가정위생

강명근 새가정사 1969 새가정 Vol.- No.-

가정위생

강명근 새가정사 1969 새가정 Vol.- No.-

가정위생

강명근 새가정사 1969 새가정 Vol.- No.-

Evaluation of Unpreparedness When Issuing Copies of Medical Records in Tertiary Referral Hospitals

강명근,문명모,서순원,박우성,김윤,김성수,최은미,박종,박일순 대한의료정보학회 2010 Healthcare Informatics Research Vol.16 No.2

Objectives: As a baseline study to aid in the development of proper policy, we investigated the current condition of unpreparedness of documents required when issuing copies of medical records and related factors. Methods: The study was comprised of 7,203 cases in which copies of medical records were issued from July 1st, 2007 through June 30th, 2008 to 5 tertiary referral hospitals. Data from these hospitals was collected using their established electronic databases and included study variables such as unpreparedness of the required documents as a dependent variable and putative covariates. Results: The rate of unpreparedness of required documents was 14.9%. Multiple logistic regression analysis revealed the following factors as being related to the high rate of unpreparedness: patient age (older patients had a higher rate), issuance channels (on admission > via out-patient clinic), type of applicant (others such as family members > for oneself > insurers), type of original medical record (utilization records on admission > other records), issuance purpose (for providing insurer > medical use), residential area of applicant (Seoul > Honam province and Jeju), and number of copied documents (more documents gave a lower rate). The rate of unpreparedness differed significantly among the hospitals; suggesting that they may have followed their own conventional protocols rather than legal procedures in some cases. Conclusions: The study results showed that the level of compliance to the required legal procedure was high, but that problems occurred in assuring the safety of the medical information. A proper legislative approach is therefore required to balance the security of and access to medical information.

생물무기 공격위협에 대한 각국의 대비 및 대응현황

강명근 서울大學校 保健大學院 2001 보건학논집 Vol.38 No.1

The recent terrorist attack against civilians of the United States with mails enveloped Anthrax spore in 2001 might be a turning point of response on attacks with biological weapons in that most of all countries would be forced to build an adequate national readiness system prepare for domestic bioterrorism including preparedness and response programs. The purpose of this article was to review the present conditions of preparedness and response against threats of attack on civilian with biological weapons across the world. Many of experts related to the bioweapons have asserted that to build a preparedness and response system for bioterrorism had to be based on the assessment on the real threat. With which each country was faced. Then, the learning form both the international and the national experiences of response against threats of attack with bioweapons were useful to the countries preparing for a readiness and response plan. Regarding the international efforts banning the development, production and stockpiling of biological weapons, Biological and Toxin Weapons Convention was opened for signature in 1972 and entered into force three years later. Concerns about the continuing threat of biological warfare became raised by revelations during the early 1990s about biowepons programs in the former Soviet Union and Iraq. In 2001, World Health Organization was preparing the revision of Health Aspect of Biological and Chemical Weapons' published in 1970. The revised version include a standard model for national readiness plan encompassing preparedness and response programs. which would guide many countries to build an effective readiness system. And it seems to be necessary to expand SWAT across the world such as Task Force scorpio, an equipped and trained team of specialists that could have been dispatched by ambulance jet at short notice to an afflicted area. Regarding national level prepareness and response, the United States was said to have had more stringent system than those of any other countries since late 1990s when it started preparing readiness system for domestic boiterrorism because of the increase level of threats. Among the output of its efforts against bioterrorism, the approach and the 13 modular components of BW-IRP(Biological Warfare Improved Response Program) developed by U.S. Army Soldier and Biological Chemical Command may be the most valuable one to the other countries preparing readiness plan, in that it may make possible to efficient system building relevant to the threats with which they were faced. In Korea, the principal frame for the readiness system against attack with bioweapons has set in National System for Disaster Control, following Basic Civilian Defence Act and Disaster Control Act, which did not reflect all the specific aspects necessary for the readiness system. Especially, the lack of the communication network, very low level of awareness of the first responders including medical personnels such as primary physicians, emergency medical personnels were major defects of Korean readiness system against bioweapons. Now, what should be start to compensate them is stagnant and continuing efforts for building a flexible and efficient readiness system based on the assessment of real threats and the cooperation of resources of government, military forces and civilian field. For the effort, it might be of worth to learn form the experiences, and first of all it should be remembered that our peace free from bioweapons would come from not harm to others.

가정위생

강명근 새가정사 1969 새가정 Vol.- No.-

의료기관 학습조직 운영효과에 관한 연구

강명근,남종해,조우현,이선희,권순창,문기태 한국병원경영학회 2004 병원경영학회지 Vol.9 No.2

고객만족도 조사도구의 차원별 가중치 부여방법 비교

강명근,조우현,이선희,최귀선,문기태 한국의료QA학회 2000 한국의료질향상학회지 Vol.7 No.2

Background : The measuring instruments for customer satisfaction in hospitals are often composed of some dimensions reflecting the conceptive complexity of' them. Then, overall satisfaction would be expected to be equal the 'weighted' sum of scores by dimensions because the importance rated by customers may bedifferent across the dimensions. But the issue of how to weight the dimensions with importance is not yet solved. We examined 3 sets of weighting methods as to make effect on predictive power against overall satisfaction. Methods : We conducted a survey included 483 subjects who had visited or admitted to a university hospital, using the short form questionnaire being developed by The Korean Society of Quality Assurance in Health Care for out-patient and in-patient. By using a multiple linear regression model, we compared among changes of explanatory powers against overall satisfaction as dependent variable after weighting 4 dimensions of the survey questionnaire as independent variables with importance scores of dimensions perceived by consumers. And we compared the feasibility of each weighting, methods by checking missing cases. Results : There were no weighting methods increasing the explanatory power after applying them. The method of absolute scoring was found higher explanatory-power than others, but this finding had no statistical significance. Regarding the number of missing value, method of absolutely scoring had the least cases. Conclusion : Our findings suggested that weighting the dimensions with importance might have little significance in the cases of scales having items highly correlated, such as consumers' satisfaction. Though asking with items to be answered absolutely, customers might be rating relatively in some degree and this method produced least missing cases. Considering these points, in the cases when weighting the dimensions with importance would be required, we suggest that weighting method by absolute scoring might be better than others.

Association between Job Stress on Heart Rate Variability and Metabolic Syndrome in Shipyard Male Workers

강명근,고상백,차봉석,박종구,우종민,장세진 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.5

환자와 의사의 의료에 대한 태도 차이 -한 중소도시의 대학병원과 한의과대학 부속 한방병원을 중심으로-

강명근,박종구,김한중,손명세,김달래,Kang, Myung-Guen,Park, Jong-Ku,Kim, Han-Joong,Sohn, Myong-Sei,Kim, Dal-Rae 대한예방의학회 1998 예방의학회지 Vol.31 No.3

The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilzers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's $\alpha$ coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care-preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a univisity hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demanad side such as the developement and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be neccessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.