• The Korean Society of Law and Medicine
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• v.23 no.2
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• pp.97-118
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• 2022

The use of diagnostic radiation in medical institutions is rapidly increasing. Accordingly, the collective effective dose is on the rise every year. Therefore, it is necessary to reduce the radiation exposure of the person undergoing the radiation examination as low as reasonably achievable. And we must establish a legal system to perform the safe management of radiation for diagnosis efficiently. In this way, I went over the problems of the Act and Subordinate Statutes regarding radiation safety management for diagnosis. As a result, the main contents are as follows. First, in the 「Medical Service Act」, there is no basis for the Safety Inspection Institute of Radiation and Radiation Exposure Measuring Institutes. And there are no provisions concerning delegation of administrative disposition. Therefore, it is necessary to secure legal justification by providing the basis for the Safety Inspection Institute of Radiation along with Radiation Exposure Measuring Institutes and the basis for administrative dispositions against these institutions in the 「Medical Service Act」. Second, the 「Rules on the Installation and Operation of Special Medical Equipment 」 should be integrated with the 「Rules on the Safety Management of Radiation Generators for Diagnostics」 to unify administrative procedures such as reporting for radiation special medical equipment for diagnosis. Third, in the case of violating the diagnostic radiation safety management standards in the 「Rules on the Safety Management of Radiation Generators for Diagnostics」, it is necessary to supplement the insufficient sanctions such as administrative disposition. Fourth, regulating diagnostic radiation and therapeutic radiation used in medical institutions with the dual legal system of the 「Medical Act」 and the 「Nuclear Safety Act」 is not efficient in the safety management of diagnostic radiation. Therefore, it is necessary to uniformly regulate diagnostic radiation and all medical radiation, including therapeutic radiation and nuclear medicine, in the 「Medical Service Act」 system.

• Journal of Korean Academy of Nursing Administration
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• v.14 no.3
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• pp.332-343
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• 2008

Purpose: The purpose of this study was to investigate the nurses' perception on hospice law in hospice institutions using questionnaire and to recommend bill of hospice law. Method: The data were collected from 95 nurses who have experienced in hospice care using a self-completion questionnaire. To analyze prescriptive data, content analysis was done using an analysis scheme developed by the investigators. Results: The separate hospice law suggested was types and purpose of law, certification of patient, living will and right to attorney, staff, institutions, service, and payment. The analysis scheme consisted of 6 categories and 17 subcategories. 83 significant statements were analyzed and categorized. Hospice nurses indicated that their operation, financing, manpower, institution, patient right, drug management is needed to enact for bill. Conclusions: The results of this study on hospice law contents will contribute to build the national hospice system in Korea.

• The Journal of the Korea Contents Association
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• v.21 no.5
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• pp.525-537
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• 2021

Since the late 1990s, public nursing hospitals have been established, and as of 2018, 79 hospitals account for 5.1% of all nursing hospitals. Announcing the public Moon Jae-in dementia in the state government responsibility for the convalescent hospital with dementia to patients for specified to the hospital with severe dementia specialist care institution. A different policy options and development. In this regard, the Dementia Management Act was revised in 2018 to provide a legal basis for the operation evaluation of public nursing hospitals, and this evaluation will begin in 2020. As part of the study to conduct the operation evaluation of public nursing hospitals to be implemented from 2020, the research established a function to foster public nursing hospitals as specialized institutions for dementia patients and competent institutions for treating rehabilitation patients during the period of recovery, and developed an evaluation system to evaluate their behavior as medical services, public nature and public institutions.

• Korean Medical Education Review
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• v.21 no.2
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• pp.112-122
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• 2019

The purpose of this study was to identify the current status of the new graduate nurses' education system, to establish guidelines for the education of new graduate nurses, and to provide dates for the improvement of the education system. Eighty-nine hospitals participated in the survey from July to August 2018. The questionnaires consisted of 24 items including general characteristics, new graduate nurses' education system, operation of nursing education teams, and preceptorship programs. The average duration of education/training for new graduate nurses was 57.3 days, and 26.6%-58.5% of general hospitals, hospitals, and long-term care hospitals had less than 30 days of new graduate nurses education/training, which is shorter than the education/training period of tertiary hospitals. There were new nursing education guidelines in 88.8% of all medical institutions and 58.6% of them had nursing education teams. Most of the personnel in charge of nursing education were not dedicated to education. A total of 87.6% of the all participating medical institutions had preceptorship programs, while 23.1%-33.3% of hospitals and long-term care hospitals did not. The breakdown of preceptorship programs showed 68.4% as "preceptor and preceptee are in charge of one team, and preceptor is teaching preceptee," and 19.7% were "preceptor and preceptee are in charge of each team, and preceptor is teaching preceptee at the same time." These results show that standardization and management of new graduate nurses' education programs is necessary. For the standardization and management of new graduate nurses' education programs, joint efforts of nurses' associations and support from the government should be encouraged.

• 대한핵의학회:학술대회논문집
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• 2002.05a
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• pp.45-53
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• 2002

Positron Emission Tomography(PET) was introduced as a research tool in the 1970s and it took about 20 years before PET became an useful clinical imaging modality. In the USA, insurance coverage for PET procedures in the 1990s was the turning point, I believe, for this progress. Initially PET was used in neurology but recently more than 80% of PET procedures are in oncological applications. I firmly believe, in the 21st century, one can not manage cancer patients properly without PET and PET is very important medical imaging modality in basic and clinical sciences. PET is grouped into 2 categories : conventional(c) and gamma camera $based_{(CB)}$ PET. $_{CB}PET$ is more readily available utilizing dual-head gamma cameras and commercially available FDG to many medical centers at low cost to patients. In fact there are more $_{CB}PET$ in operation than cPET in the USA. $_{CB}PET$ is inferior to cPET in its performance but clinical studies in oncology is feasible without expensive infrastructures such as staffing, rooms and equipments. At Ajou university Hospital, CBPET was installed in late 1997 for the first time in Korea as well as in Asia and the system has been used successfully and effectively in oncological applications. Ours was the fourth PET operation in Korea and I believe this may have been instrumental for other institutions got interested in clinical PET. The fellowing is a brief description of our clinical experience of FDG CBPET in oncology.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.169-208
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• 2016

"Act on Remedies for Injuries from Medical Malpractive and Mediation of Medical Disputes)" has been enacted to solve medical dispute. In addition, mediation and arbitration procedures have started since April 8th, 2012 from the Establishment of Korea Medical Dispute Mediation and Arbitration Agency. The average initiation rate of mediation for the past three years turned out to be 43%. Hereupon, Establishment of Korea Medical Dispute Mediation and Arbitration Agency has created a solution for automatic initiation if relevant to particular conditions to improve initiation rate of mediation procedures and passed it through the Assembly plenary session in May, 2016 and promulgated on the 30th of the same month. However, even if mediation procedure initiation rate is increased, there is no guarantee for mediation establishment rate to be improved according to current law. If Establishment of Korea Medical Dispute Mediation and Arbitration Agency intends to increase aforementioned value, automatic initiation is not the only solution. Instead, it seems to be a major assignment to identify fundamental reasons for why major health care facilities have not participated in it and to restore reliability on them. In addition, among crimes specified on the Article 268 of Criminal Act in the Article $51^*$ of "Act on Remedies for Injuries from Medical Malpractive and Mediation of Medical Disputes)", revision must be made so that the clause of clue and death by occupational or gross negligence is applied. Furthremore, it is suggested to supplement previously insufficient policies with the operation so that mediation procedures created by Establishment of Korea Medical Dispute Mediation and Arbitration Agency are stably settled in the perspective of medical institutions including the establishment of new conditions for medical institutions founders or health and medical service personnel to claim the proxy payment for damage.

• Health Policy and Management
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• v.25 no.1
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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.

• Quality Improvement in Health Care
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• v.2 no.1
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• pp.118-124
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• 1995

Background: Clinical indicators are objective measures of process or outcome of patient care in quantitative terms. This study aims to review the medical records of patients who 'return to operating room during the same admission', which is one of the critical clinical outcomes, and describe the result by unplanned reoperation rate. Methods: Computerized patient registry was used for selecting subject conditions. For medical records retrieved, two nurse evaluators identified the presence of explicit reoperation planning in medical records. Results: Overall reoperation rate was 2.8% and unplanned reoperation rate 1.3%. The main category of reoperation cause was the postoperative bleeding. Duration of stay from previous operation to reoperation of the unplanned group, 12.7 days, was shorter than that of the planned(p< .05). The differences did not reach statistical significance in age, sex and length of stay. Conclusion: Results suggested that unplanned reoperation rate was lower than 'threshold' level other institutions had established. However, this result could become comparable only after management of medical records would be improved and risk adjusted.

• The Korean Journal of Emergency Medical Services
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• v.5 no.1
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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.

• The Korean Journal of Health Service Management
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• v.1 no.1
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• pp.110-124
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• 2007

Currently, we have seen sudden increase of demand for emergency medical services by reason for high-speed economic development increase of traffics, etc. in this society. Consequently the government enforced & operated emergency medical system in 1991 as a link of more positive countermeasure against it, but many problem; still remain in reality. In particular, the regional emergency medical center designated by the Ministry of Health and Welfare falls short of our expectations for its essential role by the reason of such as insufficiency in professional manpower and institutions concerned in small-scale hospital, matters with transportation system, preference of large hospital, etc. Therefore, this study was conducted grasp for the actual conditions of emergency medical system based upon literature research & the preceding studies and interview research the motive of coming hospital, satisfaction & understand to the subject of 150 persons of patients and their guardians who used regional emergency center of Pusan National University Hospital, thereby examining & analysing the cause of emergency room overcrowding by non-emergency cases, one of the problem; enumerated from preceding studies. The main result of this study is as follows. First the actual condition of non-emergency patients coming hospital for examining overcrowding of emergency medical center showed that, of the patients who used the emergency medical center, non-emergency patients accounted for 49.3%, which acted as the main cause of delaying medical care for emergency cases, cases of which medical person or first-aid man decided to come hospital accounted for 36.1 %, thereby suggesting essential need for re-education & wide public information to even the professional manpower besides patients & guardians for their using emergency medical system. Second, as the result of researching patient acknowledgement with reference to their using emergency medical center, the rate of their giving right answer is no more than 60%, which means that non-emergency cases' using as such is due to the shortage of their knowledge of the said emergency medical center, which suggests us that wider P.R for emergency medical system to common people who may be one of the patients of it at any time is still in need. Third, the result of researching for finding out a future remedy of emergency medical system showed that the users who know well of the way of using emergency medical center had relatively high satisfaction of it, ones who have lesser knowledge of it lower satisfaction and users who feel in need of emergency specialized manpower feel the necessity of public information of emergency medical information center(1339) at the same time. The finding of examining the subject of study, in conclusion, showed that the degree of the patients & their guardians' understanding of emergency medical system is lower and the medical persons concerned also had no distinct difference in their understanding of it from the common people's, which suggests us for extensive enforcement of systematic education and public information in aspect of the government via various media for the purpose of effective operation of emergency medical center.