목적: 복강경하 질식 전자궁적출술 (LAVH)의 적응증, 장점, 합병증 등에 관해 검토하기 위하여 본 연구를 후향적으로 시행하였다. 연구 방법: 성균관대학교 강북삼성병원 산부인과 학교실에서 2003년 3월부터 2004년 2월까지 만 12개월간 시행된 복강경하 질식 전자궁적출술 환자 154명을 대상으로 병록 일지를 분석하여, 환자의 나이, 분만력, 이전 개복수술, 수술 전 적응증, 수술 후 병리진단, 수술시간, 적출된 자궁무게, 헤모글로빈 변화, 재원일수
Background: On September 25, 2023, the law requiring the mandatory installation and operation of closed circuit television (CCTV) in the operating room went into effect. In this study, doctors’ perceptions of the law were re-examined on September 23, 2023 (just prior to the law’s enforcement), following a survey conducted on July 21, 2021 (before the re-examination of the bill). This study aimed to confirm doctors’ perceptions of the infringement of fundamental rights of this law, the collapse of essential medical services due to the avoidance of surgery, and other concerns and priority solutions ahead of the law’s enforcement.Methods: The survey was conducted from 8 to 18 September, 2023, by the Korean Medical Association Doctor Survey; a total of 1,267 doctors responded to the survey.Results: Out of 1,267 respondents, 1,156 (91.2%) said “yes,” and 111 (8.8%) said “no” to issue concerning constitutional violations of fundamental rights–such as the freedom of medical personnel to practice their profession–and moral rights. A total of 1,149 (90.7%) respondents agreed with the concern regarding the collapse of essential medical care due to the avoidance of surgeons.Conclusion: Sufficient guidance should be provided, along with guidelines that provide explicit standards for the installation and operation of the CCTV systems, along with safety management measures. Medical disputes and the heavy legal responsibility of medical personnel are the main reasons as to why essential medical care collapses, given the avoidance of surgery. Medical disputes should be avoided in order to prevent essential medical care collapse, as the video is used as evidence for criminal sanctions.
2021년 9월 24일 전신마취 등 의식이 없는 환자를 수술하는 의료기관의 수술실 내 CCTV 설치 의무화 조항(의료법 제38조의2)이 공포되었다. 개정된 「의료법」은 수술실 내에서 발생할 수 있는 불법행위를 효과적으로 예방하고, 의료분쟁 발생 시 적정한 해결 도모를 목적으로 한다. 이로 인해 2023년 9월 25일까지 전신마취 등 의식이 없는 상태의 환자를 수술하는 의료기관은 수술실 내 CCTV를 의무적으로 설치해야 하고, 의료인의 동의 여부에 관계없이 환자와 환자 보호자의 요청만으로도 수술장면을 촬영해야 한다. 해당 법안은 기본권 침해 최소를 위한 입법 장치를 법률에 규정하지 않고 하위법령에 위임하였다(제38조의2 제10항). 정보주체의 기본권 침해를 최소화하기 위한 가장 현실적인 정책방안은 구체적인 규정을 마련하는 것이다. 이에 본 논문에서는 수술실 내 CCTV 설치 의무화 법안의 입법 배경과 개정안의 주요 내용을 살펴보고, 주요 쟁점을 분석함으로써 하위법령 마련 시 검토되어야 할 사안을 제안하였다. 수술실 내 촬영 대상인 정보주체의 기본권 침해 최소화 원칙 준수를 기준으로 촬영 요건, 촬영 거부 정당화 사유, CCTV 설치 위치, 촬영 범위ㆍ대상, 영상정보 안전 조치 의무와 처벌의 적절성 등을 검토하였다. 수술실 내 CCTV의 정보주체는 수술에 참여하는 보건의료인과 환자일 것으로 이들의 개인정보자기결정권, 인격권, 인권 등의 침해를 최소화하면서 설치 의무화법의 목적이 달성될 수 있도록 하위법령 마련 시 고려되어야 할 사안을 제안하였다. 본 논문이 하위법령 논의 시 검토되어 정보주체의 기본권 침해 최소화 방안 마련에 기여할 수 있기를 기대한다.
Purpose The purpose of this paper is to describe a recent effort by the South Korean Government to stimulate a domestic disaster risk reduction (DRR) technology industry for the export market. The project is a novel form of public-private partnership (PPP) that simultaneously fulfills the mandates of the Sendai Framework for Disaster Risk Reduction while promoting Korea’s economic development agenda. Design/methodology/approach The research is primarily a review study of the Global DRR Technology project as it is situated in the literature of PPP research from both the public administration and disaster management disciplines. Findings Korea’s approach to address DRR through a PPP targeting the needs of East Asian countries is unique. The overall effectiveness of the effort will take time to assess, but the model is an interesting and potentially fruitful mean of advancing DRR technology dissemination. Practical implications Korea may position itself as a global leader of DRR technology through this effort in terms of both market share and support of the Sendai Framework’s objectives. If successful, the PPP approach may be adopted as a viable means of improving DRR for other countries. Social implications Using PPPs for various aspects of DRR can be win-win situation for economic development and disaster management outcomes. Originality/value This paper presents a distinct application of the PPP model for DRR that other countries may appreciate and/or adopt for their own DRR needs.
The current national health-insurance system of the Republic of Korea uses the negative-list method to determine benefit coverage, which includes most medical services. However, financial limitations have led to frequent conflicts between medical-service providers and the Health Insurance Review and Assessment Service (HIRA) about the inclusion of specific service-providers' practices within benefit coverage. The role of HIRA is to determine whether payments claimed by service providers are clinically valid and formulated in a cost-efficient manner. This article describes the present state and structure of the benefit system in the Korean national health-insurance system. We focus on issues of arbitrary uninsured benefits that may arise when service providers request patients to pay in full (with their approval) for a service that is not included in the benefits, according to the National Health Insurance Act. We also consider the legal treatment of arbitrary uninsured benefits in Korea and other countries. We suggest measures to improve the payment system for arbitrary uninsured benefits in Korea. Laws and regulations should be revised to cover these arbitrary uninsured benefits in a manner that can be agreed upon by HIRA, service providers, and patients.
영산강 하구역은 하구둑에 의해 하천의 수체가 정체되어 수질문제가 심각한 지역이다. 이를 관리하기 위해 수질변화의 예측은 필수적이며, 주로 EFDC(Environmental Fluid Dynamics Code) 모델이 활용된다. EFDC 모델의 모의 결과로는 Binary 형식의 대용량 결과파일이 생성되며, 모의 결과의 공간적인 분포를 확인하기 위해서는 이미지 형태로 변환하는 후처리과정이 필요하다. 이를 위한 대표적인 후처리기로는 EFDC_Explorer가 있다. 그러나 EFDC_Explorer에서 제공되는 이미지 파일은 단순한 캡처 형식의 자료로 다른 주제도와의 중첩 기능이 지원되지 않는다. 이는 다양한 GIS자료와의 연계 분석이나 고차원적인 분석에서 제약이 될 수 있다. 따라서 본 연구에서는 GIS에서 활용을 고려한 EFDC 모델 모의결과 후처리 시스템을 개발하고자 하였다. 이를 위하여 주요 입력파일 수정 모듈과 Binary 형식의 결과 자료를 ASCII 형식으로 변환하는 모듈, GIS기반의 환경에서 활용이 가능한 레이어 형식으로 재구성하는 모듈을 개발하였으며, 재구성된 모델결과를 효율적으로 가시화할 수 있는 모듈을 개발하였다. 개발된 시스템을 통해 생성되는 결과 레이어는 다양한 주제도간의 중첩 분석이나 다양한 GIS기반의 환경에서 연계분석이 가능하여, 최종적으로 수질관리를 지원하는 자료로 활용될 수 있다. The Yeongsan river estuary has a serious water quality problem due to the water stagnation and it is imperative to predict the changes of water quality for mitigating water pollution. EFDC(Environmental Fluid Dynamics Code) model was mainly utilized to predict the changes of water quality for the estuary. The EFDC modeling normally accompanies the large volume of modeling output. For checking the spatial distribution of the modeling results, post-processing for converting of the output is prerequisite and mainly post-processing program is EFDC_Explorer. However, EFDC_Explorer only shows the spatial distribution of the time series and this doesn't support overlay function with other thematic maps. This means the impossible to the connection analysis with a various GIS data and high dimensional analysis. Therefore, this study aims to develop a post-processing system of a EFDC output to use them as GIS layers. For achieving this purpose, a editing module for main input files, and a module for converting binary format into an ASCII format, and a module for converting it into a layer format to use in a GIS based environment, and a module for visualizing the reconfigured model result efficiently were developed. Using the developed system, result file is possible to automatically convert the GIS based layer and it is possible to utilize for water quality management.
NGIS and other related public projects have contributed to the generalized use of the digital maps. The accuracy and cost-effectiveness of such digital maps can be enhanced from the integrated use with airphotos and satellite imagery. This study mainly focuses on the investigation of a efficient way of integrating the digital map and image data along with searching for a proper standard format for the easier distribution of image data. This includes a thorough investigation of the available oversea image data-DoQ, DEM, DRG-and exisiting data transfer format such as widely used Geo TIFF and BIIF, supported by ISO. Also, major advantages and problems from integrating both data have been discussed to seek alternatives. The major conclusion from the study includes the need for more supports to activate the use of image data by policy-makers and the establishment of standards towards BIIF considering the accuracy, exchangeability, and trends.
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