의료기관의 공익성과 경영성과의 관계: 체계적 문헌 고찰

서슬기,조경준,최재영 한국경제연구학회 2022 한국경제연구 Vol.40 No.2

This is the first study to systematically review literature on the association between hospitals‘ publicness and management performance in Republic of Korea. Based on systematic review of 11 publications included in this study, we found, contrary to widely known perception, no consistent evidence of hospitals’ publicness with management performance. Based on our review, we suggest the following. First, more research using the valid and robust methodological approach are needed. Second, more research on various types of hospitals are needed. 본 연구는 국내 의료기관의 공익성과 경영성과의 관계를 다룬 기존 문헌들을 체계적으로 검토한 첫 연구다. 총 11편 연구를 분석한 결과, 대부분 연구가 공공기관을 분석대상으로 한 단면연구였으며, 의료기관의 경영성과와 공익성이 대립되는 가치라는 일반적 인식과 달리, 대부분의 분석에서 유의미하지 않은 결과가 보고되었다. 선행연구 고찰에 근거하여 본 연구는 다음과 같은 내용을 제언한다. 첫째, 타당성이 확보된 방법론을 사용한 더 많은 연구가 필요하다. 둘째, 다양한 의료기관을 대상으로 한 연구들이 수행되어야 한다.

작업치료 프로그램이 만성 조현병 환자의 정신건강에 미치는 효과 : 사례연구

서슬기,강대혁,박소연 한국정신보건작업치료학회 2012 한국정신보건작업치료학회지 Vol.2 No.1

목적 : 본 연구의 목적은 정신과에 입원한 조현병 환자를 대상으로 다양한 작업치료 프로그램을 적용한 사례를 통하여, 작업치료가 조현병 환자의 정신건강에 미치는 긍정적인 효과를 알아보는 것이다. 연구방법 : 경상도 소재의 병원에 조현병으로 입원중인 30세 여성 1명을 대상으로 직업재활, 수공예 등 다양한 작업치료 프로그램을 실시하기 전과 후에 단독 면담을 통하여 양성 및 음성 증후군 척도(PANSS)와 한국어판 정신분열병의 캘거리 우울증 척도(K-CDSS)로 평가를 시행하였다. 결과 : 다양한 작업치료 프로그램을 적용한 결과, 양성 및 음성 증후군 척도의 일반정신병리 영역에서 25점에서 16점으로 변화를 보였고, 한국어판 정신분열병의 캘거리 우울증 척도의 절망과 자기비하 항목에서 각각 2점과 1점에서 0점으로 감소되었다. 결론 : 다양한 작업치료 프로그램 참여는 조현병 환자의 증상과 우울감에서 긍정적인 변화를 나타내었다. 입원중인 다양한 환자 개개인에게 흥미와 특성에 맞는 작업치료 프로그램을 적용할 수 있도록 다양한 연구들이 지속되어야 할 것이다. Objective : The aim of this research is to identify the effectiveness of occupational therapy for a person with schizophrenia, who participated in various occupational therapy programs. Methods : The study was conducted with a 30-year-old woman diagnosed with schizophrenia a national hospital in Gyeonsang-province. The patient participated various occupational therapy programs such as occupational rehabilitation, handcraft, etc. The Positive and Negative Syndrome Scale(PANSS) and the Korean version of the Calgary Depression Scale for Schizophrenia(K-CDSS) were used in pre and post tests through a personal interview. Results : Both the PANSS and the K-CDSS scores were changed between pre and post tests. The general psychology scale of the PANSS decreased from 25 to 16. The level of frustration decreased from score 2 to 0, and the level of self depreciation decreased from score 2 to 1 in the K-CDSS. Conclusions : Various occupational therapy programs appear to have positive effects on patient’s schizophrenic symptoms and depression. Further studies are suggested to verify the effectiveness of occupational therapy programs by developing various individualized and client-centered occupational therapy programs in the future.

중소병원의 환자경험 결정요인

서슬기,최재영 한국경제연구학회 2023 한국경제연구 Vol.41 No.2

중소병원의 환자경험 결정요인은 알려진 바가 거의 없다. 본 연구는 2021년 환자경험 평가 결과를 이용하여 중소병원의 환자경험을 결정하는 요인을 규명하고자 하였다. 공공병원 여부, 상급병실 비율, 간호간병통합서비스 병상 비율, 임상의 질, 시장경쟁 수준, 고가 의료장비의 보유가 중소병원의 환자경험 평가 결과의 결정요인인 것으로 나타났다. 본 연구는 환자경험 평가 결과를 개선하고자 하는 중소병원 관리자들, 그리고 환자경험 평가의 보완을 꾀하고자 하는 보건의료정책 입안자들을 위한 실무적·정책적 함의를 제공하였다.

Dynavision을 이용한 시지각 훈련이 ADHD 성향 대학생의 집중력과 시지각 향상에 미치는 효과

서슬기,김진경 대한아동·학교작업치료학회 2019 대한아동 ․학교작업치료학회지 Vol.8 No.1

목적 : 본 연구는 ADHD 성향의 대학생(이하, ADHD 성인) 3명을 대상으로 Dynavision을 이용하여 시지각과 집중력을 향상시키고자 하였다. 연구방법 : 이 연구는 A-B 개별실험연구를 통해 이루어졌다. 독립변인으로 Dynavision의 visual tracking, self-paced, apparatus-paced, digital flash 프로그램이 사용되었다. 중재는 적응기간(2회기)과 훈련기간으로 구성하였는데, 대상자 A의 훈련기간은 10회기, B와 C는 각각 7회기였다. 종속변인으로 중재 후의 시지각(MVPT-3, TVMS)과 집중력(스트룹, 100칸 계산문제)을 측정하였다. MVPT-3와 TVMS, 스트룹 검사는 중재 전과 후에 측정하였고, 100칸 계산문제는 매회기 측정하였다. 결과 : 중재 전, 후 대상자 모두 MVPT-3, TVMS 점수가 향상되었고 스트룹 검사의 수행 시간은 감소되었다. 또한, 회기 가 진행될수록 100칸 계산문제의 풀이속도가 증가하였고 오답수는 감소되었다. 결론 : 본 연구결과를 통해 ADHD 성인의 시지각과 집중력 향상에 Dynavision 훈련이 효과적임을 확인할 수 있었다. 향후에는 ADHD 아동이나 치매 노인을 대상으로 Dynavision을 인지에 적용한 연구들이 많이 이루어지길 기대해 본다. Objective : The purpose of this study was to enhance visual perception and concentration using Dynavision program in adults with ADHD. Methods : This study was used A-B single subject design. The independent variable was a Dynavision training program(visual tracking, self-paced, apparatus-paced, digital flash). Intervention was consisted of two adapted and training sessions. Subject A was trained ten sessions. Subjects B and C were trained each seven sessions. Dependent variables were visual perception(MVPT-3, TVMS) and concentration (Stroop test, 100 cell calculation problems). MVPT-3, TVMS, and Stroop test were conducted before and after the intervention and 100 cell calculation problems were measured every session. Results : The MVPT-3 and TVMS scores were improved and the reaction time of Stroop test was decreased after intervention. In addition, as the sessions progressed, the speed of solving the 100 cell calculation problems was increased and the number of wrong answers was decreased. Conclusion : The results revealed that Dynavision training program was effective for the enhancement of ADHD adults’ visual perception and concentration. Based on the result, provision of more extended research will be conduced in ADHD children or dementia elderly.

병원의 전문화 수준에 따른 재원일수, 진료비 차이에 대한 연구 : 대장항문질환, 관절질환, 뇌혈관질환을 중심으로

서슬기,최재영 경희대학교 경영연구원 2019 의료경영학연구 Vol.13 No.1

This study investigated the relationship of hospital specialization with length of stay and inpatient medical charge using claims data of the Health Insurance and Review Assessment National Inpatient Sample from 2016 (HIRA-NIS-2016) for colon-rectal, joint, and cerebrovascular conditions. To this end, we employed multivariate hierarchical linear models using two-tier data from 78,693 patients discharged with colon and rectal conditions from 653 hospitals, from 16,409 patients discharged with joints conditions from 316 hospitals, 13,236 patients discharged with cerebrovascular conditions from 246 hospitals. Multivariate results indicate that patients who were discharged with colon-rectal and joint conditions from specialized hospitals stayed shorter and paid more inpatient charge than those who were discharged from less specialized hospitals, after controlling for patient demographic and clinical factors and hospitals’structural, operational and ecological factors. We also found that patients who were discharged with cerebrovascular conditions from specialized hospitals stayed longer and paid more inpatient charge than those who were discharged from less specialized hospitals. This finding suggests that one size does not fit all when it comes to the hospital specialization. We discussed several managerial and health policy implications below.

한려해상국립공원 거제지구 팔색조 서식 현황

서슬기,홍길표,오구라타케시,송재영 한국환경생태학회 2019 한국환경생태학회 학술대회지 Vol.2019 No.1

중소병원의 전문화 전략과 운영성과의 관계에 대한 실증연구: 포괄수가제 대상 소화기계 질환을 중심으로

서슬기,최재영 경희대학교 경영연구원 2020 의료경영학연구 Vol.14 No.2

The aim of this study is to explore the associations between small and midsize hospital specialization and length of stay and inpatient medical charge using claims data of the Health Insurance and Review Assessment National Inpatient Sample from 2018 for anal surgery, hernia surgery, and appendectomy. To this end, we used multivariate hierarchical linear models(a.k.a., multi-level models) using two-tier data from 4,970 patients discharged after anal surgery from 91 hospitals, from 378 patients discharged after hernia surgery from 73 hospitals, 856 patients discharged after appendectomy from 91 hospitals. We found that patients who were discharged after anal surgery or hernia surgery from specialized small and midsize hospitals stayed shorter and paid more inpatient charge than those who were discharged from less specialized hospitals, after controlling for patient demographic and clinical factors and hospitals’structural, operational and contextual factors. Furthermore post-hoc analysis revealed that patients discharged after complex appendectomy from more specialized hospitals stayed shorter and paid more inpatient charge than those who discharged from less specialized hospitals. We discussed managerial and health policy implications below.

의료기관 특성별 코로나19 전후 경영성과 변화

서슬기,심재선 한국공공관리학회 2024 한국공공관리학보 Vol.38 No.1

This study confirmed whether there were changes in hospital management performance due to the COVID-19 infectious disease pandemic. Paired T-test and Two-way ANOVA were conducted to determine whether changes in management performance differed depending on hospital characteristics. As a result of the analysis, the smaller the size and the type of establishment was a public hospital, the greater the financial damage. Regionally, the financial damage to public hospitals in the metropolitan area was more severe. As a result, it was found that there was a significant difference in business performance before and after COVID-19 depending on hospital characteristics. In addition, through hierarchical regression analysis, it was found that the factors influencing the degree of increase or decrease in profitability before and after COVID-19 were the type of establishment and the ratio of labor costs, material costs, and management costs. Therefore, in order to prevent some hospitals from facing a management crisis, it was suggested that policies such as appropriate compensation and support systems and public-private cooperation infectious disease response systems are needed

β-arrestin2 Affects Cardiac Progenitor Cell Survival through Cell Mobility and Tube Formation in Severe Hypoxia

서슬기,김나리,이주희,김상민,이상엽,배장환,황경국,김동운,Walter J. Koch,조명찬 대한심장학회 2018 Korean Circulation Journal Vol.48 No.4

Background and Objectives β-arrestin2 (β-arr2) basically regulates multiple signaling pathways in mammalian cells by desensitization and internalization of G-protein coupled receptors (GPCRs). We investigated impacts of β-arr2 on survival, mobility, and tube formation of cardiac progenitor cells (CPCs) obtained from wild-type (WT) mouse (CPC-WT), and β-arr2 knock-out (KO) mouse (CPC-KO) cultured in presence or absence of serum and oxygen as non-canonical roles in GPCR system. Methods CPCs were cultured in Dulbecco's Modified Eagle Medium/Nutrient Mixture F-12 -based media containing fetal bovine serum and growth factors. Survival of 2 types of CPCs in hypoxia and/or serum deprivation was measured by fluorescence-activated cell sorting. Wound healing ability, and tube formation ability on Matrigel of 2 kinds of CPCs were compared in normoxic and hypoxic cultures. Protein expression related to survival and mobility were measured with the Western blot for each culture conditions. Results CPC-KO showed significantly worse mobility in the wound healing assay and in tube formation on Matrigel especially in hypoxic culture than did the CPC-WT. Also, CPC-KO showed significantly higher apoptosis fraction in both normoxic and hypoxic cultures than did the CPC-WT. Expression of proteins associated with cell survival and mobility, e.g., protein kinase B (Akt), β-catenin, and glycogen synthase kinase-3β (GSK-3β) was significantly worse in CPC-KO. Conclusions The CPC-KO had significantly worse cell mobility, tube formation ability, and survival than the CPC-WT, especially in the hypoxic cultures. Apparently, β-arr2 is important on CPC survival by means of mobility and tube formation in myocardial ischemia.

의료기관의 수익성과 모바일 기반 Personal Health Record 서비스 도입과의 관계

서슬기,최병관,최재영 건강보험심사평가원 2022 HIRA RESEARCH Vol.2 No.1