Physician's perception of and attitudes towards patient safety culture and medical error reporting

The objectives of this study were (1) to describe doctors' perception and attitudes toward patient safety culture and medical error reporting in their working unit and hospitals, (2) to examine whether these perception and attitudes differ by doctors' characteristics, such as sex, position, and specialties, and (3) to understand the relationship between overall perception of patient safety in their working unit and each sub-domain of patient safety culture. A survey was conducted with 135 doctors working in a university hospital in Korea. After descriptive analyses and chi-square tests of subgroup differences, a multivariateregression of overall perception of patient safety in their unit with sub-domains of patient safety culture was conducted. Overall, a significant proportion of doctors expressed negative perception of their working units' patient safety culture, many reporting potentials for patient safety problems to occur in their unit. They also negatively viewed their hospital leadership's commitment on patient safety. Regarding the patient safety in their working unit, doctors were most worried about staffing level and observance of safety procedures. Most doctors did not know how and which medical error to report. They also perceived that medical errors would work against them personally and penalize them. About 22 percent of respondents believed that even seriously harmful medical errors were not reported.OAIID:oai:osos.snu.ac.kr:snu2005-01/102/0000028528/4SEQ:4PERF_CD:SNU2005-01EVAL_ITEM_CD:102USER_ID:0000028528ADJUST_YN:NEMP_ID:A076124DEPT_CD:811FILENAME:07 환자안전문화와 의료과오 보고에 대한 의사의 인식 조사연구.pdfDEPT_NM:간호학과EMAIL:[email protected]:

Review of Association Rule

데이터 마이닝 기법 중 하나인 Association Rule(연관 규칙)은 대용량의 데이터에서 숨겨진 유용한 정보를 찾아내는 방법이다. 이 Association Rule은 한 항목들의 그룹과 다른 항목들의 그룹 사이에 강한 연관성이 있음을 밝혀 준다. “Market Basket”분석 이라고 불리는 Association Rule의 목표는 데이터에서 변수가 X= {X_1, X_2, … , X_p} 일 때, 가장 빈번히 발생한 항목들의 결합 변수를 찾는 것이다. 이를 바탕으로 고객의 구매 패턴을 알 수 있고, 상품 진열, 상품 판매 촉진, 경영의사결정, 마케팅 활동 등에 활용할 수 있다. 본 논문에서는Association Rule을 찾아주는 알고리즘으로 Apriori와 Eclat 두 가지 방법론을 적용하여 항목간의 패턴을 찾아보고, 그 결과를 비교해 본다. 두 가지 방법론에 대해서 Simulation data와 Real data를 사용하여 그 성능을 비교 분석 하였다. 그 결과 Eclat 방법론이 Apriori 방법론 보다 훨씬 짧은 시간에 연관성이 높은 항목들을 찾을 수 있음을 볼 수 있다. Real data의 경우에는 두 방법론 모두 연관성이 높은 규칙들을 잘 찾을 수 있음을 보였다. 하지만 Support(지지도)가 아주 낮고 Confidence(신뢰도)가 높은 규칙을 찾는 것은 구조적으로 아주 많은 시간이 걸리는 것을 피할 수는 없다.;Association Rules are used to discover the relationships, and potential associations, of items or attributes among huge data. These rules cans be effective in uncovering unknown relationships, providing results that can be the basis of forecast and decision. Since association rules are useful and easy to understand, recently, the discovery of association rules from database has become an important research topic and there have been many successful business applications, including cross-marketing, attached mailing, store layout, customer segmentation, telecommunication, and web analysis. A typical example of association rule mining is “Market Basket” analysis. In well-known market basket problems, the association rule has been used to discover buying patterns such as two or more items that are often bought together. In this paper, I discover the patterns of items using the association rule methods, especially Apriori algorithm and Eclat algorithm. I analyze the performance of two algorithms with simulation data and real data. I know that the Eclat algorithm has much shorter time to make association rules. In the real data case, two algorithms have a good performance to select high quality items. But having the low support and the high confidence, it takes time to find association rules.Ⅰ.서론 1 Ⅱ.Methodology 2 A.Association Rule mining 2 B.Apriori Algorithm 3 C.Eclat Algorithm 5 Ⅲ.Simulation of study 8 Ⅳ.Real data 12 A.Marketing data 12 1.변수 설명 12 2.변수 변환 13 3.Result 17 B.Bank data 29 1.변수 설명 29 2.변수 변환 30 3.Result 33 Ⅴ.Conclusion 40 참고문헌 41 ABSTRACT 4

‘Postwar-East Asia’ and the Korean War : A Comparative Study of China and Japan’s Construction of the Cold War

본 연구는 한국전쟁을 계기로 중국과 일본이 국제적 냉전질서에 마주하게 된 과정을 ‘전후 동아시아’의 맥락에서 고찰한 것이다. 기존의 한국전쟁과 동아시아 냉전질서에 대한 연구는 개별국가의 역사적 맥락을 중심으로, 미소 대리전으로 환원되지 않는 ‘다양한’ 냉전의 지역적 경험을 밝히는데 주목해왔다. 이와 달리 본 연구는 중국과 일본에 대한 비교연구를 통해 두 국가의 서로 다른 전쟁경험이 동아시아 지역 층위에서 어떻게 구조적으로 맞물려 있었는가 규명하고자 하였다. 본 연구는 1945년 이후 ‘전후 동아시아’가 안게 된 국가권위의 부재사태와 전후 국가재건의 맥락에서 논의를 출발한다. 개별적인 지역적 맥락보다도 중국과 일본의 전후사회에서 공통적으로 전개되었던 치열한 국가재건의 경합과 평화와 민주적 개혁에 대한 열망, 그리고 이분법적 냉전 이데올로기를 넘어선 다양한 정치적 요구에 주목하기 위함이다. 한국전쟁이 발발하기 이전 ‘전후 동아시아’의 정치적 환경을 확인하여 중국과 일본 비교연구의 기준선을 설정한 것이다. 연구설계는 콜리어와 콜리어(Collier & Collier, 1991)의 역사제도주의(historical institutionalism) 분석틀을 차용했다. ‘전후 동아시아’의 사전조건(antecedent condition)에서 나타났던 다양한 역사적 경로의 가능성이 ‘한국전쟁’을 결정적 국면(critical juncture)으로 하나의 경로로 확정되는 과정을 추적하였다. 특히 중국과 일본의 신정부를 핵심 행위자로 상정하여 한국전쟁 시기 신정부가 항미(抗美), 반공(反共)의 냉전적 수사를 전략적으로 활용해 전후 국가재건의 추진력을 독점하게 되는 과정을 중점적으로 분석하였다. 구체적으로, 한국전쟁 시기 추진된 중국의 항미원조운동(抗美援朝運動)과 일본에서의 기지제공 및 레드퍼지(Red Purge)의 시행과 확산 과정을 비교하였다. 전후 중국과 일본은 탈식민국가와 패전국가로서 출발선의 정치적 지위가 상반될 뿐만 아니라 한국전쟁 시기에는 각각 사회주의 진영과 자유주의 진영에 속하여 대립하고 있었다. 그러나 두 국가의 신정부가 냉전의 적대적 충동을 정치적 수사로 활용하고 미소에 대한 협상력을 확보해갔던 전략적 선택의 과정에서 한국전쟁이라는 지역 열전(熱戰)을 통해 국가-사회, 국가-국제관계를 공고히 하였던 정치적 메커니즘의 유사성을 확인할 수 있었다. 본 연구는 ‘전후 동아시아’의 맥락에서 한국전쟁과 동아시아 냉전질서의 형성 과정을 재조명해보기 위한 시도였다. 한국전쟁 시기 중국과 일본 신정부의 정치적 선택을 비교해본 결과, 한국전쟁은 전후 국가구상이 신정부의 정치적 목표로서 구체화된 계기인 동시에 전후사회의 정치적 역량과 상상력을 협소하게 만드는 과정이었다. 결국 한국전쟁이 동아시아 지역질서에 남긴 유산(legacy)은 ‘전후 동아시아’의 정치적 역동성을 냉전의 적대적인 대결구도가 압도하도록 한 것이라고 정리할 수 있을 것이다. ;This study explores the process of how China and Japan dealt with the Cold War after the Korean War in the context of ‘post-war East Asia’. The existing studies of the Korean War and the the Cold War in East Asia have emphasized the ‘diverse’ individual historical and regional experiences of the Cold War which were not reduced to US-Soviet proxy wars. In contrast, this study aims to examine how China’s and Japan’s war experiences were structurally interlocked at the level of the East Asia region by comparing the two countries. The starting point of the study is the absence of national authority and post-war nation building, which ‘post-war East Asia’ experienced since 1945. This study is to shed light on the fierce rivalry between nation-building, aspiration for peace and democratic reform, and a variety of political needs beyond the dichotomous Cold War ideology. This study sets the baseline for comparative study between China and Japan by identifying the political environment of ‘post-war East Asia’ before the outbreak of the Korean War. By applying Collier & Collier (1991)’s historical institutionalism as the framework, the study traces the process in which the possibilities of various historical paths appears during the antecedent condition of ‘post-war East Asia’ but were reduced into a single path, with the Korean War as the critical juncture. In particular, assuming the new governments of China and Japan as key actors, it analyzes the process in which the new governments monopolized the driving force of post-war nation-building by strategically employing the Cold War rhetoric of anti-US and anti-Communism during the Korean War. To be specific, the study compares the implementation and spread of China’s ‘The Great Movement to Resist America and Assist Korea’ and Japan’s base provision policy and the ‘Red Purge’ during the Korean War. In the context of post-1945, China and Japan had contrasting political identities as a post-colonial and a defeated state. During the Korean War, they confronted each other as a socialist state and a liberal state. However, the new governments of both countries made strategic choices to use the Cold War's hostile impulses as political rhetoric and gain bargaining power over the United States and the Soviet Union. In this process, this study identifies similar regional political mechanisms that strengthened state-society and state-international relations through the Korean War. This study is an attempt to reexamine the Korean War and the construction of the Cold War in the region through the context of ‘post-war East Asia’. By comparing the political choices of the new governments of China and Japan during the Korean War, this study finds that the Korean War served as a cause that embodied the post-war nation-building as the political goal of the new governments. At the same time, this was a process that narrowed the political capacity and imagination of the post-war societies. In conclusion, the legacy of the Korean War in the East Asian regional order was that the hostile confrontation of the Cold War overwhelmed the political dynamics of ‘post-war East Asia’.Ⅰ. 서론 1 A. 문제제기 1 B. 연구대상 2 C. 선행연구 검토 5 D. 연구설계 및 논문의 구성 9 Ⅱ. 전후 동아시아의 사전조건과 정치과제 11 A. 전후 동아시아의 사전조건: 냉전 동아시아의 보완 11 B. 전후 동아시아의 정치과제: 국가재건과 한국전쟁 17 C. 역사제도주의 분석틀 21 Ⅲ. 사전조건과 균열: 전후 동아시아와 국가건설의 경합 24 A. 탈식민 중국과 중화민족 통일정국의 재건 25 B. 패전국 일본과 메이지 국가의 재건 32 C. 소결: 신정부의 국가건설과 국제질서의 마찰 40 Ⅳ. 결정적 국면과 초기대응: 한국전쟁과 냉전의 적대적 충동 확산 42 A. 중국의 항미원조와 반미선전 42 B. 일본의 기지제공과 레드퍼지 50 C. 소결: 항미반공의 전쟁 지원과 국가-사회 관계의 변화 59 Ⅴ. 유산: 샌프란시스코 체제와 냉전 동아시아의 형성 62 A. 중소동맹의 공고화와 중국의 사회주의 개조 62 B. 샌프란시스코 체제와 일본의 국가주권 회복 64 C. 소결: 전후 국가재건과 국가-국제관계의 변화 66 Ⅵ. 결론 67 참고문헌 69 ABSTRACT 8

Effectiveness of official development assistance for tuberculosis control by governance of recipients

To evaluate the importance of governance in controlling tuberculosis (TB), we explored the relationship between recipient countries' governance and TB control outcome. Using OECD statistics, World Development Indicators dataset, and Worldwide Governance Indicators database, we tested the role of governance in 117 developing countries from 2002 to 2014 in terms of TB control. Results show that the current level of good governance and its accumulated stock over time are keys to improving the effectiveness of foreign aid in reducing the incidence of TB

"Back to basics" approach for improving maternal health care services utilization in Lao PDR

Earlier studies claim inadequate knowledge and understanding of maternal health care service among women and families account for low demand and utilization of these services. This study explores maternal service utilization in Lao PDR by interviewing women, families, health service providers, and community members in Xiengkhuang province. In general, women's attitude and acceptance of maternal health care were positive, with many expressing appreciation and need for maternal health services. Nevertheless, utilization of maternal health services remained poor largely due to dissatisfaction with services: inaccessibility, irregular services, fund shortage, poor facilities, and problems dealing with male health service providers. It appears that utilization of maternal health care services in Lao PDR is as much a health system concern as it is a user preference issue. This article advocates a "back to basics" approach for reviewing maternal health care infrastructure systems in developing countries to improve community health services and utilization. © 2016 APJPH

Rapid Growth-What's Next for Gender Mainstreaming? Analyzing the Gender Impact Assessment System in Korea

While the gender impact assessment (GIA) system has been expanding in Korea with surprising and impressive speed, its actual influence on policies and programs remains quite uncertain. By conducting in-depth interviews with 16 frontline public officials and by systematically comparing it with environmental impact assessment (EIA) and regulatory impact assessment (RIA), the present study evaluates the current GIA system in Korea and identifies areas and issues for future improvement. Our findings show that an independent law, a separate managing division, clear criteria for selecting target policies and programs, and solid assessment measures are critical requirements for successful GIAs. In addition, we find that one of the most essential tasks is overcoming cultural resistance, especially the low priority gender issues have for male policy decision makers

Corruption and population health outcomes: an analysis of data from 133 countries using structural equation modeling

Objectives The current study aims to develop a theoretical framework for understanding the antecedents of corruption and the effects of corruption on various health indicators. MethodsUsing structural equation models, we analyzed a multinational dataset of 133 countries that included three main groups of variables-antecedents of corruption, corruption measures, and health indicators. Results Controlling for various factors, our results suggest that corruption rises as GDP per capita falls and as the regime becomes more autocratic. Higher corruption is associated with lower levels of health expenditure as a percentage of GDP per capita, and with poorer health outcomes. Countries with higher GDP per capita and better education for women have better health outcomes regardless of health expenditures and regime type. Conclusions Our results suggest that there is no direct relationship between health expenditures and health outcomes after controlling for the other factors in the model. Our study enhances our understanding of the conceptual and theoretical links between corruption and health outcomes in a population, including factors that may mediate how corruption can affect health outcomes

THE PERFORMANCE MANAGEMENT SYSTEM OF THE KOREAN HEALTHCARE SECTOR: DEVELOPMENT, CHALLENGES, AND FUTURE TASKS

During the past two decades, performance management programs in Korea's healthcare sector have become increasingly diversified in terms of the measures used and the scope of the healthcare services measured. Despite the recent growth of peiformance management programs in Korea's healthcare system, few studies have evaluated performance management programs as a whole in the context of national healthcare system objectives. Drawing on Talbot's performance regime framework, this study describes the major challenges to Korea's performance-based healthcare management systems. We suggest that the challenges can be addressed by creating a coherent conceptual framework and a macro-level coordination body. We further suggest that relevant performance interventions be chosen based on theoretical models of performance management. Our findings have implications for future studies on performance management of healthcare systems in other countries as well as in Korea

Public Preferences in Resource Allocation for Insurance Coverage of Dental Implant Service in South Korea: Citizens' Jury

The Korean government sought to include dental implant services for the elderly in the benefits package of the national health insurance. In 2014, the Citizens' Jury was held to discuss the topic, during which thirty jurors, randomly selected from the 2665 applicants, participated in a day-long deliberation process after having an information session on the topic by a team of experts. There was a substantial shift in opinion during the deliberation session toward a more cost-conscious view. Most jurors supported limiting the coverage of dental implant to only one tooth per individual given the extent of the financial burden that will be imposed on the population. They opposed covering implant services for the front teeth, given that the implant of front teeth generally serves aesthetic purposes rather than restoring mastication function. The government's final decision in 2014 was to offer coverage up to two teeth, regardless of tooth location. This scheme based on the jury's recommendations in 2014 has been implemented without policy failure to date, which shows that the lay public can meaningfully contribute to a decision-making process regarding controversial agendas such as benefits packages for expensive health services

Life course indices for social determinants of self-rated health trajectory in Korean elderly

Objectives: This study investigated the self-rated health trajectories of the Korean older population and revealed life-course factors that affect the trajectories over the life course. Methods: Around 1000 older adults were randomly allocated by stratified multi-stage sampling based on the population census, and underwent face-to-face interviews. Self-rated health status, socioeconomic variables over the life course, and demographic variables were included in the analysis. A group-based trajectory model was used to investigate the association between self-rated health and explanatory variables. Results: The enrolled men and women were divided into three groups by trajectory analysis, which showed marked differences in self-rated health trajectories from childhood to senescence. Among older men, those who experienced skipping meals in childhood and those with chronic disease conditions were more likely to be in the lower trajectory groups. Compared to the older men, the likelihood of being in the lower trajectory groups in older women was increased by experience of skipping meals, lower household income, housekeeping labor, receiving Basic Livelihood Security and chronic disease conditions. Conclusion: Various self-rated health trajectories of the Korean older population were identified, and differed according to socioeconomic variables during their life course. Therefore, socioeconomic variables during the life course should be monitored, and health policies directed at the elderly should focus on initial health status from the perspective of a life-course approach. (C) 2017 Elsevier B.V. All rights reserved