• Title/Summary/Keyword: practitioner

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Distributional changes in Physicians' Medical Care Expenses from the National Health Insurance and its Determinants After the Separation of Prescription and Dispensing (의약분업 전후 의원의 건강보험 진료비 분포변화 및 결정요인분석)

  • Lee Ae Kyoung;Jeong Hyun Jin
    • Health Policy and Management
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    • v.14 no.3
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    • pp.20-44
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    • 2004
  • The National Health Insurance Expenditure has been increased rapidly since the introduction of the separation of prescription and dispensing in 2000, and this trend of rapid growth in overall spendings rate has been observed predominantly among medical practitioners. This study was conducted to investigate the growth rate and distributional changes in private medical practitioners' expenses from 1999 to 2002 and its determinants using the National Health Insurance claims data. The total increasing rate of all medical practitioners' expenditure paid by the National Health Insurance between 1999 and 2002 was $41.71\%$, which exceeding that of general hospitals by $20\%$p. But the income distribution among each practitioner was improved as the changes in Gini coefficient(from 0.40 to 0.38) and decile distribution ratio(from 0.25 to 0.29) during the same period showed. However, this improvement in distributional patterns is not enough since even in 2002 it turned out that the highest $10\%$ income group earned 33times more than the lowest $10\%$ income group did. Also, higher Gini coefficient was observed in larger cities and some department like plastic surgery, obstetrics and gynecology. The major causes of this differentials in medical practitioners' expenses were factors related to medical demand like proportion of old population, residential economic status in a given area. In addition, providers' economic incentives also played an important role in determining their income distribution. The large income differentials among physicians may imply a skewed distribution of patients and thus long waiting time, inefficient utilization of resources and potential inadequate quality of care. In this sense, unreasonable distributional gaps should be reduced, so effective measures as well as ongoing monitoring would be necessary to correct current distributional problems.

Study of Focusing Characteristics of Ultrasound for Designing Acoustic Lens in Ultrasonic Moxibustion Device (뜸 자극용 초음파 치료기기의 음향렌즈 설계를 위한 초음파 집속 특성 연구)

  • Bae, Jae-Hyun;Song, Sung-Jin;Kim, Hak-Joon;Kim, Ki-Bok
    • Journal of the Korean Society for Nondestructive Testing
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    • v.35 no.2
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    • pp.134-140
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    • 2015
  • Traditional moxibustion therapy can cause severe pain and leave scarring burns at the moxibustion site as it relies on the practitioner's subjective and qualitative treatment. Recently, ultrasound therapy has received attention as an alternative to moxibustion therapy owing to its objectiveness and quantitative nature. However, in order to convert ultrasound energy into heat energy, there is a need to precisely understand the ultrasound-focusing characteristics of the acoustic lens. Therefore, in this study, an FEM simulation was performed for acoustic lenses with different geometries a concave lens and zone lens as the geometry critically influences ultrasound focusing. The acoustic pressure field, amplitude, and focal point were also calculated. Furthermore, the performance of the fabricated acoustic lens was verified by a sound pressure measurement experiment.

The Effect of a Workshop on a Urinary Incontinence Self-Management Teaching Program for Community Health Nurses

  • So, Aeyoung;De Gagne, Jennie;Park, Sunah;Kim, Young-Oak
    • Research in Community and Public Health Nursing
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    • v.26 no.3
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    • pp.260-267
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    • 2015
  • Purpose: This study aimed to examine the effectiveness of the workshop on the nurses' knowledge about urinary incontinence (UI) self-management, attitudes toward UI, and self-efficacy to plan and implement a UI self-help group program for their clients. Methods: A one-group pretest and posttest design was used to examine changes in knowledge, attitudes, and self-efficacy following a one-day training workshop. Twenty-seven community health nurses completed a questionnaire before and after the workshop. Before participating in the workshop, the participants were required to take a UI online continuing education program developed by the researchers. During the workshop, the participants took four sessions which consisted of an introduction of a self-help group program, demonstration of a 5-week UI self-management program contents, pelvic floor muscle training and biofeedback practice, and group discussions to plan the implementation in their workplaces. Results: A significant improvement in knowledge of and attitudes toward UI were found (t=3.53, p=.002; t=2.83, p=.009, respectively) after the workshop. Participants also demonstrated improvement in their self-efficacy to plan and operate a UI self-help group program (Z=-2.64, p=.008). Conclusion: The one-day workshop for community health nurses is a feasible strategy to increase their abilities and confidence in operating a UI self-help group program.

National survey of inferior alveolar nerve and lingual nerve damage after lower third molar extraction (하악 제3대구치 발치 후 발생한 하치조신경 및 설신경 손상에 관한 연구)

  • Han, Sung-Hee
    • The Journal of the Korean dental association
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    • v.47 no.4
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    • pp.211-224
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    • 2009
  • This retrospective study was to analyze the inferior alveolar nerve and lingual nerve damage after the removal of mandibular third molars. In this questionnaire study, the subjects chosen for this study were 2472 dentists who answered the questionnaire about numbness after the extraction of lower third molars. The data collected by E-mail and web site included the incidence of removal of the lower third molars, the incidence and the experience of numbness of the inferior alveolar nerve and lingual nerve, rate and duration of recovery, the influence in day life after the long-term sensory loss, the period and amount of the indemnity in the case of medical dispute. The results are summarized as follows. 1. The experience rate and the incidence rate of the inferior alveolar nerve numbness by oral surgeons in the past year were19.9% and 0.14%. Those of the lingual nerve by oral surgeon were 7.7% and 0.05%.2. The experience rate and the incidence rate of the inferior alveolar nerve numbness by the dentists except oral surgeons in the past year were 9.7% and 0.19%. Those of the lingual nerve by the dentists except oral surgeons were 5.5% and 0.11%.3. The recovery rate of the inferior alveolar nerve after 1 year and 2 years were 85.6% and 91.3%. The recovery rate of the lingual nerve after 1 year and 2 years were 84.8% and 89.3%.In conclusion, most of numbness may be recovered within 2 years. However the possibility of long term and persistent numbness should not be neglected. Therefore practitioner must inform the possibility of nerve injury and include this possibility in the consent forms.

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Management for traumatic neuropathy after dental treatment (치과 시술 후 나타난 신경손상의 관리)

  • Jeong, Sung-Hee;Lee, Sunhee;Ahn, Yong-Woo;Heo, Jun-Young;Jeon, Hye-Mi;Ok, Soo-Min
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.2
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    • pp.123-129
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    • 2016
  • Whereas a somatic pain notifies tissue damage, a neuropathic pain presents disorder of the nerve itself. The causes of neuropathic pains are trauma, infection, chronic irritation by adjacent tissue and so on. The iatrogenic trauma or infection also causes traumatic neuropathy, which may exert a bad influence on doctor-patient relationship. Some of related dental treatments are implantation (directly or indirectly through heating), root canal treatment, teeth extraction, block anesthesia, mandibular surgery. If inappropriate management is performed after nerve trauma, there will be many chances to develop chronic neuropathy for the patient. It is important that the sign of nerve trauma have to be caught by the practitioner as soon as possible and treated properly.

Current Issues and Future Considerations in Undergraduate Medical Education from the Perspective of the Korean Medical Doctor Development System (우리나라 의사양성체제의 관점에서 본 의과대학 교육의 문제점과 개선방향)

  • Han, Jae Jin
    • Korean Medical Education Review
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    • v.20 no.2
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    • pp.72-77
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    • 2018
  • Observation of the current Korean medical education and training system shows that certain negative traits of unchangeable solidification engraft themselves so deeply into the overarching system that they are now hampering the state of the national health welfare. Focusing only on undergraduate medical education, we can point out some glaring side-effects that should be of concern to any stakeholder. For instance, a graduate can legally begin his career as an independent practitioner immediately after passing the licensing exam and return to the old stuck school-year system of 2-year-premedical and 4-year-medical programs where outcome-based and integrated curricula are incomplete and unsatisfactory. In terms of learning opportunities, the balance between patient care and public health, as well as that between in-hospital highly specialized practice and community-based general practice, has worsened. Every stakeholder should be aware of these considerations in order to obtain the insight to forge a new direction. Moreover, our medical schools must prepare our students to take on the global roles of patient care within the Fourth Industrial Revolution, health advocacy for the imminent super-aged society, and education and research in the bio-health industry, by building and applying the concept of academic medicine. We will need to invest more resources, including educational specialists, into the current undergraduate medical education system in order to produce proper outcomes, smart curriculum, innovative methods of teaching and learning, and valid and reliable monitoring and evaluation. The improved quality of undergraduate medical education is the starting point for the success of the national system for public health and medical care as a whole, and therefore its urgency and significance should be emphasized to the public. The medical society should go beyond fixing what is broken and usher in a new era of cooperation and collaboration that invites other health professionals, governmental partners, law-makers, opinion leaders, and the general public in its steps toward the future.

Differencies in the Level of Knowledge on Cervical Cancer among Health Care Students, Midwives and Patients in Serbia

  • Antic, Ljiljana Gojko;Djikanovic, Bosiljka Svetozar;Antic, Dragan Zivojin;Aleksopulos, Hristos Georgios;Trajkovic, Goran Zivojin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3011-3015
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    • 2014
  • Background: Level of midwife knowledge is particularly important because of their role in the cervical cancer prevention programme. The aim of this study was to examine differences in the level of knowledge among health care students, midwives and women in the general population of Serbia. Materials and Methods: A cross-sectional approach was used with health care students of the medical shool, midwives in their practice, and women visiting a chosen general practitioner as respondents. Results: In comparison with the students and midwives, women had lower level of knowledge of causative agents of the cervical cancer, genital warts, HPV types, screening for cervical cancer as well as about the target population for vaccine and its role. Differences in the numbers of right answers of respondents were statistically significant (p<0.001). Four or more correct answers were obtained from 22.7% women, 35.3% from midwives and 83.8% from students. Conclusions: Midwives should improve their own level of knowledge related to preventive practice for cervical cancer, as well as their personal compliance with recommended practices, in order to be qualified and credible promoters of cervical cancer control among women in Serbia.

Clinical Application Status Analysis of Chuna Manual Therapy after Musculoskeletal Disorder Surgery (근골격계질환 수술후 추나 기법 임상적용 현황분석)

  • Lee, Sang-Jin;Lee, Kang-Joon;Park, Jung-Sik;Song, Yun-Kyung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.14 no.2
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    • pp.123-134
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    • 2019
  • Objectives : The purpose of this study was to analyze the clinical application status in papers related to Chuna Manual Therapy after musculoskeletal disorder surgery. Methods : We searched 6 electronic databases(RISS, DBpia, KISS, NDSL, OASIS, Pubmed) and 2 associated journals (Korea CHUNA Manual Medicine for Spine & Nerves, Korean Medicine Rehabilitation). We classified the papers by related musculoskeletal region and analyzed them in detail. Results : 1. Of the 24 papers included in the final analysis list, 13 were carried out for fascia and 18 for joints. 2. There were positive effects on the improvement of symptoms, including the relief of pain in patients, and there were no cases of severe side effects and adverse events. 3. Thus, CMT can be used as a safe and effective treatment if a skilled practitioner makes proper use of the follow-up procedure based on accurate judgment of the patient's postoperative condition. Conclusions : Through this paper, we expect that there will be active research on the clinical applications of Chuna Manual Therapy in Korean rehabilitation treatment after musculoskeletal disorder surgery.

A Study on the Countermeasure Against the Disinformation: the Possibility of Citizen Participation (허위정보(disinformation)에 대한 대응 탐색: 시민참여 가능성을 중심으로)

  • Chung, Yeonwoo
    • The Journal of the Korea Contents Association
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    • v.20 no.2
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    • pp.226-239
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    • 2020
  • The study seeks to present ways to form and express political opinions while monitoring, regulating and critically accepting the production and distribution of false information and platforms, which are spread channels, through the participation of citizens. First, it logically identified the unfairness of legal regulations on false information. In other words, it is often practically impossible to judge whether false information is false or not, and even false information can sometimes fall within the category of freedom of expression protection. It also revealed that voluntary regulation by platform operators was limited. As an alternative, it was theoretically clear whether civil society should participate in the maintenance and development of democratic public debate sites and create social discourse. The specific method is to find and classify false information and share it with citizens to raise awareness. Second, it forms an autonomous cooperative system with platform operators and others. Third, develop critical media capacity of citizens. Fourth, it responds to producers and platform operators of false information while engaging in community activities as a direct practitioner.

A Study on Analysis and Modification of OAK Metadata Elements (OAK 메타데이터 요소 분석 및 수정(안) 제안에 관한 연구)

  • Rho, Jee-Hyun;Lee, Eun-Ju;Lee, Mihwa
    • Journal of Korean Library and Information Science Society
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    • v.48 no.1
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    • pp.137-160
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    • 2017
  • OAK(Open Access Korea) is a national repository project to support free access to Korea's open access knowledge information. However various problems and limitations are recognized when organizing and sharing metadata with OAK-IR system. This study aims to suggest a modified metadata standard to improve the quality of OAK metadata. To the end, this study analyzed all metadata elements used by OAK participating organizations and compared the metadata with the metadata of other typical repository systems. In details, metadata organized in 17 OAK participating organizations were analyzed with their metadata specifications, input data examples, and practitioner interviews. And a case study on DSpace, EPrints, BEPress, ETD-db, dCollection was conducted. The final modified OAK metadata elements were suggested through group discussion and coordination by the practitioners of OAK participating organizations, OAK supervisors, and the developers of OAK-IR system.