• 대한간호학회지
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• 제26권2호
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• pp.399-412
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• 1996

Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current nursing productivity of nurses is not desirable unless the quality of care considered. Moreover. nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. As for the nurse scheduling, the critical problem of it in the hospital is determining the day-to-day shift assignments for each nurse for the specified period in a way that satisfies the given requirements of the hospital. Nurse scheduling, however, involves many factors and requirements, manual scheduling requires much time and effort to produce an adequate schedule. Under these backgrounds, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. This study was performed to develop a system computerizing nurse staffing and scheduling based on the patient classification. As a preliminary step for the system development, nursing workload in a secondary hospital was measured from Sep. to Oct. 1994. On the grounds of this result, computerization of nurse staffing and scheduling was proceeded with three options. First one is based on the current medical law. Second one is based on the assigned number of nursing staff. And the last is based on the request by patient classification. Computer languages used in this study were MS Visual Basic 3.0 for the staffing and Access 2.0 for the scheduling, respectively. Prospective users may operate this system easily because icons and mouse are used for easier graphic user interface and reducing the need for typing efforts. This system can help nurse administrators manage nursing manpower efficiently and nurses develop quick and easy schedule generation and allow more time for the patient care.

• 문화기술의 융합
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• 제2권2호
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• pp.45-49
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• 2016

해외 의료서비스 시장의 메가 트렌드는 글로벌 융합, 인접 분야와의 융합, ICT기술의 적극적 도입, 공공과 민간의 파트너십(Public Private Partnership)을 통한 혁신 4가지로 요약될 수 있다. 의료서비스는 더 이상 local industry가 아니며, Global Convergence 되어가고 있다. 선진국의 경우 소득 수준의 증가, 새로운 의학기술의 발전, 전문화된 의료서비스의 증가, 인구 고령화 등 의료 수요가 증가하면서 외국 의료진의 이주 증가하고 있으며, 지리적 근접성이나 비용에 상관없이 최고 의료기술에 대한 선택 증가하고 있다. 고품질이면서 상대적으로 가격이 낮은 외국 의료서비스에 대한 수요 증가하며 특히 미국 JCI등 국제적 병원인증 기준의 확산되고 있다. 병원 수출은 관련 기술을 더욱 더 효율적으로 융합해서 수출 할 수 있는 'ICT 융합병원' 수출 산업화의 길을 열었다고 평가되고 있다. 현재 국내의 병원은 이미 포화상태에 이르렀고, 국내병원들의 세계화가 필요한 시점임. 따라서 국가별로 전략을 달리하고, 기술 이전뿐만 아니라 건물마련, 의료장비 구매, 현지 의료인력(의사 및 간호사) 선발 및 교육훈련, 홍보마케팅 등 토탈 수출도 가능하다. 이에 공공성 유지와 해외 진출을 위해 현행 의료법이 전향적으로 개정될 필요가 있으며, 해외 의료서비스의 국내법 적용에 보다 신축성 있는 법적용과 더 나아가 적극적 정책지원이 필요하다.

• 의료법학
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• 제11권2호
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• pp.181-208
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• 2010

Maternity services is often perceived as a troublesome business and obstetric litigation is on the increase in Western countries. Overall, the number of claim and cost of litigation to the NHS Litigation Authority (NHSLA) from maternity services in the UK is increasing every year. Maternity services account for 60-70% of the total sum paid. This has widespread implications for both the individual practitioners and the institutions where they work, due to increasing malpractice insurance premiums. Fear of litigation is also attracting fewer medical graduates into the specialty, leading to a recruitment crisis in obstetrics and gynaecology. The litigation process can cause pain, suffering and distress to clinicians as well as to the patients and their families. Litigation in maternity services is the result of a complex of events when malpractice (presumed or real) impacts on the attitude of pregnant women and their environment. In such complexity, information is mandatory but may often be misinterpreted. If messages are not tailored to the receiver's capacity, communicating well with the pregnant patient becomes crucial. Therefore, to reduce medicallegal issues in obstetrics, increasing attention and an applicable standard of obstetric care to avoid negligence and medical errors should go along with other measures. Considering UK's experiences, NHS redress scheme make it easier to pursue small claims and birth related claims, without necessarily reducing the number of claims processed through the conventional legal system and perhaps encouraging even more of them. The task of dealing with the greater number of inquiries into their practice would inevitably create an added burden for clinicians and hospital managers. Thus further proposals are required to limit the cost of processing inflated claims and to consider whether clinicians should be given some protection from litigation alleging a failure to prevent birth related impairment.

• 의료법학
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• 제22권2호
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• pp.81-109
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• 2021

본 논문에서는 민법전에 의료계약에 관한 규정을 신설하기 위한 논의의 과정에서 의료관련 법률의 진료거부금지 규정과 의료계약에서 계약자유의 원칙의 관계를 검토하였다. 그 내용은 다음과 같다. 의료법의 진료거부금지 규정이 의료계약 체약의 자유를 제한하는 것은 아니다. 환자의 요청에 따른 진료개시와 진료개시 후 의학적 판단에 기초한 의료내용의 결정과 진료비에 대한 협의 하에 체결되는 의료계약의 성립은 구별된다. 반면 진료거부금지 규정으로 의료계약 해지의 자유는 제한된다. 의료계약은 전문가인 의료인과 자신의 생명·신체에 대한 처분을 전문가에게 맡긴 환자의 신뢰에 기초한 것이기 때문에 신뢰가 깨지면 계약을 해지할 수 있을 것이다. 그러나 계약의 해지로 환자의 생명·신체에 불이익을 주어서는 안 되기 때문에, 의료계약의 해지에는 일정한 제한을 두어야 할 것이다. 의료계약의 체약을 강제하고 정당한 사유가 있는 때에만 계약을 해지할 수 있도록 하는 것이 현재 의료법의 태도이다. 민법전의 의료계약에 관한 규정에서는 의료계약 해지의 자유를 인정하되, 일정한 경우에 계약의 해지를 제한하는 방향을 제시하였다. 계약의 해지를 위한 정당한 사유가 인정되고, 환자가 다른 의료인으로부터 진료를 받을 수 없는 등 불리한 시기가 아닌 경우에 계약의 해지를 인정한다. 의료법의 진료거부금지의무 위반에 대한 처벌규정을 삭제하고, 계약법의 문제로 옮겨와야 할 것이다. 진료를 거부한 행위 자체에 대해서는 국민건강보험법의 요양급여거절의무에 따른 행정제재로 규율하여야 할 것이다.

• 한국의사학회지
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• 제26권2호
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• pp.175-185
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• 2013

Purpose : The current Medical Law and the Pharmaceutical Affairs Act, which are incapable of utilizing the research results and the advanced academic, clinical, and pharmaceutical system of the present-day Korean (Oriental) medicine, have limitations and create a paradox by provoking social conflict among the professionals in the field. The aim of this study was to find out the legal and systematic problems that contributed to a complicated conflict amongst Korean (Oriental) medicine doctors, doctors, pharmacists, and Korean (Oriental) pharmacists regarding the classification of their functions. Methods : We reviewed the history and characteristics of the legislation regarding the duties of Korean (Oriental) medicine doctors and Korean (Oriental) pharmacists as well as the relevant and important public health policies since the enactment of the National Medical Services Law in 1951. We focused on the laws and regulations that are made in the process of the separating functions of physicians and pharmacists and the dispute between the Korean (Oriental) medicine doctors and the Korean (Oriental) pharmacists in the 1990s and 2000s. Results : The legislations and amendments of the medical and pharmaceutical laws and regulations that reflect the modern academic, clinical, and pharmaceutical system of the Korean (Oriental) medicine and the research results could be summarized as follows: 1) A partial amendment of the Medical Law in 1987, which added the provision of "Oriental health guidance" as one of the duties of Korean (Oriental) medicine doctors, assured a place for Korean (Oriental) medicine doctors in the field of public health. 2) A partial revision of Pharmaceutical Affairs Act in 1994 established a new system for Korean (Oriental) pharmacists, bringing about the creation of dualistic pharmaceutical system that complements the dualistic medical system. 3) The Promotion of the Research and Development of Wonder Drugs by Using Natural Substances Act was legislated in 2000 in order to stimulate research and development of Korean (Oriental) medicine and its industrialization. 4) Oriental Medicine Promotion Act in 2003 was enacted to lay foundation to specify and promote technology and industry that are related to Korean (Oriental) medicine. Discussions and conclusions : Although the dualistic medical and pharmaceutical system is set up by the Medical Law and Pharmaceutical Affairs Act, it is shown that the relevant regulations have been developed from a perspective of the western medicine.

• 보건행정학회지
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• 제28권3호
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• pp.217-221
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• 2018

Korea Institute for Family Planning (KIFP) was established on July 1, 1971 (Law 2270) and Korea Health Development Institute (KHDI) was established on April 19, 1976 (Law 2857). Korea Institute for Population and Health (KIPH) was formed through the merger of KIFP and KHDI (Act 3417) on July 1, 1981. Korea Institute for Health and Social Affairs (KIHASA), the former KIPH, was renamed KIHASA on December 30, 1989 (Law 4181) with its additional function of research in social security. It was transferred on January 29, 1999 to the Office of State Affairs Coordination pursuant to the Law on the Establishment, Operation and Promotion of State-Sponsored Organizations (Law 5733). Annually it conducts approximately 50 short- and long-term research projects to accumulate a wide range of research experience. Also it studies and evaluates the primary issues of national health services, health and medical industries, social insurance, social security, family welfare, and population. it conducts joint research projects and active information exchange programs with related domestic and international organizations through seminars and conferences. It executes specific research and development projects according to the government's requests. it educates and trains people domestically and abroad by disseminating a wide-range of information on health and social affairs. it conducts national household surveys on areas of fertility, health and medical care of the disabled, the elderly, and low-income earners. The mid- and long-term research goals of KIHASA should be established and managed systematically. A new organization such as 'Center for Policy Evaluation' is needed to enhance research abilities and experiences. Able research personnels should be recruited and current researchers should try to develop their abilities.

• 의료법학
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• 제9권1호
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• pp.385-411
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• 2008

The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

• 보건행정학회지
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• 제27권4호
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• pp.347-358
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• 2017

Background: The recent revision of South Korea's Mental Health Law emphasizes the role of the Mental Health Review Board. For this study, we examined the current status of continuing hospitalization judgement in Mental Health Review Board at the national level and aimed to determine the directions of improvement. Methods: Using a qualitative case study as the research method, we interviewed 30 Mental Health Review Board members and analyzed the results. Results: Each municipality had very different continuing hospitalization judgement methods. In our systematic review, which consisted of document inspection, we identified reliability problems due to limitations in Mental Health Review Board's operating systems, discharge orders, etc. Additionally, continuing hospitalization judgement needs to improve the objectivity, fairness, and effectiveness of their screening examinations. Conclusion: Based on the results of this study, we suggest policy proposals to improve these systems, such as standardizing examination processes, strengthening on-site inspections, increasing the independence and neutrality of judgment in Mental Health Review Board, building community mental health infrastructures, and establishing integrated management systems.

• 한국사회복지학
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• 제61권1호
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• pp.263-291
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• 2009

성폭력피해자를 위한 의료지원에 대한 전문가 의견조사로서, 의료서비스 제공 주체인 의사의 성폭력 피해자 및 진료에 대한 태도, 의료서비스 제공실태 및 필요한 의료지원에 대한 의견을 조사하였다. 남녀의사 83명으로부터 수집된 설문조사 자료를 토대로, 피해자 치료경험여부와 해당 진료과여부에 따라 의사유형을 분류하여 비교하였다. 치료경험이 있는 의사(type1)는 성폭력피해자 치료비 보장과 정액반응검사, 다양한 법정증언지원에 대한 필요도가 높았다. 치료경험이 없지만 해당 진료과인 의사(type2)는 피해여성에 대한 부정적 견해, 진료에 따르는 현실적 어려움을 예상하는 정도가 높았다. 특화의료지원 및 사정지원방안에 대한 필요도는 낮은 반면, 법정증언 지원방안에 대한 필요도는 높게 나타났다. 치료경험이 없고 해당진료과가 아닌 의사(type3)는 피해여성에 대한 이해도가 높았고 성폭력관련 법지식과 관련기관에 대한 인지도도 높았다. 반면, 진료시 예상하는 어려움의 정도가 가장 높았으며, 피해여성 진료에 필요한 의료지원방안, 사정지원방안, 법정지원방안에 대한 필요도가 대체로 높게 나타났다. 연구결과를 토대로 의사유형별 차이점에 따라 성폭력피해자 진료가능성을 증진시킬 수 있는 방안과 성폭력피해자를 위한 의료지원방안이 제시되었다.

• 대한방사선기술학회지:방사선기술과학
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• 제44권5호
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• pp.545-554
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• 2021

According to the changes of the medical environment of the times, it is necessary to discuss the issues of the doctor's medical guidance and to conduct continuous research so that alternatives can be prepared systematically. Furthermore, in order to enhance the professionalism of radiological technologists and to develop the medical technician system, the new Radiological Technologist Independent Act has been established, which contains the overall contents of the scope of work, professional qualifications, and specialized education of radiological technologists, and provides quality medical services to patients through professional procedures and treatment. In order to increase the level of medical care, the purpose, definition, mission, role, and scope of work specified in the Medical Act, Medical Service Technologists, etc. Act, the Enforcement Decree, and the Enforcement Rules were variously analyzed and new directions were presented. First, the definition of a medical technician should use a generic term so that the factors of conflict and prejudice could be resolved. Second, change the doctor's guide to doctor's prescription; and then legislate the authority to sign and write medical records after examination by radiological technologists, thereby prohibiting unlicensed technicians that seriously endanger patient safety. Third, an accurate definition of radiological technologists' roles should be established; not only selection and management of radiological technologists' work but also procedures and treatment for each radiology field should be specified to suit the current medical system. Fourth, a professional radiological technologists' qualification system and a specialized education system should be established in order to secure human resources that could provide patients trust in procedures and treatment based on professional knowledge and experience in the field of radiology. Fifth, the Education and Evaluation Institute should be operated in Korea education system to educate the professional knowledge and competency for students. In addition, it is necessary to in-depth analysis of foreign cases could be applied to the medical system and education system in Korea; it could strive to nurture systematic human resources.