• 의료법학
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• 제16권2호
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• pp.295-326
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• 2015

2012. 2. 1. 의료법이 개정되며 의료인은 2개 이상의 의료기관을 개설할 수 없을 뿐 아니라 운영에도 관여할 수 없게 되었다. 그러나 이러한 개정 법률의 입법목적이 무엇인지 불분명할 뿐 아니라 여러 제반사정을 기초로 입법목적을 확정하더라도 개정 법률이 그러한 목적을 달성하기에 적합한 수단이 되기 어렵다. 이 글에서는 의료법 개정 경과와 의료기관 1인 1개설주의의 연혁, 개정 의료법의 입법목적을 확정 검토하는 한편, 개정 의료법이 제한하는 기본권과 명확성의 원칙, 과잉금지원칙을 토대로 동 법률의 위헌성을 살펴보기로 한다.

• 융합정보논문지
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• 제11권4호
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• pp.203-210
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• 2021

본 연구는 의료기관의 설립운영 관리주체에 따라 운영자금 조달방법별 조달비율과 이들이 경영성과에 미치는 영향을 살펴보고자 의료기관 회계정보 공시시스템에 등록된 재무정보를 이용하여 분석하였다. 분석방법은 설립운영 관리주체별 차이비교를 위하여 분산분석을 실시하였으며, 운영자금 조달방법별 조달비율이 경영성과에 미치는 영향은 로지스틱 회귀분석과 회귀분석을 실시하였다. 연구결과, 운영자금 대비 총수익 비율은 설립운영 관리주체에 따라 유의한 차이가 있었다. 그리고 운영자금 조달방법별 조달비율은 경영결과(적자, 흑자)와 유의하게 인과관계가 있는 것으로 확인되었으며, 운영자금 조달방법 조달비율이 경영성과에 미치는 영향은 설립운영 관리주체에 따라 차이가 있었다. 이상의 결과 의료기관의 운전자금 관리는 운영자금에 대한 수익의 비율을 고려한 비용관리를 우선적으로 적용하고 그 다음으로 내부운영자금을 활용하는 방안의 적용이 적절할 것으로 사료된다.

• Journal of Preventive Medicine and Public Health
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• 제34권3호
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• pp.219-227
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• 2001

Objectives : To understand the current status of the opening, closing and relocation of primary medical institutes in Korea and identify the underlying decision factors. Methods : Sources of analyzed data included the medical institutional master file at the National Health Insurance Corporation(1998, 2000) and Regional Statistic Annual Bulletins. To investigate changes including the opening, closing and relocation, a total of primary medicalinstitutions(16,757 in 1998, 19,267 in 2000) were analysed. Results : Between 1998 and 2000, there was a 15.0%(2,510) increase in the number of primary medical institutions and the rate of increase in the rural area was higher than the urban area, and higher for specialty clinics than primary practice. However, these findings did not suggestany improvement in the maldistribution of primary medical institutions. During the time period studied, newly opened and closed primary medical institutions numbered 4,085 and 1,573, respectively. Additionally, institutions thatrelocated numbered 2,729, or 16.3% of all primary medical institutions in operation in 1998. These openings and closings were more frequent among young doctors. As a result of our analysis on the underlying regional factors forrelocation, the factors that were statistically significant were local per capita tax burden and the number of schools per ten thousand persons. !n, the case of institutional factors, movements were significantly associated with gender and the location of primary medical institutions. Conclusions : In order to establish effective long-term intervention for primary medical institutions, further study and monitoring of primary medical institutions and the identification of factors influencing opening location and relocation is necessary.

• 대한한의학회지
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• 제29권4호
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• pp.114-122
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• 2008

Objectives: To determine the factors affecting the assessment of Oriental medical institutions under the Oriental Medical Institution Assessment System and thereupon, provide for some basic data and alternative measures for assessment of Oriental medical institutions. Methods: The researcher sampled 320 people employed by 26 Oriental medical institutions designated as model Oriental medical institutions subject to assessment in 2008 and 2009 and thereupon, used a structured and open-ended survey table for them to collect the data. The size of the final sample was n=302. Results: The Oriental medical institution staff were highly aware of the Oriental medical institution assessment (OMIA), After adjusting the other factors by multiple regression, the factors affecting such recognition were different significantly depending on age (those in their 30's), types of job (nurses and treatment assistants) and locations of hospital (GyeongSang-do). The staff expected the OMIA could helpful for improving facilities and system of hospitals, thus promoting satisfaction of patients. To do so, they felt it necessary to develop an assessment scale reflecting the special conditions besetting the Oriental medical institutions as well as the indices for improvement of Oriental medical service quality. Conclusion: It is hoped that this study will be followed up by future studies which will comparatively analyze Oriental medical institution staff's perception of the assessment system before and after its operation and thereby, suggest some ideal policy alternatives for assessment of the Oriental medical institutions. Furthermore, future studies are requested to research into Oriental medical institution staff's needs and consumers' needs as well in consideration of the characteristics of the Oriental medical institutions and thereupon, suggest some alternatives for continued education, development of the assessment tools, methods and policies.

• 한국방사선학회논문지
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• 제17권4호
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• pp.565-572
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• 2023

본 연구에서는 국내 공공 부문에서 실시하고 있는 의료기관 평가 중 영상검사와 관련된 현황을 살펴보고 개선 방향을 제시하고자 하였다. 의료기관 평가 중 영상검사와 관련된 주요 평가는 의료기관 인증평가와 영상검사 적정성 평가가 있으며, 의료기관 인증평가에서는 영상검사 운영과정, 정확한 결과 제공, 안전관리 절차 준수 등을 평가하고 있다. 영상검사 적정성 평가에서는 인력, 장비와 관련된 구조 지표, 환자평가 실시율, 피폭 저감 프로그램 등이 포함되어 있었다. 하지만 좀 더 안전하고 질 높은 영상검사를 위해서는 의료기관의 인증평가 참여율을 높이는 방안 마련이 필요하며, 영상검사 적정성 평가의 인력지표 개선과 인센티브 지급에 대한 고려도 필요하다. 마지막으로 국가 차원의 방사선 노출 통합관리도 함께 병행되어야 할 것이다.

• International Journal of Quality Innovation
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• 제9권3호
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• pp.29-56
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• 2008

Since the execution of National Health Insurance system in Taiwan, the competition of medical industry is becoming more and more severe. The ways the hospital operate knowledge management (KM) concept, combine current human resources and professional knowledge by information techniques and upgrade the competitiveness through reinvention of organizational culture have become the important issues. This research is based on the relationship between KM and organizational operation, integrates the characteristic of medical institutions and framework of medical knowledge cycle and starts the research subject by questionnaires from three dimensions: current situation of KM construction in medical organizations, executive effect of KM activities and the challenges faced by KM; subsequently, from qualitative interview, this research attempts to understand how a medical organization executes and adjusts in the consideration of theory and reality as well as quality and costs when actually operates the organization. This research accesses to KM system application of medical institutions and the empirical executive benefits and difficulties through questionnaires. The research results are as follows: (1) having initial understanding toward current KM establishment of medical institutions; (2) confirming the most important items of KM establishment of medical organizations; (3) understanding the most difficulty which the medical organizations encounter when executing KM; (4) establishing medical knowledge cycle figure of the hospitals receiving interviews. Through case interview, this research profoundly accessed to the actual operation of KM application of medical organizations. The target hospitals intended to try many medical KM measures; however, during to complicated hospital organizations and cultural characteristics, the promotion was not successful and the results were not apparent. The most difficulty was to change the employees’ behavior. The targets believed that only the continuous promotion of KM can allow it to be an important aspect of organizational culture and the competitiveness could constant be upgraded.

• 의학교육논단
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• 제25권1호
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• pp.17-34
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• 2023

This study aimed to investigate the current status of faculty development (FD) programs operated by medical colleges and institutions in Korea, and to suggest future-oriented directions for FD. A survey was conducted targeting medical colleges and medical education institutions that operate FD programs. We investigated the reasons for selecting topics, program themes, program operation methods, longitudinal program status, program improvement and quality control methods, the evaluation of the program effects, the outcomes and problems of the programs, and opinions on the latest trends. Twenty-nine out of 40 medical colleges and three out of six institutions responded. Topics were selected based on an analysis of medical education trends and the educational environment in both groups. The most common program themes were assessments in medical colleges, and teaching/learning and curriculum themes in institutions. FD was perceived to induce professors' and administrators' interest in medical education and improve the quality of medical education. The most common program method was workshops. Three medical colleges and one institution had longitudinal programs. Participant surveys constituted the most common method of evaluating programs' effects. Difficulties in publicizing programs and inducing voluntary participation were the most common problems in both groups. New attempts for FD were perceived as the role of external institutions. Based on the results, it is necessary to develop a framework and quality improvement indications for FD programs in the future, and FD programs are expected to be developed through new initiatives, such as longitudinal programs and those focusing on the community of practice.

• 대한기관윤리심의기구협의회지
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• 제5권1호
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• pp.21-32
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• 2023

Purspose: The purpose of this study is to examine the meaning and definition of vulnerable subjects in clinical trials in light of domestic and international regulations and guidelines, to analyze the contents of standard operation procedures (SOPs) among advanced general hospitals in Korea that conduct clinical trials, and to examine deliberation procedures for operation plans. Methods: The study examined how vulnerable research subjects were defined and described in related regulations and the classification of vulnerable research subjects presented in the IRB/HRPP SOPs of 18 clinical trial institutions, including 11 AAHRPP-accreditated general hospitals in Korea, as well as the operation of the IRB deliberation. Results: Among all domestic and international regulations and guidelines, only the The Council for International Organization of Medical Sciences (CIOMS) guidelines explain why vulnerability is related to judgments on the severity of physical, psychological, and social harm, why individuals are vulnerable, and for what reasons. However, the classification of vulnerable subjects by institutions differed from the classification by the International Conference on Harmonization-Good Clinical Practice (ICH-GCP). A total of the 16 institutions classified children and minors as vulnerable research subjects. 14 institutions classified subjects who cannot consent freely were classified as vulnerable subjects. 15 institutions classified sujects who can be affected by the organizational hierarchy were classified as vulnerable subjects. Subjects in emergency situations were regarded as vulnerable research subjects in 8 of institutions, while people in wards, patients with incurable diseases, and the economically poor including the unemployed were categorized as vulnerable research subjects in 7, 4, and 4 of institutions, respectively. Additionally, some research subjects were not classified as vulnerable by ICH-GCP but were classified as vulnerable by domestic institutions 15 of the institutions classified pregnant women and fetuses as vulnerable, 11 classified the elderly as vulnerable, and 6 classified foreigners as vulnerable. Conclution: The regulations and institutional SOPs classify subjects differently, which may affect subject protection. There is a need to improve IRBs' classifications of vulnerable research subjects. It is also necessary to establish the standards according to the differences in deliberation processes. Further, it is recommended to maintain a consistent review of validity, assessment of risk/benefit, and a review using checklists and spokeperson. The review of IRB is to be carried out in a manner that respects human dignity by taking into account the physical, psychological, and social conditions of the subjects.

• 한국병원경영학회지
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• 제25권3호
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• pp.38-52
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• 2020

Purpose: The purpose of the study is to suggest the main functions and implications of public hospitals to effectively respond to the future epidemic crisis based on analyzing the accessibility to designated Coronavirus Disease 2019 (COVID-19) medical institutions of Seoul and examining the main features of the quarantine of Seoul municipal hospitals. Method: To analyze the response and function of Seoul municipal hospitals, we reviewed the Infectious Disease Control and Prevention ACT, 258 articles of Seoul Metropolitan Government press releases from January to the end of April, 48 articles of Seoul Metropolitan Government's daily newsletters, 2019 Health Bureau Budget report. We also referred to internal data of Seoul Children's Hospital, Seoul Seobuk Hospital, and Seoul Eunpyeong Hospital during the same period. Besides, the accessibility to medical institutions was analyzed by using the COVID-19 data which was announced daily basis. Results: The accessibility of COVID-19 patients living in the Southeastern part of Seoul to a medical institutions was 16.2km on a distance basis, and it was the lowest accessibility among four regions of Seoul since it took about 40 minutes by car. On the other hand, patients living in the Northeast part had the highest accessibility, as the access to medical institutions was 10.7km and 27 minutes by car. Also, the main functions of the municipal hospital of Seoul against COVID-19 were to shift the public hospital function to COVID-19 patients only hospitals, to perform the epidemiological investigation by medical doctors, and to support the operation of self-isolation facilities, community treatment centers and triage rooms of community health centers. Conclusion: Through the experience of COVID-19, we suggested that the functions of public hospitals will be reorganized as the reinforcement of infectious disease treatment and mental health for quarantined patients, cooperation with private hospitals, supporting for strengthening community health capacity and preparation for another epidemic.

• 한국경제지리학회지
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• 제16권2호
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• pp.198-217
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• 2013

본 연구에서는 원격진료 이용자 행태를 시공간 재구조 관점에서 살펴보았고, 원격진료의 양면적 성격, 즉 확장성과 제약성에 관해 고찰하였다. 연구 결과에 의하면, 원격진료의 도입은 직접적인 온라인 서비스의 수혜자인 환자의 행태 변화에 영향을 끼치나, 이는 원격진료 이전의 일반적 의료 행태와 확연한 차이를 보인 것은 아니다. 이와 더해, 의원급 병원의 의료진 및 원격진료 최종 서비스 제공자인 토가네현립병원의 의료진의 행태에는 거의 영향을 주지 않는 것으로 나타났다. 원격진료의 도입으로 인해 의료기관에로의 접근성 및 효용성의 향상에 도움이 된 것은 사실이나, 여전히 원격진료는 최소한 한번 이상의 직접 진료를 요구하고 있고, 인간의 생명과 직접적으로 연계됨에도 불구하고 불완전한 기술적 특성을 가지고 있으며, 원격진료 이용에 있어서의 의사-환자, 의사 사이의 합의 문제로 인해 시공간적 제약성을 내포하게 된다. 결과적으로, 당초 원격진료가 처음 고안되었을 당시 많은 이용자들에게 주었던 기대감(확장성)과 달리, 오늘날의 원격진료는 시공간을 초월한 개념이라기보다는 기술, 사회, 문화, 경제 등의 다양한 요인으로 인해 제약성을 내포한 형태로 발전하고 있다고 할 수 있다.