상은 사고 발생지 국내법에 의해 해결하는 추세이다. 2001년 발생한 9.11 테러 공격은 세계 최대 강국인 미국이라도 대규모 제3자 피해를 혼자 감당하기 어려운 것을 인식하게 된 가운데 국제민간항공기구(ICAO) 주도하에 국제사회 공동으로 향후 재발에 대비한 배상 체제를구축코자 ICAO 법률위원회의 수년간 작업 끝에 제3자 피해 배상에 관한 현대판 조약을 캐나다 몬트리올 외교회의에서 채택케 된 것이다. 과거 지상 제3자 피해 배상에 관한 협약과는 달리 공중 충돌로 제3자가 피해를 볼 경우도 포함시켜 '지상'이라는 표현이 협약 제목에서 삭제된 한편, 과거 협약이 항공기를 테러로 이용하여 제3자 피해가 발생할 것을 예상하지 못하였지만 금번 채택 협약은 9.11 사태와 같이 항공기를 이용한 테러공격으로 제3자 피해가 발생할 경우의 배상에 주안을 두었다. 그런 가운데 조약 제정 편의상 테러 공격에 의한 제3자 피해에 대한 배상을 위한 "불법방해배상협약"과 그렇지 않은 일반 위험 (general risks)으로 인한 제3자 피해 배상에 관한 "일반위험협약"으로 분리하여 2개의 조약을 외교회의의 컨센서스로 채택하였다. 상기 2개의 조약은 대규모 제3자 피해 발생을 염두에 두고 배상 상한을 대폭 인상하여 피해 배상을 현실화함과 동시에 신체적 피해로 인한 정신적 피해도 배상 대상에 포함시키면서 오늘날 항공운송 사고 시 승객에게 적용되는 조건을 제3자 피해자에게도 적용하는 등 조약의 내용을 현대화 시켰다. 그러나 "불법방해배상협약"은 대규모 피해에 대비한 배상금 충당을 위하여 "국제민간항공배상기금"을 창설하면서 어느 한 나라가 협약 당사국이 되느냐 마느냐에 따라서 협약이 운명이 좌우되게끔 하는 유별난 조항을 포함시켰다. 이는 미국을 염두에 둔 내용으로서 협약의 보편성을 해치는 한편, 일반적으로 국가가 배상책임을 지는 사안인 테러에 의한 피해 배상을 항공 산업에 있어서만 항공운송업자와 승객이 책임을 부담도록 하는 등의 독특한 내용들을 담고 있는 특징과 함께 협약의 장래 전망이 우려된다. 이는 국제 정치 현실상 몇 나라가 부담하는 테러 위험을 아무런 보상도 없이 여러 나라에 분산시키는 결과를 가져오는 내용이기 때문에 더욱 그러하다.

• 간호행정학회지
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• 제4권2호
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• pp.307-319
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• 1998

This study is an empirical investigation and study on the measurement of nursing service quality as perceived by patients. A series of H1. H2. H3 alternative hypotheses were tested using a sample of 250 patients in Taegu City. Korea. HI hypothese were tested for application of five component of service quality (SERVQlTAL and SE RPERF : tangiblity. reliability. responsiveness. accessibility. understandability) in Taegu area Hospitals. Validity test - the five components of service quality were rearranged into two components of service quality (personal factor. nonpersonal factor). Although SERVQUAL was verified in USA. application for five components of service quality in Korea indicated that it need more analytical studies. Nobody can deny the fact that the recent growth of the nursing service quality is one of the most important driving forces of hospital management. In many hospitals. the nursing quality charges more than 50% of the medical service quality. As a result. many hospital managers should be enormous interests in the investment potentiality of the nursing service. However. doesn't many researchers invest their time and effort on the research of the quality control in nursing service. Nursing service management is the process to satisfy customer's desires and expectations through the various service activities. Presently nursing service are being faced with three Common tasks of improving quality of nursing service. competitively differential advantage and productivity because of quantitative expansion of Nursing service. Such a phenomenon is also found in our medical service industry. resulting from increasing demands for medical service owing to national medical insurance policy and consumer's attitude change emphasizing prevention of illness. excessiveness of medical facilities in large cities and increasing medical lawsuits due to influence of consumerism. Therefore. under such circumstances. this research on nursing service is conducted from nursing managements to improve the nursing service quality problems faced by medical institutions. The results of this theoretical/empirical research are as follows: 1. Nursing service Quality is regarded as patients' perceived quality and evaluated on the basis (5 dimension) of technical and functional quality. 2. Nursing service Quality is a concept of patients evaluation on the measurable multi-dimensions intrinsic and extrinsic attributes of service. 3. Nursing service Quality is conceptually defined as the difference between the perceived service and the expected service. 4. Korean consumers trend to evaluate nursing service quality based on such dimensions as responsiveness and reliability. understandability. accessibility. tangibility. 5. After analyzing whether or not there are some differences in respective medical institution. it was found that there are significant difference on understandability. reliability. communicability. courtesy. competence. 6. After analyzing the difference between the expected nursing service and the nursing perceived service, it was found that the expected nursing service is higher than the perceived service in every medical institution. 7. HI hypothesis was tested with regard to the validity test between SERVQUAL and SERVPERF in nursing service quality. The result of validity test between SERVQUAL and SERVPERF was found to have differential result. That is the R2 of SERVPERF is higher than that of SERVQUAL. Therefore. HI was verified in nursing management. H2. H3 hypotheses were tested whether or not the nursing service quality and patient satisfaction is the preceding variable. The result of H2 hypothes is that the nursing service quality is the preceding variable of patient satisfaction and the patient satisfaction is that of revisiting intention. After analyzing whether or not there is any differences on the demographic variable of five nursing service quality factor. it was found that there are statistically significant differences on communicability and courtesy at the sex. understand ability. accessibility and tangibility at the age. understandability at the academic background respectively.

• 한국중재학회지:중재연구
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• 제20권2호
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• pp.173-198
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• 2010

The purpose of this paper is to research on the liability for the space damage and the settlement of the dispute with reference to the space activity under the international space treaty and national space law of Korea. The United Nations has adopted five treaties relating to the space activity as follows: The Outer Space Treaty of 1967, the Rescue and Return Agreement of 1968, the Liability Convention of 1972, the Registration Convention of 1974, and the Moon Treaty of 1979. All five treaties have come into force. Korea has ratified above four treaties except the Moon Treaty. Korea has enacted three national legislations relating to space development as follows: Aerospace Industry Development Promotion Act of 1987, Outer Space Development Promotion Act of 2005, Outer Space Damage Compensation Act of 2008. The Outer Space Treaty of 1967 regulates the international responsibility for national activities in outer space, the national tort liability for damage by space launching object, the national measures for dispute prevention and international consultation in the exploration and use of outer space, the joint resolution of practical questions by international inter-governmental organizations in the exploration and use of outer space. The Liability Convention of 1972 regulates the absolute liability by a launching state, the faulty liability by a launching state, the joint and several liability by a launching state, the person claiming for compensation, the claim method for compensation, the claim period of compensation, the claim for compensation and local remedy, the compensation amount for damage by a launching state, the establishment of the Claims Commission. The Outer Space Damage Compensation Act of 2008 in Korea regulates the definition of space damage, the relation of the Outer Space Damage Compensation Act and the international treaty, the non-faulty liability for damage by a launching person, the concentration of liability and recourse by a launching person, the exclusion of application of the Product Liability Act, the limit amount of the liability for damage by a launching person, the cover of the liability insurance by a launching person, the measures and assistance by the government in case of occurring the space damage, the exercise period of the claim right of compensation for damage. The Liability Convention of 1972 should be improved as follows: the problem in respect of the claimer of compensation for damage, the problem in respect of the efficiency of decision by the Claims Commission. The Outer Space Damage Compensation Act of 2008 in Korea should be improved as follows: the inclusion of indirect damage into the definition of space damage, the change of currency unit of the limit amount of liability for damage, the establishment of joint and several liability and recourse right for damage by space joint launching person, the establishment of the Space Damage Compensation Review Commission. The 1998 Final Draft Convention on the Settlement of Disputes Related to Space Activities of 1998 by ILA regulates the binding procedure and non-binding settlement procedure for the disputes in respect of space activity. The non-binding procedure regulates the negotiation or the peaceful means and compromise for dispute settlement. The binding procedure regulates the choice of a means among the following means: International Space Law Court if it will be established, International Court of Justice, and Arbitration Court. The above final Draft Convention by ILA will be a model for the innovative development in respect of the peaceful settlement of disputes with reference to space activity and will be useful for establishing the frame of practicable dispute settlement. Korea has built the space center at Oinarodo, Goheung Province in June 2009. Korea has launched the first small launch vehicle KSLV-1 at the Naro Space Center in August 2009 and June 2010. In Korea, it will be the possibility to be occurred the problems relating to the international responsibility and dispute settlement, and the liability for space damage in the course of space activity. Accordingly the Korean government and launching organization should make the legal and systematic policy to cope with such problems.

• Journal of Preventive Medicine and Public Health
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• 제11권1호
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• pp.86-97
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• 1978

The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

• 한국산학기술학회논문지
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• 제11권12호
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• pp.4863-4872
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• 2010

본 연구는 농 어촌지역 환자들을 대상으로 질병양상을 살펴보고 의료이용 실태를 분석하여 농 어촌지역 의료 관련 기관의 보건의료서비스 계획수립에 필요한 자료를 제공 하고자 시행되었다. 노령화가 진행된 농 어촌지역 G도 G군에 소재한 종합병원을 대상으로 2009년 7월부터 12월까지 6개월 동안 퇴원환자 2,365건 전수의 의무기록 자료를 토대로 분석하였다. 분석결과, 조사대상 환자의 성별은 남자 55.3%, 여자 44.7%, 연령별은 70세 이상 후기 고령자가 42%로 나타냈다. 입원유형별로는 외래경유 입원환자가 65.5%이며, 진료과목으로는 내과 49.7%, 정형외과 16.7%, 신경외과 13.8% 순이었다. 주 진단명(3단 분류)별 10대 다 빈도에서 S00-T98 18.4%, J00-J99 15.5%, I00-I99 11.5% 순이었다. 평균재원일수는 14.8일이었으며, 주 진단명을 포함한 상병개수는 평균 5.6개이었다. 주 진단명(3단 분류) 다빈도 10대에서 성별, 보험유형별, 입원경로, 연령별 분포 등이 통계적으로 유의한 차이가 있었다. 월별 주 진단명(3단 분류) 다 빈도 10대 분류 분포는 통계적 유의한 차이가 있었다. 주 진단명(3단 분류) 다 빈도 10대분류에 따른 평균재원일수와 상병개수는 통계적으로 유의한 차이가 있었다. 결론적으로, 농 어촌지역의 질병분포는 작업환경과 연중 신체적 무리가 가는 노동행위에 따른 외상성 질환 및 호흡기 질환과 노령화에 따른 각종 만성질환 등 이었다.

• 대한간호학회지
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• 제4권1호
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• pp.162-178
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• 1974

The present study is purported to provide a basic information to be utilized by nurses to care and attend effectively for patients nearing the moment of death. Therefore, the primary purpose of the study has been placed upon grasping an understanding of the trends of death in general. For this purpose: 1. By utilizing the schneidman questionnaire, the trend of death has been categorized by 6 parts and analyzed. 2. A search has been conducted to find out dying patient's needs, nurse's attitudes viewed by the patient, and nurse attitudes to dying patient. The followings are itemized results of analysis: 1. Analysis by the schneidman questionnaire. (1) In general concepts of death. the first sighting of the occurrence of death was experienced upon strangers, grandfather and great grandfather. The death is openly discussed among people of all ages and sex. Ages in which the death is mostly feared were from 12 to well over 70 yews old that are evenly distributed regardless of difference in age. (2) As to the attitudes toward death the occurrence of death to most closely associated person influenced most upon the attitude of their own termination of lives. Among the reading materials, the maximum influence was effected by the Bible. In terms of religion, the thoughts of death were Influenced by religions education in case of the believers of the western religions (36%), and by their own health and physical conditions in case of the believers in the oriental religions (35%). In case of non-believer, their attitude toward death were largely determined through their own thinking meditation (45%). People aged 20 or thereunder revealed that they wished to know the day of their own death to be occurred (58%). However, the older the less thor wanted to know. (3) As to the choosing the time of death, 57% preferred senility, and 30% preferred the time in mediately following the prime period of their lives in general. In terms of religion, 85% of the believer in the oriental religion preferred senility, and 67% in the western religion, 58% in others, Therefore. the desiring of their lives to be terminated in earlier stage, not by the natural senility. sequenced as follows : Others, western religions and oriental religions. (4) Referring to the disposal of the corpse under the assumption that it had already occurred, majority desired the burial system. There has been seen a slight tendency to consider the importance of holding funeral services for the sake of survivors. Concerning the life insurance policy, it showed that the nurse had less belief in it than the patient (5) Upon the subject of life-after-death. religion wise, 72% of western religion believers preferred to have an existence of life-after-death: Among the believers of oriental regions, 35% desired this category, 30% did not mind either way. and 35% did not desire the existence of such a life-after-death. In others, 53% did not mind whether or not such a life existed. (6) In general, serious thoughts were not being attended to the commitment of suicide. 37% emphasized that such an act should be prevented. However, 30% insisted that such commitment should not be bothered, and that society possesses no right to prevented it. More male wished to commit suicide (13%) than females (9%). 2. Nurse's attitudes toward terminal patients and patient's needs. In the instance where the patient realized that their death is imminent, most of them showed desire to discuses mainly on the problems of life. When faced a situation of this nature, it is revealed that 40% of nurses could not furnish appropriate care for them.

• Journal of Hospice and Palliative Care
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• 제5권2호
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• pp.146-154
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• 2002

배경 : 세계적으로 암의 발생률과 사망률은 증가하는 추세로, 그로 인한 의료비 상승의 문제로 국가 정책의 필요성이 대두되고 있다. 이에 저자 등은 호스피스 케어를 위해 입원한 말기 암 환자들의 의료비용 실태를 조사하고 이와 관련된 요인도 함께 살펴보아 불필요한 의료비용 부분의 효과적 감소에 도움이 되고자 하였다. 방법 : 2000년 7월 1일부터 2002년 6월 30일 사이에 경기도 고양시에 소재한 모 병원 가정의학과에 말기 암으로 입원하여 사망한 환자 259명을 대상으로 인구통계학적 자료 암의 기왕력, 임상소견, 의료비용을 조사하였다. 의료비용은 환자의 사망직전 입원 당시의 원무과 계산서를 근거로 세부 항목을 조사하였다. 인구통계학적 특성, 암의 기왕력, 임상 소견과 평균 의료비용과의 상관관계를 ANOVA로 조사하였다. 결과 : 말기 암 환자 259명중 남자가 135명(52.1%), 여자가 124명(47.9%)이었으며, 암의 종류는 위암이(58명, 22.4%) 제일 많았다. 입원 당시의 임상소견은 식욕부진이 227명(87.6%), 통증이 199명(76.8%), 오심 구토가 152명(58.7%) 순으로 높게 나타났다. 총 의료비용은 740,628,045원이었으며 환자 1인당 평균 의료비용은 $285,968{\pm}3,070,272$원이었다. 총 의료비용 중에서 주사료가 237,038,259원(32.0%)로 가장 많았고 병실료가 206,416,669원(27.9%), 검사료(임상병리 검사료와 진단 방사선료)가 103,417,747원(14.0%) 순이었다. 평균 의료비용은 주사료, 치료방사선료, 병실료 순으로 높았다. 인구통계학적 특성, 암의 기왕력, 임상소견의 항목 중 통증만 유일하게 평균 의료비용과 상관관계가 있었다(P<0.05). 결론 : 호스피스 케어를 받는 말기 암 입원 환자들에서 불필요한 마약성 진통제 등 주사 투여를 가능하면 줄이고 가정 내 호스피스를 활성화하고 과도한 검사를 줄임으로써 보다 더 효과적인 비용 절감을 도모할 수 있을 것으로 보인다.