처방전달체계에 대한 사용자 만족도에 영향을 미치는 요인

김창엽,하범만,강길원,김병익,김용익,이진석,Kim, Chang-Yup,Ha, Bum-Man,Kang, Gil-Won,Kim, Byoung-Yik,Kim, Yong-Ik,Lee, Jin-Seok 대한예방의학회 2000 예방의학회지 Vol.33 No.4

Objectives : To identify the factors affecting users' satisfaction with the Order Communicating System(OCS) and to highlight the factors important for the successful establishment of OCS. Methods : A Users Satisfaction survey was sent to 4,513 people, consisting of 1,503 doctors, 2,379 nurses, 255 pharmacists and 370 administrative workers in 16 hospitals which had introduced OCS. The response rate was 63.9%. Measurement of users' satisfaction was peformed with the instrument which was used in Doll's study. Some aspects of Doll's instrument were adjusted according to the aims of this study. The classifying sections of this survey included age, job and status classification, computer experience, OCS education, duration of daily OCS use, type of order entering, number of personnel in the Hospital Information System's department, cost of OCS, problem frequency, proportion of work managed by hand, OCS type, and Hospital establishment type. Results : There was a positive correlation between satisfaction level and managerial status throughout all job classifications. Irrespective of the importance of OCS education as a factor relating to users' satisfaction, the additional work load caused by OCS lowered users' satisfaction. Different factors affected users' satisfaction according to job and status classification. The composition of factors affecting the pharmacist and administrative worker satisfaction levels was simpler than that of the doctor and nurse levels. There were no statistically significant differences between the actual computer experience duration of daily OCS use and users' satisfaction with OCS. Conclusions : There was an understandable relationship between users' attitude to OCS and factors affecting users' satisfaction. The results of this study could be used as a basis for the successful expansion of the operation of OCS. But more detailed studies on users' satisfaction and further improvements of methodologies are required for the successful establishment of OCS.

일부 다빈도 입원 및 수술례의 진단과 치료과정에 대한 연구

김창엽,김윤,권영대,김용익,신영수,안형식,Kim, Chang-Yup,Kim, Yoon,Kwon, Young-Dae,Kim, Yong-Ik,Shin, Young-Soo,Ahn, Hyeong-Sik 대한예방의학회 1993 예방의학회지 Vol.26 No.3

The aim of this study is to analyze the variations among hospitals and hospital groups in resource use and procedures of diagnostic and therapeutic process, such as laboratory tests, radiologic examinations, tissue diagnosis, timing of surgery after admission, the time required for operation. The study was performed for five procedures including cesarean section (C/S), appendectomy, cholecystectomy, cataract extraction, and pediatric pneumonia. The 2,316 subjects were selected from medical insurance claims list, and from this list 413 cases were sampled for medical record review. The patterns of resource utilization and process of treatment were described according to hospitals and characteristics of hospital groups. The major results were as follows : 1. The numbers of laboratory and radiologic tests showed significant difference among hospitals and hospital groups. In case of hospital groups, we could find tendencies of more tests with increasing hospital bed size. 2. In general, the proportion of operative cases evaluated by tissue diagnosis postoperatively among all operations ranged from 28.3% to 100%. The proportion varied among hospital groups, of which general hospital A group(more than 15 specialty) showed the highest proportion. 3. Post-admission delay until operation and the time required for operative procedure were not invariable among hospitals and hospital groups. The duration of operation in tertiary hospitals was slightly shorter than general hospitals, with varying statistical significance. We could find that probably there were differences of quality among hospitals in some components of procedures, which suggested that the implementation of quality assurance activities would be mandatory. In this study, we simply described the patterns of resource utilization and some features of clinical process, with institution of the need for advanced studies with in-depth analyses for each component of diagnosis and treatment procedures.

상지 굴곡근피로가 주관절의 위치 감각에 미치는 영향

김창엽,김은혜,오연경,오태영,Kim, Chang-Yeop,Kim, En-Hye,Oh, Yeon-Kyeung,Oh, Tae-Young 대한물리치료과학회 2012 대한물리치료과학회지 Vol.19 No.3

Background and Purpose : This study was to analysis effects of muscle fatigue on error of elbow joint sense. Methods : A total 19 healthy student(men = 10, women = 9) who did't have any problem of musculoskeletal system in upper extremities participated this study. we divided two groups into young group(n = 10, $19.67{\pm}.5$) and old group(n = 9, $28.56{\pm}1.5$). In order to evoke muscle fatigue of elbow flexor, we used Biodex, and participations performed concentric contraction of elbow flexor 150 numbers as well as we measured error of joint sense using by Biodex. We collected data just after, 30min, 2hour, 24hour after evoked muscle fatigue, and we finanlly acquired average value of three times measured joint sense of elbow joint. And we calculated value of percentage of error of joint sense. We analyzed collected data by repeated ANOVA, ANOVA using by SPSS ver.12.0 program. Result : This study showed that there was no significantly effects between groups and within groups, we could see that there was significantly difference among duration by each group of age, and sex(p<.05). Conclusion : The error of joint position sense presented highest value just period after evoked muscle fatigue compared after 30 min, 2 hours, 24 hours, and we can't find out interaction between duration and age and sex.

의료시장 개방 논의의 문제점

김창엽,Kim, Chang-Yeop 대한예방의학회 2004 예방의학회지 Vol.37 No.1

2000년 시행될 의료정책

김창엽,Kim, Chang-Yeop 한국가톨릭의료협회 2000 한국가톨릭병원협회지 Vol.30 No.-

입원과 수술시행의 적정성 평가

김창엽,안형식,이영성,권영대,김용익,신영수,Kim, Chang-Yup,Ahn, Hyeong-Sik,Lee, Young-Seong,Kwon, Young-Dae,Kim, Yong-Ik,Shin, Young-Soo 대한예방의학회 1992 예방의학회지 Vol.25 No.4

The aim of this study was to evaluate the appropriateness of some kinds of surgery and admission, such as cesarean section (C/S), cholecystectomy, and pediatric pneumonia. For appropriateness evaluation, we ourselves developed some criteria, which were included in the category of explicit and linear criteria, with the assistance of specialists of relevant clinical field. The evaluation of appropriateness was performed by two family physicians. The major findings were as follows: 1. For cesarean section, 77.6% of deliveries were determined to be 'appropriate', but the level of appropriateness was not significantly different among hospitals and between hospital groups by size. The most freqeunt indication of C/S was repeated operation, followed by cephalopelvic disproportion (CPD). The labor trials for vaginal delivery among repeated C/S and CPD cases were performed in 24.5% of pertinent deliveries. 2. About 73.8% of cholecystectomy cases was appropriate to one of the surgical indications, without significant differences among hospitals. Of surgical indications, 'sufficiently frequent and intense symptom recurrence' was the most frequent, and 'confirmed acute cholecystitis' was the second. 3. Of children admitted due to pneumonia, only 57.4% of cases satisfied admission criteria, and the level of appropriateness of admission was different among hospitals. The common reasons fur admission were 'failure to initial treatment', 'suspected bacterial pneumonia', 'young infant', etc. We could find that there were differences of quality among hospitals in some procedures, especially in the pediatric pneumonia and labor trial before C/S, which suggested that the implementation of quality assurance activiteis would be necessary in this country. In this study, we used some simple and primitive research tools and the numbers of subjects and tracer procedures were limited. So advanced studios with plentiful subjects and more representative diseases or procedures should be tried.

1990년부터 1996년까지 국내 일부 의학연구 학술지에 발표된 암 관련 논문 초록의 분석

김창엽,이영성,강철환,유근영,강길원,하범만,강영호,Kim, Chang-Yup,Lee, Young-Sung,Kang, Chul-Whan,Yoo, Keun-Young,Kang, Gil-Won,Ha, Beom-Man,Khang, Young-Ho 대한예방의학회 2001 Journal of Preventive Medicine and Public Health Vol.34 No.3

Objective : To explore the status of cancer research in the Republic of Korea. Methods : Thirty-eight medical journals, published in Korea between 1990 and 1996, were reviewed for abstracts relating to cancer research. Of the 5,899 eligible abstracts related to cancer, 4,732 were collected and evaluated. Results : Including first author and first two co-authors, a total of 7,427 authors were identified. Those who published an average of one or more article per one year were defined as cancer researchers for this study. This group, however, accounted for a small proportion of the total (3.1%). Analysis of the selected abstracts showed that the study goals in more than half focused on pathophysiologic mechanisms. Studies that were designed to use causal relationships such as cohort studies and randomized controlled trials were rare. A greater number of analytic and experimental studies were found in abstracts published by the cancer researcher group. More advanced study designs that explored causal relationships and analytic procedures were found in abstracts published later than those abstracts published from 1990 to 1992. Conclusion : Our findings show that researchers who published more articles adopted more advanced study designs. This study provides primary data that can be used to compare the status of cancer research in future studies.

일제하 근로자의 건강상태에 관한 문헌고찰

김창엽,문옥륜,Kim, Chang-Yeop,Moon, Ok-Ryun 대한예방의학회 1991 예방의학회지 Vol.24 No.1

The history of occupational health in Korea s covered the era of the Republic of Korea after the Liberation from the Japanese colonialism. But the number of Korean workers exceeded about 2 millions at the times of liberation in 1945, so that it is expected that many occupational health problems inflicted Korean workers under the Japanese colonialism. The authors reviewed medical literatures, administrative documents, and other available data which were published under the colonial state, and collected things which had reference to the health status of Korean workers. The results were as follows : 1. Nutritional status of Korean workers was supposed to be inferior to that of general population, some students, and poor inhabitants in a remote mountain villages. 2. It was supposed that the constitution of Korean workers was near lower limit of average build of contemporary Koreans. 3. The accidents rate in mines was significantly high but decreasing year after year, and the most important cause of accidents was the fall of roof in the mine. The medical facilities and equipments for miners were supposed to be not sufficient in the mines and workshops. 4. Some occupational disease including silicosis, noise-induced hearing impairment, and decompression disease were known. But, overall incidence or prevalence of these diseases could not be identified. 5. On the whole, the fatalities of acute infectious diseases of Korean workers were higher than those of Japanese inhabitants in Korea and Korean inhabitants. The prevalence of pulmonary tuberculosis of Korean workers was increasing with every passing year. 6. The medical personnels and facilities were so deficient that most Korean workers were out of adequate medical use. We discussed only a part of the health status of Korean workers under the Japanese colonialism, so it would be necessary to have a better grasp of details of occupational health policy and health status in the era of afflicting.

북한의 동.서의 결합

김창엽,이상구,임병묵,Kim Chang-Yup,Lee Sang-Gu,Lim Byung-Mook 대한예방한의학회 2000 대한예방한의학회지 Vol.4 No.2

According to the North Korean documents , North Korean government have emphasized the development of the Koryo medicine (traditional korean medicine) and encouraged the combination of the Koryo and the modern medicine. It is regarded that this attitude arose from the ruler's will toward independency in the medical field and at the same time the lack of modern medical resources . Combinations of the Koryo medicine and the modern medicine in the clinical textbooks are classified as follows: first, mixed medication of the Koryo and the modern medicine. Second, combination of the traditional acupuncture(or moxibustion) and the medication of modern medicines. Third, injection of modern medicines at acupoints. Forth, an intramuscular or an intravenous injection of the Koryo medicine. Fifth, anesthesia using Koryo medicine. Sixth, simple surgery at the acupoints. Lastly, combination of injection and the traditional therapy(eg. acupuncture, moxibustion and cupping) Despite of many achievements in the field of combined medical treatment, recent economic failure and severe famine for several years caused collapse of the health care delivery system in North Korea, and it is hard to find combined practices actually.

과학기술은 나라의 종자이다

김창엽,Kim, Chang-Yeop 한국과학기술단체총연합회 1998 과학과 기술 Vol.31 No.9