제 2 주제 : 의료의 질 향상 개념과 기법 / 질 향상 활동의 개념

송정흡 한국병원경영학회 2000 한국병원경영학회 학술대회연제집 Vol.2000 No.1

입·퇴원 module시스템의 효과 분석 : ocs 입원 관리 시스템 효과 분석

송정흡 한국의료QA학회 2005 한국의료질향상학회지 Vol.12 No.1

Background : There were so many patients who are waiting for admission in Emergency room in spite of more than one hundred empty beds everyday. This study was conducted to evaluate admission-discharge module system by OCS which reduce empty beds. Methods : The data of bed utilization in general beds from 2004 were reviewed. For evaluation of performance at admission-discharge module system by OCS, the change of Occupancy of bed were calculated. Results : The percentage of Average Bed Emptiness was changed from 13.8% to 9.2%. The residents in surgery(100%) and in internal medicine(75.5%) approved this system. Conclusion : The personnel in hospital recognized that it was very important to manage bed. The management of beds by OCS was helpful to reduce empty beds and was important.

웹 및 OCS를 활용한 직원 건강검진 프로그램의 효과 분석

송정흡,하태희 한국의료QA학회 2008 가을학술대회 Vol.2008 No.2

3차 진료기관 외래약국 투약대기시간 단축을 위한 택배 제도 도입 타당성 조사

송정흡 한국의료QA학회 1996 한국의료질향상학회지 Vol.3 No.1

Background : Because of introduction of nationwide health care system in 1989 and the improvement of socioeconomic status of population the number of outpatient visiting university hospital has good facilities and manpower has increased. So the waiting time for medical service at university hospital are lengthened. Particularly outpatients complain that waiting for prescribed drugs at pharmacy depart are long. Reducing waiting time at pharmacy depart door-to-door delivery system that the patients applying for door-to-door delivery receive prescribed drug at home without waiting at pharmacy depart were studied. The objective of this study is to analysis to opinion of outpatients for door-to-door delivery system, to study the appropriateness of adopting the system and to produce ideal model for the system. Method : Outpatients waiting drug at pharmacy depart were questioned about door-to-door delivery system. To find the factors affect utilizing the system the logistic regression was used. Result : 83.3% of the patients want to utilize the system without charging, and 72.9% of the patients want to utilized system with charging. 68.3% of patients with charging want to use this system because of long waiting time at pharmacy depart. 50% of patients who do not want to use door-to-door do not use this system because of incorrect delivery. The affecting factors to utilize the system were sex, waiting time, fee. Conclusion : The model for door to door delivery system 1. door-to-door personnel reside in hospital and the patient want to utilize the system apply for the delivery with charging. 2. The applied drugs dispense at spare time. 3. Delivery company gathers drug at appointed time and delivers. 4. The delivery fee is 2,000-3,... won. 5. To prevent from loss and changing the drug the name of patient on packet are printed and drug packet are sealed. 6. The company submit the confirm sheet which are written that the patient received drug correctly to hospital 7. The delivery time of drug is reserved for the convenience of receiving.

감귤원과 그 주변 기주식물에서 볼록총채벌레의 연중발생 양상

송정흡,김창석,양영택,홍순영,이신찬,Song, Jeong Heub,Kim, Chang Seog,Yang, Young Taek,Hong, Soon Yeong,Lee, Shin Chan 한국응용곤충학회 2013 한국응용곤충학회지 Vol.52 No.3

제주지역 노지감귤에서 2007년부터 볼록총채벌레 Scirtothrips dorsalis Hood에 의한 피해가 증가하고 있으나 시기별 발생특성에 관한 연구는 명확하지 못한 실정이다. 본 연구에서는 감귤원 주변에 분포하고 있는 볼록총채벌레의 기주식물 종류와 이와 연관된 발생특성을 구명하였다. 감귤원 주변에서 조사된 볼록총채벌레의 기주식물은 수목류 23과 39종, 초본류 10과 15종으로 총 32과 54종이었다. 조사된 기주식물 중 볼록총채벌레 제1세대 발생과 관련된 것은 인동덩굴과 사위질빵, 송악, 아왜나무였으며, 이들 식물에 월동성충이 3월 하순~4월 상순에 산란하여 성충이 4월 하순~5월 하순에 발생되는 것으로 추정되었다. 감귤 피해와 관련된 기주식물은 예덕나무와 동백나무 그리고 사위질빵, 계요등, 거지덩굴 같은 덩굴성 식물이었다. 황색끈끈이트랩을 감귤나무와 감귤원 경계에 설치하여 볼록총채벌레의 시기별 발생밀도를 조사한 결과 비슷한 발생양상을 보였으며, 연간 7세대를 경과하는 것으로 추정되었다. 감귤 열매에 피해를 주는 시기는 6월 하순~7월 상순과 8월 하순~9월 상순으로 어린 열매와 성숙 초기 2회에 걸쳐 피해를 주며, 이는 각각 볼록총채벌레 제 3세대와 제 6세대 성충 발생 최성기와 일치하였다. 볼록총채벌레 발생밀도는 기주식물의 새순 발생량에 따라 차이가 컸으며, 감귤원 주변 기주식물에서 번식한 후 감귤나무로 이동하여 피해를 주는 것으로 나타났다. The damage of citrus by Scirtothrips dorsalis Hood appears to have increased since 2007 in Jeju, although the characteristics of seasonal abundance are not clear. This study was conducted to investigate the relationship between host plants and the seasonal abundance of S. dorsalis, observing plants distributed around citrus orchards. The host plants of S. dorsalis surrounding citrus orchards were determined to include 32 families, 54 species: 39 woody plant species and 15 herbaceous plant species. The host plants which related to the occurrence of 1st generation of S. dorsalis were Lonicera japonica, Clematis apiifolia, Hedera rhombea, and Viburnum awabuki. The occurrence of 1st generation S. dorsalis was estimated to be due to overwintered female adults having laid eggs into those plants from late March to early April, and the new adults having emerged from late April to late May. The host plants which were associated with fruit damage of citrus were Mallotus japonicus, and Camellia japonica, as well as creeping plants such as Clematis apiifolia, Paederia scandens and Cayratia japonica. The adult phase density of S. dorsalis caught on yellow-color sticky traps placed on the citrus trees on the edge of the citrus orchard. S. dorsalis were predominantly 3rd generation from late of June to early of July, and 6th generation from late of August to early of September, and their numbers were directly related to the degree of damage caused to the citrus fruit. The density of S. dorsalis depended on the number of new growing shoots of host plants, which indicated that the immigration of adults of S. dorsalis to the citrus was based in the suitability of host plants surrounding the orchards.

입.퇴원 module 시스템의 효과 분석 -ocs 입원 관리 시스템 효과 분석-

송정흡,Song, Jung Hup 한국의료질향상학회 2006 한국의료질향상학회지 Vol.12 No.1

Background : There were so many patients who are waiting for admission in Emergency room in spite of more than one hundred empty beds everyday. This study was conducted to evaluate admission-discharge module system by OCS which reduce empty beds. Methods : The data of bed utilization in general beds from 2004 were reviewed. For evaluation of performance at admission-discharge module system by OCS, the change of Occupancy of bed were calculated. Results : The percentage of Average Bed Emptiness was changed from 13.8% to 9.2%. The residents in surgery(100%) and in internal medicine(75.5%) approved this system. Conclusion : The personnel in hospital recognized that it was very important to manage bed. The management of beds by OCS was helpful to reduce empty beds and was important.

Notes on the Aloe Vera Aphid, Aloephagus myersi Essig (Hemiptera: Aphididae) on Non-native Aloe Plants in Korea

송정흡,서수정,Song, Jeong-Heub,Suh, Soo-Jung Korean Society of Applied Entomology 2014 한국응용곤충학회지 Vol.53 No.3

온실에서 재배되는 수입 알로에묘목에 알로에베라진딧물, Aloephagus myersi Essig, 이 채집되었다. 이 종의 원산지는 아프리카로 알려져 있고 수입된 식물을 통해 온실에 도입된 것으로 추정된다. 우리나라의 자연환경에 도입과 정착을 방지하기 위한 이들 종의 진단형질, 사진자료, 기주 및 분포정보를 제공하고자 한다. The aloe vera aphid, Aloephagus myersi Essig, was collected on imported Aloe vera (L.) Burm.f. (Xanthorrhoeaceae) grown in greenhouses in Korea. This species is native to tropical Africa and probably was introduced into greenhouses via the aloe plant trade. This introduction reinforces the need to focus attention on the eradication from collected localities, and for constant surveillance and detection at ports of entry to prevent introduction and establishment of new pests in the Korean environment. In this paper, additional information for the aloe vera aphid is provided with diagnoses and photographs along with host plant and distribution data for accurate species identification.

감귤원에서 가을철 귤응애 성충의 공간분포와 표본조사

송정흡,김수남,류기중 한국응용곤충학회 2003 한국응용곤충학회지 Vol.42 No.1

Dispersion pattern for adult citrus red mite (CRM), Panonychus citri (McGregor) using by Taylor's power law (TPL) and Iwao's patchiness regression (IPR) was determined to develop a monitoring method on citrus orchards, on Jeju, in Autumn season, during 2001 and 2002.CRM population was sampled by collecting leaves and fruits. The relationships of CRM adults between leaf and fruit were analyzed by different season. The regression equation for CRM adults between leaf (X) and fruit (Y) was ln(Y+1) : 1.029 ln(X+1) ( $r^2$ : 0.80). The density of CRM was higher on fruit than on leaf according to fruit maturing level. TPL provided better description of mean-variance relation-ship for the dispersion indices compared to IPR. Slopes and intercepts of TPL from leaf and fruit samples did not differ between sample units and surveyed years. Fixed-precision levels (D) of a sequential sampling plan were developed using Taylor's power law parameters generated from adults of CRM in leaf sample. Sequential sampling plans for adults of CRM were developed for decision making CRM population level based on the different action threshold levels (2.0,2.5 and 3.0 mites per leaf) with 0.25 precision. The maximum number of trees and required number of trees sampled on fixed sample size plan on 2.0,2.5 and 3.0 thresholds with 0.25 precision level were 19, 16 and 15 and their critical values T$_{critical}$ at were 554,609 and 659, respectively. were 554,609 and 659, respectively. 귤응애 성충의 표본추출법을 개발하기 위하여 2개년(2001-2002년)동안 8월부터 11월까지 잎과 열매에 대해 각 조사일에 평균밀도를 조사하였다. 잎과 열매에서 귤응애 성충 밀도의 관계를 시기별로 비교하였으며, Taylor's power law (TPL)와 Iwao's patchiness regression (IPR)을 이용하여 분산지수를 비교하였다. 잎(X)과 열매(Y)에서 귤응애 성충 밀도의 관계는 ln(Y+l)=1.029 ln(X+l)($r^2$=0.80)의 직선적인 관계가 있었으며, 열매가 성숙될수록 잎보다 열매에서 귤응애 밀도가 높아지는 경향이었다. 잎과 열매의 표본조사에서 TPL이 IPR보다 평균-분산 관계를 더 잘 나타내었으며, TPL의 기울기와 절편은 두 표본단위간, 연도간에 차이가 없었다. 정착도 0.25일 때 요방제밀도 2.0, 2.5와 3.0에서의 의사결정을 위한 표본추출조사법을 개발하였으며, 조사에 필요한 최대조사나무수(고정표본크기에서 필요 나무수)는 각각 19, 16과 15주였으며, 이 때의 의사결정임 계값 $T_{critical}$은 각각 554,609와 659였다.,609와 659였다.

Web OCS(Order communication system)

송정흡,하태희 한국의료QA학회 2009 한국의료질향상학회지 Vol.15 No.2

Objectives: Toevaluatethe effectof heath examinationprogramwhich introduce web-based inputsystem, OCS(Order communicating system) and interface with national health insurance corporation, this studywas done. Method: To Exam/Orderand tests separately at anytime, the experimental health examination program whichhad web-based questionnaire inputsystem, on-linemeasurement inputsystem, interface program with national health insurance corporation and introduced OCS was developed. Experiment and old examination program were compared in terms of satisfaction and cost. Result: The 95.7% of respondents were satisfied with web-based input system, the 95.4% satisfied with OCS use,and 97.8% satisfiedwith test at anytime theywant. The cost and time reduction between experiment and old program were 4,159,000won and 600.3±5.75(seconds) per man input-time. Conclusion : The experimental health examination program is good for employee and hospital. If the health examinationprogram for non-employee will be developed, it will be done efficiently and effectively, but Internet securities will be considered.

대구지역 한 중소병원의 교대제 근무에 의한 외래진료에 관한 연구

송정흡,김징균,하영애,예민해 한국의료QA학회 1994 한국의료질향상학회지 Vol.1 No.2

의료소비자인 환자들은 바쁜 일상생활 때문에 야간외래진료를 원하고 있다. 이것은 환자의 편의 측면 및 서비스 개선 차원에서 병원에서는 긍정적인 검토를 해야 하나 현재의 수가 체계와 환자의 수요 및 추가 인건비를 포함한 비용면을 고려할 때 실행에는 어려운 문제점이 있다. 이에 본 저자는 환자의 요구와 병원의 경제적인 면을 모두 해결할 수 있는 교대제 근무에 의한 외래진료 제도를 개발해서 그 효과와 야간외래진료의 대안으로서의 가능성을 분석하기 위하여 본 연구를 하였다. 본 연구는 기초조사, 개입 및 효과분석으로 구성되다. 기초조사는 야간외래진료의 수요에 대한 기초조사, 병상, 의사, 직원 수에 대한 조사, 진료및 근무 시간 조사, 94년 1월시간별 환자수를 조사하고 개입(intervention)은 진료시간 변경, 시간대별 환자수를 고려한 각 부서별 근무시간 조정, 최소한 인원 증원이며 효과 분석은 시간대별 환자수, 각 부서별 시차제 근무 효과, 외래와 입원 환자수를 개입 연구 전후로 비교하고 7-8시, 18-20시의 환자수 분석, 교대제 군무에 의한 외래진료에 대해서 의사, 직원, 환자들의 의견을 설문 조사하였다. 교대제에 의한 외래진료의 진료시간은 오전반은 오전 7시에 출근하여 오후 3시까지 근무하고 오후반은 12시부터 20시까지 점심, 저녁 시간 없이 진료를 하는 제도이다. 실시 과는 내과, 일반외과, 정형외과, 산부인과이고 증우너된 인원은 24명이고 진료지원 부서는 환자의 내원시간과 부서별 특성을 고려하여 탄력적으로 조정하였다. 이 제도 실시후 환자의 시간대별 분포는 비슷했으나 7-8시 18-20시의 환자 수가 약간 증가했다. 특히 야간 외래진료 시간대인 18-20시의 환자 수는 25-30명으로 1개과당 6-7명이었다. 환자수는 전년 대비 외래는 평균 13%, 입원은 10% 증가했다. 이 제도 실시에 대한 설문조사에서 의사는 100% 직원은 94.6% 환자는 86.4% 찬성했고 장점은 여유시간 활용, 진료시간 연장, 환자의 분산및 대기시간 단축, 응급환자 신속 처리 등이었으며 단점은 인력 부족으로 일이 힘들다. 전과 불실시로 인한 문제, 진료의 연속성, 점심 저녁 시간이 없다. 회진 문제, 진료의 연속성, 점심 저녁 시간이 없다. 회진 시간이 불규칙하다 라고 하였다. 현재까지는 야간에 외래진료를 이용하는 환자가 많지 않기 때문에 초과근무수당 및 인력 투입하는 야간외래진료 보다는 교대제 근무에 의한 외래진료가 효율적인 것 같다. 이 제도의 실시는 환자의 실외래 진료 이용 시간을 5시간 30분 증가시켰다. 이 제도의 효과를 높이기 위해서는 전과 실시가 필요하나 병원의 경제적인 여건 미비로 힘들다. 만약 정부에서 정책적으로 전과 실시때문에 발생한 손실 대한 한시적인 보조가 있다면 이 제도의 조기 정착에 도움이 될 것이다. Medical consumers(patients) want evening-clinic because of busy work. For patient's convenience and improving service, hospital should accept it. Considering payment system and patient's demand, personnel expenses, hospital can not accept. The practice of shift system to accept patient's demand and hospitals economic aspect was made. To analysis the effect of the system and probability to alternative to evening clinic this study was done. This study was composed of basal study, intervention, evaluation of effect. The basal study were composed of studying demand on evening clinic, the number of beds, doctors employee, the time table of practice and work, and the number of pattents at arrival time. The intervention composed of changing of practice time, changing of working time by the number of patients at arrival time, increasing of employee. The evaluation of effect were composed of evaluating the number of patient at time, the effect of shift system, the comparison of the number of in and out patients and questionnairing the practice of shift system. In the practice time at 2 shift system First team works 7-15 hours and Second team 12-20 hours, there are no lunch and supper time. At 18-20 hours the number of patients were 25-30. The number of patient a depart were 6-7. The number of out-patient increase in 13% and inpatient increase in 10% before the system. Doctors(100%), employee(94.6%), and patients(86.4%) approved this system. The advantage of this system were utilization of surplus time, lengthen the practice time, even distribution of patients and shortening of waiting time, rapid treatment of emergent patients. The disadvantage of this system were shortage of manpower, not all depart practice, continuity of practice, no lunch and supper time, irregular rounding. At present because of small Demanding on evening clinic, this shift system was economical. To succeed this study more effectively all depart in hospital participate. But because of economical reason it is impossible for hospital to do it. If the government assist the economic loss that all depart participate in this system it is very helpful for hospital to succeed in implementing this system more early.