의료서비스의 질향상 진화와 현안 : 미국의 동향

한휘종 한국의료QA학회 2008 한국의료질향상학회지 Vol.14 No.2

흔히 관리의료 (Managed Care)라 불려지는 미국의 의료체계는 과거 약 30여년간 미국내 의료비용증가의 억제, 의료서비스 접근성 개선, 의료의 질향상이라는 세가지 목표를 이루기위해 시행되어 왔다. 이 관리의료체계는 지속적으로 증가하는 의료비용을 어느정도 억제하는데는 성공하였으나, 몇년전부터 의료정책전문가들은 관리의료체계의 의료비용증가 억제 역할은 이미 한계에 다다렀다고 판단하고 있으며, 의료서비스 접근성 개선이나 의료의 질향상에는 큰 성과를 이루지 못했다고 평가하고 있다. 그럼에도 불구하고 미국의 의료서비스 질향상을 위한 노력은 지속적이면서도 체계적으로 진행되어왔다고 자부하고 있다. 최근 미국내 의료서비스 질향상을 위한 형태를 살펴보면 자주 거론되는 것이 Prevention activity, Physician Profiling, Pay-for-Performance (P4P), Clinical Practice Guideline, Health Information Technology (Health IT)등임을 알 수있다. 미국의 이러한 노력들이 최근 1-2년사이 한국내에도 널리 알려지고 이미 일부는 시범사업형태로 실시되고 있는점을 감안하면 별반 다를것이 없다고 여겨질 수 있으나, 여기서 주목할 것은 이러한 노력들이 미국내에서 시도되게된 계기와 목적, 그리고 그 과정들을 눈여겨 볼 필요가 있다는 점이다. 하지만 민간보험 주도 형태의 미국 의료시장에서 탄생한 이런 일련의 노력들이 정부주도하의 전국민건강보험체계로 운영되는 국내 의료시장에 도입되어 실효를 거두기 위해서는 모방형 도입이 아닌 국내 의료체계와 실정에 적합하도록 수정 혹은 개선된 형태로 선별, 도입되어야 함을 암시하고 있음도 주지해야 한다.

미국 의료기관의 환자 개인정보 보호

한휘종 한국의료QA학회 2009 한국의료질향상학회지 Vol.15 No.2

의료서비스 산업화와 병원 경영

한휘종 ( Whie Jong Han ) 한국병원경영학회 2015 병원경영학회지 Vol.2015 No.S

The healthcare industry is considered as a potential industry which can lead a nation to achieve global competitiveness with value-added. In this reason Korean government selected a healthcare business as one of major driving industries for next generation, and has been supporting the industry. As of 2012, national healthcare expenditures account for 7.6% of GDP, and of those expenditures, health service business accounts for more than half of total national healthcare expenditures(65% of NHE). Industrialization of health services has been attempted from mid-2000s. Due to unique characteristics of health services, however, this drive has been facing never-ending opposition and not yet completed. This paper traces background of health services industrialization. Beginning with definition of industrialization, necessity of industrialization is described. In addition, influences of industrialization into hospital management and political implication are presented.

클라우드 도입단계 위험식별 및 감리점검체계 개선에 관한 연구

최영진,나종회,한휘종 한국엔터프라이즈아키텍처학회 2017 정보기술아키텍처연구 Vol.14 No.4

In the public sector, information system audit has been implemented to control the risksthat may arise in the introduction and construction of information systems. Information systemaudit is carried out according to audit standards and guidelines. Current information system auditstandards and guidelines focus on traditional information system development methods and do notinclude risks and controls of cloud technology changes. In this study, the risk factors that can occurin the cloud introduction stage and the items that can control the risk are presented according tothe audit structure. Considering the fact that cloud is a new technology and there is no standardizedapproach yet, we organized focus group interview with experts in industry and academiy andproceeded through interviews and discussion process. As a result, it is difficult to distinguishbetween cloud introduction activities and IT strategy planning, so based on the existing IT strategyguideline, added the cloud separately 10 items in the ISP guidelines. 공공부문에서는 정보시스템 도입 및 구축 사업에서 발생할 수 있는 위험을 통제하는 방안으로정보시스템 감리를 시행하고 있다. 정보시스템 감리는 감리 기준 및 지침에 따라 수행하는데 현재의정보시스템 감리 기준 및 지침은 전통적인 정보시스템 개발 방법에 초점을 맞추고 있어 클라우드 기술변화에 따른 위험과 통제방안을 포함하고 있지 않다. 이에 본 연구에서는 클라우드 도입단계에서 발생할 수 있는 위험요인을 도출하고 위험을 통제할 수 있는 항목을 감리체계에 따라 제시하였다. 클라우드가 새로운 기술이고 아직까지 정형화된 접근방법이 존재하지 않는다는 현황을 고려하여 산업체,학계 등의 전문가 그룹으로 포커스 그룹을 구성하고 인터뷰 및 협의 과정을 거치면서 진행하였다. 연구결과, 클라우드 도입단계 사업의 주요요건이 기존의 정보화전략계획수립과 단계를 구분하기 어렵기때문에 기존의 ISP 감리지침의 체계를 활용하면서, 각 점검항목에서 클라우드와 관련된 별도의 점검이 필요한 항목을 10개 도출하여 추가하였다.

교근 근전도 비교를 통한 턱관절 기능장애 평가

어승준,전진우,염호준,한휘종 국제문화기술진흥원 2018 The Journal of the Convergence on Culture Technolo Vol.4 No.4

인류는 과학기술의 발전과 함께 의학기술도 눈부신 발전을 거듭해왔다. 그러나 과거에도 난치성 질환은 여전히 존재하였듯이 지금도 난치성 질환이 존재하는데, 그 중 턱관절장애가 있다. 현재 의료선진국이라 불리는 대한민국 의료진들의진단은 환자의 발언, 의사의 청음진단과 자를 이용한 진단, X-ray 촬영 진단 방식을 고수하며 시대에 뒤떨어지고 있다. 그렇기 때문에 환자의 정확한 증상 여부, 의사 본인의 진단 실력과 경력이 중요하고, 증상의 경중에 따른 진단 횟수의 증가와 이로 인해 발생하는 의료비용은 막대하다. 본 연구에서는 이를 해결하기 위해 저작운동(최대폐구)시 교근에서 발생되는근전도 신호를 %MVC를 통해 정량화하였다. 정량화된 근전도는 Cortex로 비교, 평가하여 턱관절 상태 평가 기준 지표를확립할 것이다. Human beings have made remarkable advances in medical technology as well as technological advances. However, as was the case in the past, incurable diseases still exist: temporo-mandibular joint (TMJ). The diagnosis of the Korean medical staff, currently called a "medical advance," is adhering to the outdated patient's comments, diagnosis using a doctor's auditory diagnosis and a ruler, and diagnosis of X-ray imaging. Therefore, it is important to have accurate patient symptoms, to have a doctor's own diagnosis and experience, to increase the number of diagnoses due to the severity of the symptoms, and to cover the costs of medical care. To solve this problem, the core conductive signal generated from the bridge was quantified through %MVC. Quantified EMG will be assessed and compared with Cortex to establish a jaw joint condition evaluation criterion.

청소년 우울증 영향요인에 관한 연구 : 아동・청소년 패널데이터 이용

최영진,강홍익,김동욱,성규환,한휘종 한국학교·지역보건교육학회 2017 한국학교지역보건교육학회지 Vol.18 No.3

Objectives: This study aimed to analyze the association between adolescent depression and personal factors such as interpersonal relationship and personal characteristics. Methods: The data used for this study was taken from the 2014 Korean Children and Youth Panel Survey. Of those 2,351 subjects in a data set, data of 1,938 subjects were analyzed after excluding 413 subjects with missing information. Hierarchical regression analysis was conducted for multi-variate analysis. In addition, controlling effects of ego-resiliency was analyzed. SPSS 22.0. was utilized for statistical analyses. Results: The study found that the depressive index was higher in women than men, and lower in adolescent who has a good relationship with parents and friends. This study also found that adolescents with high ego-resiliency are more vulnerable to depression. Conclusions: It is recommended to understand and to utilize ego-resiliency of adolescents, in order to reduce adolescents depression. Promoting good relationship with parents and friends will also positively impact to lower adolescents depression.

Cloud data center Facilities Management System for PUE and Availability

최영진,Kim, Jinhwan,Lee, Sanghak,한휘종 한국엔터프라이즈아키텍처학회 2018 정보기술아키텍처연구 Vol.15 No.4

With increased density of data centers, power and HVAC equipment are becoming more complicated. In particular, recent cloud data centers are demanding energy efficient and high availability. To manage large scale data center, it is required to collect and analysis data from diverse equipment in data center. And it is important to have an FMS that can monitor the status of the data center equipment with minimal manpower and take immediate action. In this paper, we proposed a method to monitor and measure ICT and it's related equipment in cloud data center, such as Power, HVAC, fire control, and PUE. We also proposed an integrated FMS that can monitor these data through each collecting point. This research contributes to a high level of ICT availability while efficiently operating the data center.

지방의료원의 환경요인에 따른 공공성지표 차이 분석

최요한 ( Yohan Choi ),김영훈 ( Young-hoon Kim ),한휘종 ( Whi-jong Han ) 한국병원경영학회 2019 병원경영학회지 Vol.24 No.2

The aim of this study is to analyze the differences in the publicness indices depending on the environmental factors of regional public hospitals to derive the policy implications for improving management for regional public hospitals. The data of the 34 regional public hospitals from 2016 was used for the analysis. Major results of this study are as follows. First, the analysis of the differences in the scores of the medical safety net function showed significantly higher scores for regional public hospitals with a larger location, a larger number of hospitals in a unit area, a larger number of nurses per 100 beds, and the lower management fee ratio. Second, the analysis of the differences in the scores of the unmet healthcare needs showed significantly higher scores for regional public hospitals with a larger number of hospitals in a unit area, and a larger number of beds. Third, the analysis of the differences in the scores of the hospital-specialized services showed significantly higher scores for regional public hospitals with a larger location, a higher financial independence of the local government, a larger number of hospitals in a unit area, a larger number of beds, and a larger number of nurses per 100 beds. Major conclusions of this study are as follows. Consideration should be given to the appropriate number of nurses for each regional public hospital to maximize publicness by providing the appropriate amount of medical services, but not to incur unnecessary labor costs. In addition, efforts should be made to enhance profitability, which can be a means of strengthening publicness, by identifying the minimum administrative expenses required for efficient operation and reducing unnecessary administrative expenses. Finally, it is necessary to identify the appropriate number of beds to meet the needs of the customers and to create maximum profits.

보건소 구성원의 직무만족과 조직몰입이 공공봉사동기에 미치는 영향

장길웅(Gillung Jang),김영훈(Younghoon Kim),장정현(Jeonghyeon Chang),우정식(Jungsik Woo),한휘종(Whiejong Han) 융복합지식학회 2019 융복합지식학회논문지 Vol.7 No.2

본 연구는 보건소 구성원의 직무만족과 조직몰입이 공공봉사동기에 미치는 영향을 알아보고자 하였다. 경기도 소재 보건소 구성원 (의무직, 행정직, 간호직, 의료기술직, 보건직, 기타-위탁)을 대상으로 설문조사를 실시하여 회수된 481 부를 분석에 활용하였다. 연구결과를 요약하면 다음과 같다. 첫째, 보상적만족 수준이 높을수록 공공봉사동기에 정(+)의 영향을 미쳤다. 둘째, 정서적몰입과 지속적 몰입 수준이 높을수록 공공봉사동기에 정(+)의 영향을 미쳤다. 셋째, 고용형태(정규직/기타직)별로 직무만족이 공공봉사동기에 미치는 영향을 분석한 결과 정규직의 직무만족이 공공봉사동기에 정(+)의 효과가 있었다. The purpose of this study is to examine the effect of the job satisfaction and the organization commitment of health center members on the public service motive. This study carried out a survey targeting members(medical job, administrative job, nursing job, medical technology job, health job, and consignment of a health center in Gyeonggido) to use 481 collected copies for the analysis. The results of this study is as follows. First, the higher the compensatory satisfaction level was, the bigger positive(+) effect it had on the public service motive. Second, as for the effect of the organization commitment on the public service motive, the higher the emotional commitment and continuous commitment level was, the bigger positive(+) effect it had on the public service motive. Third, when it comes to the difference the effect of the job satisfaction and organization commitment on the public service motive and the employment pattern(full-time position/the other jobs), the full-time position had a positive(+) effect on the public service motive in the influence of the job satisfaction on the public service motive.

경영혁신동향 : 외국인 환자 유치를 위한 지원 및 마케팅 방안: 서비스믹스를 활용한 브랜드 마케팅

진기남 ( Ki Nam Jin ),한동우 ( Dongwoo Han ),박경서 ( Kyoung Seo Park ),한휘종 ( Whiejong Han ) 한국병원경영학회 2015 병원경영학회지 Vol.20 No.3

Medical tourism in Korea has been rapidly grown for last couple of years, based on exclusive support from Korean government. About 60,000 foreign patients received medial services in 2009, an initial stage of entering medical tourism business, and the number of foreign patients received medical services in Korea hiked to more than 266 thousands in 2014, which is showing 34.7% of annual average increase between 2009 and 2014. Diversification of target markets and service areas contributed on this remarkable growth. This paper describes current status of medical tourism in Korea as well as various supports from government for the growth of medical tourism. In addition, the paper presents approaches for brand marketing, by utilizing 7Ps, the marketing mix (a.k.a. service mix), in order to increase awareness and competitiveness of medical services of Korea in global market.