1.Current status of telemedicine in Japan: implications for Korea
Journal of the Korean Medical Association 2022;65(12):850-855
Since the coronavirus disease 2019 outbreak, telemedicine has become an important means of providing medical care worldwide. This study aims to highlight the implications of establishing telemedicine policies in Korea. Japan’s telemedicine policies were reviewed from the time of the first trial to the present official allowance.Current Concepts: Since telemedicine demonstration work began in 1971, telemedicine in Japan has advanced in four stages. The first stage was the operation of a remote regional comprehensive medical information system from 1971 to 1997. The second stage was when telemedicine was officially institutionalized from 1997 to 2018. The third stage was the time of expansion of telemedicine, from the announcement of the “Guidelines for the Implementation of Proper Online Care” in 2018 to when online first-time examinations were temporarily allowed in 2020. The fourth stage began in 2021 when the “Permanent Establishment of Special Cases for Online Care” was announced, and telemedicine has been officially allowed to supplement face-to-face care. Telemedicine usage was estimated to be about 53.65 million in 2021, and the total number of treatments in Japan in 2021 was estimated to be about 1.32 billion, accounting for about 4.1% of medical care.Discussion and Conclusion: For the Korean government to establish telemedicine, it needs to be promoted step by step through discussions with the medical community. Also, an appropriate medical remuneration system needs to be prepared along with guidelines reflecting the opinions of the medical community to secure the safety of telemedicine.
2.Current status and implications of policy developments regarding enrollment quotas in Japanese medical schools
Joohyun KANG ; Kye Hyun KIM ; Yohan SHIN
Journal of the Korean Medical Association 2024;67(11):710-716
Following the government’s unilateral announcement to increase medical school quotas, serious concerns are rising over the development of medical education and future healthcare in South Korea. Medical experts are disappointed by the lack of transparent decision-making. Unlike major developed countries that establish specialized bodies with expert involvement to set physician workforce policies, the Korean government plans to create a “human resource supply and demand estimation adjustment system” without sufficient consultation with medical professionals. This study analyzes Japan’s policy process regarding medical school quotas to derive implications for establishing governance for physician workforce supply and demand in Korea.Current Concepts: In Japan, the Physician Supply and Demand Subcommittee, mostly comprising medical experts, conducts in-depth discussions on adjusting physician supply and addressing regional disparities. Their discussions are transparent and publicly disclosed, influencing policy decisions such as gradual adjustments to quotas and measures to improve physician distribution.Discussion and Conclusion: Japan’s approach demonstrates the importance of involving medical experts in policymaking and ensuring transparency. The Japanese government collaborates with medical professionals to accurately project physician supply and demand, and adjusts medical school quotas gradually. In contrast, Korea’s abrupt plan to increase quotas without thorough expert consultation may lead to unintended consequences. It is imperative for the Korean government to form consultative bodies centered around medical experts to engage in in-depth discussions, ensuring that policies are realistic and effectively addressing challenges such as population decline and regional healthcare disparities.
3.Current status and implications of policy developments regarding enrollment quotas in Japanese medical schools
Joohyun KANG ; Kye Hyun KIM ; Yohan SHIN
Journal of the Korean Medical Association 2024;67(11):710-716
Following the government’s unilateral announcement to increase medical school quotas, serious concerns are rising over the development of medical education and future healthcare in South Korea. Medical experts are disappointed by the lack of transparent decision-making. Unlike major developed countries that establish specialized bodies with expert involvement to set physician workforce policies, the Korean government plans to create a “human resource supply and demand estimation adjustment system” without sufficient consultation with medical professionals. This study analyzes Japan’s policy process regarding medical school quotas to derive implications for establishing governance for physician workforce supply and demand in Korea.Current Concepts: In Japan, the Physician Supply and Demand Subcommittee, mostly comprising medical experts, conducts in-depth discussions on adjusting physician supply and addressing regional disparities. Their discussions are transparent and publicly disclosed, influencing policy decisions such as gradual adjustments to quotas and measures to improve physician distribution.Discussion and Conclusion: Japan’s approach demonstrates the importance of involving medical experts in policymaking and ensuring transparency. The Japanese government collaborates with medical professionals to accurately project physician supply and demand, and adjusts medical school quotas gradually. In contrast, Korea’s abrupt plan to increase quotas without thorough expert consultation may lead to unintended consequences. It is imperative for the Korean government to form consultative bodies centered around medical experts to engage in in-depth discussions, ensuring that policies are realistic and effectively addressing challenges such as population decline and regional healthcare disparities.
4.Current status and implications of policy developments regarding enrollment quotas in Japanese medical schools
Joohyun KANG ; Kye Hyun KIM ; Yohan SHIN
Journal of the Korean Medical Association 2024;67(11):710-716
Following the government’s unilateral announcement to increase medical school quotas, serious concerns are rising over the development of medical education and future healthcare in South Korea. Medical experts are disappointed by the lack of transparent decision-making. Unlike major developed countries that establish specialized bodies with expert involvement to set physician workforce policies, the Korean government plans to create a “human resource supply and demand estimation adjustment system” without sufficient consultation with medical professionals. This study analyzes Japan’s policy process regarding medical school quotas to derive implications for establishing governance for physician workforce supply and demand in Korea.Current Concepts: In Japan, the Physician Supply and Demand Subcommittee, mostly comprising medical experts, conducts in-depth discussions on adjusting physician supply and addressing regional disparities. Their discussions are transparent and publicly disclosed, influencing policy decisions such as gradual adjustments to quotas and measures to improve physician distribution.Discussion and Conclusion: Japan’s approach demonstrates the importance of involving medical experts in policymaking and ensuring transparency. The Japanese government collaborates with medical professionals to accurately project physician supply and demand, and adjusts medical school quotas gradually. In contrast, Korea’s abrupt plan to increase quotas without thorough expert consultation may lead to unintended consequences. It is imperative for the Korean government to form consultative bodies centered around medical experts to engage in in-depth discussions, ensuring that policies are realistic and effectively addressing challenges such as population decline and regional healthcare disparities.
5.The current status and implications of the medical insurance fee schedule in Japan
Yohan SHIN ; Kye Hyun KIM ; Sung Je MOON ; Joohyun KANG
Journal of the Korean Medical Association 2023;66(12):741-746
Korea has the most rapidly aging population in the world. Medical costs for the elderly are quickly increasing, which raises concerns about the sustainability of health insurance finances. Accordingly, the need to allocate limited medical resources efficiently has increased, with improving the fee schedule seen as an effective way to achieve this. Japan has experienced a super-aging society for at least 20 years prior to Korea and has been successful in improving its fee schedule. Korea’s fee schedule, however, needs to overcome the challenge of being relatively limited in type and simplicity.Current Concepts: The new patient consultation fee in Japan is the same regardless of the type of medical institution and is approximately 40% higher than found in Korea. In the case of established patient consultations, the fee for medical institutions with fewer than 200 beds are substantially higher than for large medical institutions, thereby suppressing re-examination at large hospitals. Japan’s additional points consist of 71 types of items, which is more diverse than Korea’s 28 types, and the additional points for children under six years of age, holidays, and late nights are set significantly higher than that found in Korea.Discussion and Conclusion: Japan designed its fee schedule to structurally reduce the consumption of medical resources and to effectively compensate for the behavior of medical providers. This policy is a standard which Korea’s fee schedule should aim for. In the future, it will be necessary to prepare measures to respond to the super-aging environment through detailed research concerning Japan’s fee schedule.
6.Improvement strategies for accessibility and quality of rehabilitation medicine through a Korea-Japan comparative study
Yohan SHIN ; Kye Hyun KIM ; Bongsik WOO ; Joohyun KANG
Journal of the Korean Medical Association 2024;67(12):781-787
Rehabilitation medicine in Korea has improved significantly; however, the rehabilitation medical delivery system still lacks well-established continuity and comprehensiveness. Since 2000, Japan has implemented a convalescent rehabilitation ward system, with continuous improvements in policies and criteria based on clinical needs. This study compared the rehabilitation systems of Korea and Japan, focusing on institutional standards and the scope of target patients in order to explore directions for enhancing the Korean system.Current Concepts: Japan applies a multi-tiered reporting system for rehabilitation wards, categorizing wards and adjusting reimbursements based on performance indicators such as functional improvement rates, discharge-tohome rates, and rehabilitation effectiveness indices. Additionally, Japan’s policies encompass a broad range of target diseases and flexible admission criteria, improving accessibility. In Korea, the scope of target diseases is relatively narrow, limiting opportunities for patients to receive appropriate rehabilitation treatment.Discussion and Conclusion: Korea could benefit from adopting a multitiered system and performance-based reimbursement structure, as seen in Japan’s model. Expanding the range of eligible conditions and reviewing certification requirements can enhance the accessibility and quality of rehabilitation services. These changes are expected to foster an environment in which patients can receive timely and comprehensive rehabilitation care, thereby facilitating physical recovery and reintegration into society.
7.Improvement strategies for accessibility and quality of rehabilitation medicine through a Korea-Japan comparative study
Yohan SHIN ; Kye Hyun KIM ; Bongsik WOO ; Joohyun KANG
Journal of the Korean Medical Association 2024;67(12):781-787
Rehabilitation medicine in Korea has improved significantly; however, the rehabilitation medical delivery system still lacks well-established continuity and comprehensiveness. Since 2000, Japan has implemented a convalescent rehabilitation ward system, with continuous improvements in policies and criteria based on clinical needs. This study compared the rehabilitation systems of Korea and Japan, focusing on institutional standards and the scope of target patients in order to explore directions for enhancing the Korean system.Current Concepts: Japan applies a multi-tiered reporting system for rehabilitation wards, categorizing wards and adjusting reimbursements based on performance indicators such as functional improvement rates, discharge-tohome rates, and rehabilitation effectiveness indices. Additionally, Japan’s policies encompass a broad range of target diseases and flexible admission criteria, improving accessibility. In Korea, the scope of target diseases is relatively narrow, limiting opportunities for patients to receive appropriate rehabilitation treatment.Discussion and Conclusion: Korea could benefit from adopting a multitiered system and performance-based reimbursement structure, as seen in Japan’s model. Expanding the range of eligible conditions and reviewing certification requirements can enhance the accessibility and quality of rehabilitation services. These changes are expected to foster an environment in which patients can receive timely and comprehensive rehabilitation care, thereby facilitating physical recovery and reintegration into society.
8.Improvement strategies for accessibility and quality of rehabilitation medicine through a Korea-Japan comparative study
Yohan SHIN ; Kye Hyun KIM ; Bongsik WOO ; Joohyun KANG
Journal of the Korean Medical Association 2024;67(12):781-787
Rehabilitation medicine in Korea has improved significantly; however, the rehabilitation medical delivery system still lacks well-established continuity and comprehensiveness. Since 2000, Japan has implemented a convalescent rehabilitation ward system, with continuous improvements in policies and criteria based on clinical needs. This study compared the rehabilitation systems of Korea and Japan, focusing on institutional standards and the scope of target patients in order to explore directions for enhancing the Korean system.Current Concepts: Japan applies a multi-tiered reporting system for rehabilitation wards, categorizing wards and adjusting reimbursements based on performance indicators such as functional improvement rates, discharge-tohome rates, and rehabilitation effectiveness indices. Additionally, Japan’s policies encompass a broad range of target diseases and flexible admission criteria, improving accessibility. In Korea, the scope of target diseases is relatively narrow, limiting opportunities for patients to receive appropriate rehabilitation treatment.Discussion and Conclusion: Korea could benefit from adopting a multitiered system and performance-based reimbursement structure, as seen in Japan’s model. Expanding the range of eligible conditions and reviewing certification requirements can enhance the accessibility and quality of rehabilitation services. These changes are expected to foster an environment in which patients can receive timely and comprehensive rehabilitation care, thereby facilitating physical recovery and reintegration into society.
9.Experiences of Interpersonal Relationships among Head Nurses in General Hospital Settings.
Myungsun YI ; Hyun Sook KANG ; Dong Oak KIM ; Won Ock KIM ; Joohyun KIM ; Byoung Sook LEE
Journal of Korean Academy of Adult Nursing 2009;21(3):324-338
PURPOSE: The purpose of this study was to understand the experiences of interpersonal relationships of head nurses in interacting with others in general hospital settings. METHODS: The data were collected by individual in-depth interviews from seven head nurses and were analyzed using qualitative content analysis. RESULTS: Five major categories emerged and they represent a major strategy according to five different groups of interacting people. 'Establishing trust' was identified as the key strategy in dealing with patients and family members. 'Embracing with sisterly love' and 'helping with self-defense' were major strategies for subordinate nurses and physicians, respectively. 'Respecting and recognizing' was the main approach for other professionals such as dietitians and 'emphasizing rules and educating' were a major one for non-professionals. Head nurses paid more attention and made efforts in dealing with their subordinate nurses than with other groups of people, because they felt the most difficulty in their relationship with subordinate nurses. CONCLUSION: The results of the study showed that head nurses employ unique strategies in interacting with different groups of people to increase the efficiency of communication. This study would help nurse administrators establish an effective program for improving interpersonal relationships of head nurse.
Head
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Hospitals, General
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Humans
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Interdisciplinary Communication
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Interpersonal Relations
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Nurse Administrators
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Nursing, Supervisory
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Qualitative Research
10.Heptachlor induced nigral dopaminergic neuronal loss and Parkinsonism-like movement deficits in mice.
Seokheon HONG ; Joohyun HWANG ; Joo Yeon KIM ; Ki Soon SHIN ; Shin Jung KANG
Experimental & Molecular Medicine 2014;46(2):e80-
Epidemiological studies have suggested an association between pesticide exposure and Parkinson's disease. In this study, we examined the neurotoxicity of an organochlorine pesticide, heptachlor, in vitro and in vivo. In cultured SH-SY5Y cells, heptachlor induced mitochondria-mediated apoptosis. When injected into mice intraperitoneally on a subchronic schedule, heptachlor induced selective loss of dopaminergic neurons in the substantia nigra pars compacta. In addition, the heptachlor injection induced gliosis of microglia and astrocytes selectively in the ventral midbrain area. When the general locomotor activities were monitored by open field test, the heptachlor injection did not induce any gross motor dysfunction. However, the compound induced Parkinsonism-like movement deficits when assessed by a gait and a pole test. These results suggest that heptachlor can induce Parkinson's disease-related neurotoxicities in vivo.
Animals
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*Apoptosis
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Astrocytes/drug effects/pathology
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Cell Line, Tumor
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Cells, Cultured
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Dopaminergic Neurons/*drug effects/pathology
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Gait
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Heptachlor/*toxicity
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Humans
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*Locomotion
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Mice
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Neurotoxicity Syndromes/etiology/physiopathology
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Parkinsonian Disorders/chemically induced
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Pesticides/*toxicity
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Substantia Nigra/*drug effects/pathology/physiopathology