The purpose of this study was to explore the difference of defense mechanisms between medicine and surgery groups, and between residents and specialists who were professors of a medical school. The author evaluated the defense mechanisms by using Ewha Defense Mechanisms Test. The author compared the defense mechanisms of medicine and surgery specialist groups who are employed by Soonchunhyang university hospital as professors in 2000, and of medicine and surgery resident groups in 1999. First, there were significant differences in mean scores of the defense mechanisms ratings. In surgery specialist group, the rate of using projection and show-off were significantly higher than those of medicine group. In resident group, show-off, passive-aggression, dissociation, somatization, acting-out and regression were significantly higher than those of specialist group. In medicine group, residents were higher than specialists in show-off, passive-aggression, acting-out and regression. But for the specialist group, the score on anticipation was higher than in the resident group. In surgery group, residents were higher than specialists in identification, rationalization and regression. In the interaction, analysis by hierarchy and field anticipation and altruism have a significant interaction effect. Second, in comparison of maturity level between the field of speciality and level of hierarchies, surgery group used more neurotic and narcissistic defense than medicine group significantly. For the level of hierarchies, residents used more immature and neurotic defense than specialists. In medicine group, residents used immature defense more than specialists, but more mature defenses were used in specialists than residents significantly. In surgery group, residents used more immature and neurotic defenses than specialists. Mature defenses have more interaction effect. This results may reflect the fact that discipline in surgery have characteristic apprentices system and more dramatical therapeutic approach. The results seem to be useful in understanding the optimal character for each speciality. In the process of selecting spescialities evaluating one's defenses and matching with the characteristics and coping mechanisms of each specialty group can be helpful.
Altruism ; Defense Mechanisms ; Rationalization ; Schools, Medical ; Specialization

OBJECTIVE: To analyze the medical equipment operation data of 44 clinical departments in the hospital from three aspects: materials and consumables, operation and maintenance depreciation, and operation management. METHODS: To formulate the evaluation standards and scoring criteria for the operation indicators, the lowest score is 0 points, and the highest score is 5 points. Based on the operation indicators of medical equipment, establish a hierarchical structure model, determine the criterion layer and sub-criteria layer, construct a judgment matrix, normalize it, and calculate the weight coefficient. RESULTS: Count equipment operation data in 2021 and 2022. Score according to the assessment standards, assign weights through the analytic hierarchy process, calculate the total score and sort, and making a special analysis on the top 10 departments and departments with a score below 4 points, and formulate a rectification plan. CONCLUSIONS The establishment of index assessment standards and the weight distribution of AHP can effectively enhance the control of equipment operating costs.
Analytic Hierarchy Process ; Rationalization ; Surgical Equipment ; Reference Standards ; Cost Control

According to 2005 OECD health data, the total Korean expenditure on health in percentage of GDP is 6%, while other OECD countries spend an average 10% of their GDP. Accordingly, health and medical professionals uniformly point out that the idea of 'proper medical treatment with a reasonable fee' is unfair. Hence, the rationalization of the national health insurance rate is a step toward the financial stability of the national health insurance system and a way to further the realization of proper medical care. The importance of strengthening national health insurance coverage through financial expansion on the national health insurance system should be recognized as an urgent social and political issue.
Delivery of Health Care ; Guanosine Diphosphate ; Health Expenditures ; Insurance ; National Health Programs ; Quality Improvement ; Rationalization

In 2000, Korea Health Industry Development Institute(KHIDI) made a plan for sharing electronic patient records between health care institutions which reflects the advance of information technology. The implementation of the plan is believed to have a number of desirable effects such as direct and indirect medical cost savings, the increase in patient satisfaction, the rationalization of health care institution management, and the improvement of health care delivery system. At the same time, however, it requires a great amount of resources for building the system at first and maintaining it since then nationwide. Therefore, the economic evaluation is required for the plan to be undertaken. This paper assessed the plan from economic perspective. In particular, cost-benefit analysis was performed and the result showed that the present value of net benefit, or the social profit is 3,046.3 billion won over the period of 2000-2030. Also, the benefit-cost ratio turned out to be 1.25. The results of cost-benefit analysis confirmed that the benefits of the plan justify the costs.
Cost Savings ; Cost-Benefit Analysis* ; Delivery of Health Care* ; Humans ; Information Dissemination ; Korea ; Patient Satisfaction ; Rationalization

BACKGROUND: In times of continuous change and volatile markets, organizations are increasingly characterized by downsizing, work intensification, and resource rationalization. This has resulted in diversification, and the emergence of new risks within the field of occupational health and safety, with an important impact. This paper focuses on one such type of risk in the modern workplace-psychosocial risks. The current study aimed to explore stakeholder perspectives, regarding the extent to which psychosocial risks are incorporated into strategic risk management practices, at both the business and policy level. METHODS: Semi-structured interviews were conducted with 14 professionals, representing employer, expert, policy maker, and trade union stakeholder perspectives. RESULTS: It was found that the majority of organizations do not sufficiently, if at all, understand and incorporate psychosocial risks into strategic decision making, whereby the key barrier related to practical difficulties of not knowing how to manage psychosocial risks adequately. CONCLUSION: The study found that there is a need to close the gap between policy and practice on a number of levels. Future recommendations comprise a policy framework and infrastructure underpinned by educational initiatives, partnerships, and networks to drive a shift in attitudes toward recognizing the duality of the concept of risk (including both potential negative and positive outcomes) and moving beyond simple regulatory compliance.
Administrative Personnel ; Commerce* ; Compliance ; Decision Making ; Humans ; Labor Unions ; Occupational Health ; Policy Making* ; Rationalization ; Risk Management*

The objectives of the study were to provide the basic informations needed in the development of balanced medical services throughout the nation. As the national health care system was expanding rapidly along with the economic growth, quantitative re-evaluation of the system is of great need. For that reason, characteristics of the admitted patients were analyzed for the case-mix and patients' flow within and through regions. Materials were 421,530 cases of inpatients, who were reported through Medical Insurance Corporation(KMIC) for insurance claim, during the period of March 1, 1985 through February 28, 1987. Korean Diagnosis Related Groups(K-DRGs) classification system was adopted for the study of case-mix and 189 cities and countries were classified into 5 district groups by factor analysis results of K-DRGs. The major findings of this study were as follows ; 1) Factor analysis of case-mix, employing K-DRG system, revealed 5 distinct functional district groups. Group A(18 district) was prominent for tertiary medical care. In group B(36 districts), rather simple procedures were prevalent. Group C(26 districts) was distinctive for the medical care of well organized internal medicine practices with qualified clinical laboratories. Group D(17 districts) was characterized by relatively high balanced medical care. Group E (92 districts) was with very low level of medical care. 2) Analysis of the case-flow through the districts showed 3 types of flow patterns ; inflow, outflow, and balanced types. Inflow type of case-flow was found in Group A, C and D while Group B and E showed outflow type. Inflow was most prominent in Group A and Group E was of typical outflow type. Group B was consistently the outflow type except for Major Diagnostic Category XX regardless of the disease treaders, but Group C and D were inflow or outflow types according to the disease tracers.
Classification ; Delivery of Health Care* ; Diagnosis ; Economic Development ; Factor Analysis, Statistical ; Humans ; Inpatients* ; Insurance ; Internal Medicine ; Rationalization

PURPOSE: The purpose of this study was to identify the major trends in research studies in the Journal of Korean Academy of Nursing Administration from 2010 to 2012. METHODS: A review using analysis criteria developed by researchers was done of 132 studies published between 2010 and 2012. Research design, participants, research domain, and keywords were analyzed from the Journal of Korean Nursing Administration. RESULTS: Job satisfaction, stress, organizational commitment, safety, turnover, nursing education, and performance were found to be major keywords. Of the research in the Journal, quantitative methods were used in 93.2% of studies. The major setting and participants were hospitals (58.2%) and nurses (65.5%) respectively. Prevalent analysis methods used were t-test, ANOVA, correlation, regression, chi-square, AMOS, and factor analysis. Major domains in the articles were: controlling, directing, staffing, nursing management education, and professionalism & legal principles. CONCLUSION: Through this study, the research trends in nursing administration were identified, but there is a need to include more of the following topics in future research: new concepts in nursing policy, enhanced deliberations of IRB, rationalization of the effects in sample size calculations, theoretical development of planning and organizing, and development of interventions for management support of the nursing management process.
Education ; Education, Nursing ; Ethics Committees, Research ; Job Satisfaction ; Methods ; Nursing Research ; Nursing* ; Rationalization ; Research Design ; Sample Size

OBJECTIVE: A defense mechanism is an automatic psychological process necessary for successful adaptation. It reflects adaptive capacity. The purpose of this study is to explore the relationship between the adaptation ability of individuals who face mandatory military service and the pattern of defense mechanisms. METHODS: The subjects were 69 men (21.4±2.2 years) who expressed psychological difficulties in three military service situations. Control group was 36 men (24.0±1.4 years) who had successfully completed military service. We examined psychiatric history, the pattern of defense mechanisms, and depression and anxiety levels. Defense mechanisms were compared between two groups. RESULTS: The maladjusted group used immature defenses more frequently than the control group did. There were no differences in the defense patterns according to diagnosis. The control group used more identification and rationalization, classified as immature defenses. The temporarily maladjusted group used more somatization, regression, and avoidance. CONCLUSION: Using mature defense mechanisms helped young adults to adapt to a particular situation. The maturity of the defense is more valuable than the psychiatric diagnosis. Some immature defenses are also helpful to adapt. We cautiously assume that some defenses can be protective or risk factors in adapting to stressful situations by young adults.
Anxiety ; Defense Mechanisms ; Depression ; Diagnosis ; Humans ; Korea ; Male ; Mental Disorders ; Military Personnel ; Rationalization ; Risk Factors ; Social Adjustment ; Young Adult

OBJECTIVES: The purpose of this study was to evaluate the characteristics of personality factor and defense mechanism and relationship with depression and social disability. METHODS: Study subjects consisted of 35 panic disorder patients diagnosed with the criteria of DSM-IV. Data were collected through Sixteen Personality Factor Questionnaire, Ehwa Diagnostic Test of Defense Mechanism, Beck Depression Inventory and Sheehan Disability Scale. Statistics employed for the analyses were Pearson correlation and independent sample t-test. RESULTS: In personality factors and defense mechanisms, there were no definitely abnormal range of scores. But, among personality factors, tension/anxiety factor scored high and unstableness/stableness, shyness/boldness and praxernia/atunia were in low range of score. In defense mechanism, somaticzation and acting-out scored high and humor, suppression, altruism, avoidance and rationalization scored low. The mean BDI score was 18.25+/-9.97. The mean score of SDS were 4.88+/-3.11 in work category and 4.57+/-2.92 in social/leasure category. Male patients were significantly correlated with guit-proneness and atuia in personality factor and passive- aggressiveness, projection, denial and show-off in defense mechanism, compared with female patients (p<0.05). The patients' age was correlated with low intelligence in persolity factor and dissociation and anticipation in defense mechanism. It was negatively correlated with show-off (p<0.05). The BDI score was correlated with low intelligence, superego, unstableness, self-conflict, high superego and atunia in personality factor and dissociation and somatization in defense mechanism (p<0.05). There was a significant relationship between BDI score and SDS work category (p<0.05). CONCLUSION: Panic disorder patients show high score of tension/anxiety factor and they frequently use neurotic defense style like somatization. The depressive symptom, which depends on symptom severity, appears to have influence on work category and to cause social disability.
Altruism ; Defense Mechanisms ; Denial (Psychology) ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Diagnostic Tests, Routine ; Female ; Humans ; Intelligence ; Male ; Panic Disorder* ; Panic* ; Surveys and Questionnaires ; Rationalization ; Superego

This study is to review the emergence of new psychiatrists, scientific rationalization, and popular internalization to reorganize the formation process of modern psychological medicine system. Unlike eugenic psychiatry from the Japanese Colonial Era, the social conditions and contexts forming autonomous system of psychiatry of Korea in the 1960s and 1970s have been concentrated. The discussion approach has been tried to secure two perspectives-treatment and criticism-at the same time and to expand the time and scope of study through the extensive texts such as newspapers, magazines, books, advertisements, and others in the 1960s and 1970s. Through formation of subject, rationalization, and popularization, this study has surveyed the characteristics of psychiatry in the 1960s and 1970s to accentuate complicated conditions and kinetic steps to systemize psychiatry as scientific field to promote treatment of patients by deviating from mental hygiene approaching national mental health from cleanliness and removal. The characteristics are summarized as follows. First, as the ethical models of good doctors, medical paternalistic doctors, and non-authoritarian symmetric doctors have been proposed as good psychiatrists by new medical specialists with experience of globality, a new subject emerges. However, there has been illegalization process of unlicensed medical practitioner excluded by the regulatory authority called “clearness.” Second, the rationalization of psychiatry has been accelerated through the dispute of enactment of Mental Hygiene Law, segmentalization of concept of mental illness, and scientific characteristics. Especially, the disputes over enactment of Mental Hygiene Law focused on criminalization of mental patients brought a result to regulate the patients as the target of humanistic treatment and potential criminals at the same time. Third, popularization of psychiatry has embraced invisible mental illness into popular daily life through visual measure called medicine advertisement, and through the discussion about social neurosis, a new paradigm for diagnosis of Korean society has been proposed. Moreover, by focusing on autobiographical works with voices of patients, this article reveals a new doctor-patient relationship.
Asian Continental Ancestry Group ; Criminals ; Diagnosis ; Dissent and Disputes ; Humans ; Jurisprudence ; Korea* ; Mental Health* ; Mentally Ill Persons ; Periodicals ; Periodicals as Topic ; Psychiatry ; Rationalization ; Social Conditions ; Specialization ; Voice