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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.
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.
김창엽,김선민 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.2
Background : Performance evaluation of medical care providers has become more important than before in Korea. Especially in university hospitals, job contents of medical staffs are so complicated that evaluation is not easily performed. In addition, in order that the feedback of evaluation be successful, acceptance of staffs to be evaluated is essential. This study is aimed at the development of items for evaluation and weighting of each item in one university hospital, and clustering departments by different weight given by medical staffs. Methods : Through resource group meeting, performance items were listed up by categories of education, research, medical services, and other activities in and out of the hospital. For each item, all the medical staffs were asked how important they thought, compared with publishing one original article. By factor analysis, the items in each category were grouped into a few subgroups. In turn, cluster analysis was done for the purpose of grouping departments by priority the medical staffs gave. Results and Conclusion : Among five major categories, medical staffs regard education, research, and medical services more important than other activities in and out of the hospital. Five categories consisted of two or three components. Departments in hospital were grouped into three. However, characteristics of each group was not clearly delineated. This result suggests that more comprehensive tool should be developed and applied in the process of performance evaluation in university hospitals.