Types Of Medical Institutions Research Articles

Strategies to enhance public health doctor system in South Korea

Background: South Korea’s public health doctor system requires physicians to provide primary healthcare in medically underserved areas, such as rural regions, as an alternative to mandatory military service. Recently, concerns have arisen over the decline in the number of public health doctors available in these underserved areas. This study reviews issues related to the public health doctor system and proposes strategies for enhancing its management.Current Concepts: The annual number of public health doctors has steadily decreased by approximately 46.6%, from 1,962 in 2008 to 1,048 in 2022. According to the survey, the reasons behind this decline include the lengthy service period of 36 months compared to the 18-month military service, poor working conditions, low financial support, unreasonable manpower deployment, and uncertain social status.Discussion and Conclusion: Several recommendations can enhance the effectiveness of the public health doctor system. First, the mandatory service period of 36 months should be shortened, and a military training period of 1–2 months should be incorporated into the overall service duration. Second, ensuring appropriate working hours, including holidays, along with improved working conditions and reasonable financial support and compensation, is essential. Third, the role of public health doctors should shift from solely providing basic primary healthcare to acting as public health managers in local communities. Lastly, a long-term plan should be developed to establish various types of medical institutions in medically underserved regions.

감염관리담당인력을 위한 감염관리교육프로그램 운영실태 및 교육요구에 관한 연구

This study was the basic data necessary to develop a training program for infection control personnel by understanding the present status and needs of infection control training programs. This is a mixed-method research using a mixture of descriptive surveys and focus interviews. A descriptive study was conducted in 9 institutions that satisfied the criteria as a training institution for those working in infection control office under the Enforcement Rules of the Medical Service Act. For the study, a survey was conducted from October 31 to November 7, 2022. Focus group interviews were conducted separately with six doctors and six nurses. Survey results showed that 31 training programs on infection control were conducted in 2022 at the nine institutions, with 5,179 participants and an average duration of 9.32 hours. About 64.5% of the cases were participants of the training program involved in two or more occupations, and there was no separate training program for other participants recognized by the heads of medical institutions. As for the training methods, face-to-face and online schemes showed similar results in the survey, but the subjects preferred face-to-face education. In this study, there was a lack of specialized training programs tailored to various types of medical institutions and training programs targeting some occupations. Therefore, cooperative efforts by each organization are needed to establish governance to set up a step-by-step infection control education system that can meet education demans and provide systematic education, such as integrating or developing new programs.

Effects of intensive care unit quality assessment on changes in medical staff in medical institutions and in-hospital mortality

BackgroundQuality assessments are being introduced in many countries to improve the quality of care and maintain acceptable quality levels. In South Korea, various quality assessments are being conducted to improve the quality of care, but there is insufficient evidence on intensive care units (ICUs). This study aims to evaluate the impact of ICU quality assessments on the structural indicators in medical institutions and the resulting in-hospital mortality of patients.MethodsThis study used data collected in the 2nd and 3rd ICU quality assessments in 2017 and 2019. A total of 72,879 patients admitted to ICUs were included during this period, with 265 institutions that received both assessments. As for structural indicators, changes in medical personnel and equipment were assessed, and in-hospital deaths were evaluated as patient outcomes. To evaluate the association between medical staff and in-hospital mortality, a generalized estimating equation model was performed considering both hospital and patient variables.ResultsCompared to the second quality evaluation, the number of intensivist physicians and experienced nurses increased in the third quality evaluation; however, there was still a gap in the workforce depending on the type of medical institution. Among all ICU patients admitted during the evaluation period, 12.0% of patients died in the hospital. In-hospital mortality decreased at the 3rd assessment, and hospitals employing intensivist physicians were associated with reduced in-hospital deaths. In addition, an increase in the number of experienced nurses was associated with a decrease in in-hospital mortality, while an increase in the nurse-to-bed ratio increased mortality.ConclusionsICU quality assessments improved overall structural indicators, but the gap between medical institutions has not improved and interventions are required to bridge this gap. In addition, it is important to maintain skilled medical personnel to bring about better results for patients, and various efforts should be considered. This requires continuous monitoring and further research on long-term effects.

The Delivery Model of Perceived Medical Service Quality Based on Donabedian's Framework.

The implementation of the National Health Insurance has transformed the medical care landscape in Taiwan, rendering perceived medical service quality (PMSQ) and patient satisfaction significant focal points in medical care management. Past studies mostly focused on the technical aspects of medical care services, while overlooking the patients' perception of services and the delivery process of PMSQ in the medical care experience. This study integrated the theoretical framework of the Donabedian SPO model and the SERVQUAL questionnaire. The survey was conducted among the outpatients of three types of medical institutions in northern Taiwan: academic medical centers, metropolitan hospitals, and local community hospitals. A total of 400 questionnaires were collected, and 315 valid questionnaires remained after eliminating the incomplete ones. This study established a PMSQ delivery model to explore patients' perceptions of medical service quality. It was found that the variable, Assurance, could deliver the PMSQ and enhance the Medical outcome (MO), while improving the variable, Tangible, in medical institutions could not significantly enhance the MO. These findings emphasize the importance of healthcare institutions prioritizing the professional background, demeanor of their healthcare staff, treatment methods, and processes over tangible elements.

Nurse Wage Status and Wage determinants

Purpose: The purpose of this study is to identify the causes of the shortage of nurses in local small and medium-sized hospitals by confirming the wage status according to the characteristics of nurses and the characteristics of medical institutions and analyzing the factors affecting the wages of nurses.Methods: The study was conducted by linking the DB of medical institutions owned by the National Health Insurance Corporation, DB of medical personnel, and DB of health insurance qualification. As of the end of 2018, only nurses working at hospital-level medical institutions who were reported to the Health Insurance Review & Assessment Service were registered as registered members of the health insurance at the medical institution. The dependent variables were the monthly average wage of nurses, and the independent variables were age, institution establishment, medical institution type, region, and number of beds. In the analysis, first, wages by individual and institutional characteristics were identified through basic statistical analysis, and factors affecting wages were analyzed through regression analysis.Result: As a result, the wages of nurses increased 71,184 won as the age increased, and the establishment of medical institutions was 291,574 won less and corporations 660,725 won less than the national government. The types of medical institutions were 400,964 won less and 675,829 won less than general hospitals. The size of the city was 325,989 won less in metropolitan cities and 263,672 won less in metropolitan areas than in the metropolitan area. As the number of beds at medical institutions increased by one bed, it was 708 won higher.Conclusion: According to the analysis of the wage status according to the characteristics of nurses’ personal characteristics and medical institutions, and the wage determinants of nurses, the relatively low wages of nurses in local small and medium hospitals were the main cause of job shortage. The market principle is that the wage increases if there is a shortage of supply in the labor market compared to the demand of nurses. On the contrary, the wage is lower in local SMEs. As a result, there seems to be some nurses who give up their activities. In order to resolve the labor shortage in local small and medium-sized hospitals, it is necessary to narrow the wage gap, and to create a working environment such as elastic working so that the daily work can be balanced.

The Impact of COVID-19 on Medical Institutions in Korea: Focusing on Financial Losses

Purposes: It is known that medical institutions suffered substantial financial losses due to the COVID-19 pandemic, but studies that specifically identified the size of losses are lacking. This study aims to analyze in detail how much financial loss medical institutions suffered in 2020, at the beginning of the COVID-19 pandemic.Methodology: This study used national health insurance claim data from 2018 to 2020 provided by the Health Insurance Review and Assessment Service. Financial losses were conceptualized and classified as the increase or decrease in total medical expenses or the proportion of increased or decreased institutions. The trend of total medical expenses was analyzed by medical institution type, health insurance qualification type, and treatment type (inpatient/outpatient).Findings: The results showed that the decrease in medical expenses due to COVID-19 was the largest at clinic-level medical institutions, and the distribution of each clinic’s increases and decreases was wide. In addition, almost all of the pediatrics and otolaryngology clinics had a reduction in medical expenses due to COVID-19.Practical Implications: Medical institutions have been pleading about the pain caused by the COVID-19 pandemic. However, it was known that the decrease in total medical expenses in 2020 compared to 2019 was insignificant. This study overcame the trap of average through more detailed analyses, confirming the need for differentiated policy support in the event of a similar situation.

The current status and implications of the medical insurance fee schedule in Japan

Background: 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.

Trends in Nasal Septal and Inferior Turbinate Surgery in Korea From 2010 to 2022

Background and Objectives: Since the introduction of nasal valve surgery, trends in septoplasty and inferior turbinate surgery (ITS) have changed in Korea. However, a detailed analysis of these changes has yet to be conducted.Methods: Data on septoplasty and ITS performed from 2010 to 2022 were extracted from the Health Insurance Review and Assessment Service (HIRA) Bigdata Open portal and trends were analyzed. Analyses according to the type of medical institution, patient sex and age, and the specialty of the surgeon were also conducted.Results: The frequency of both septoplasty and ITS gradually decreased from 2012 to 2017, which marked the low point, and the frequency of these procedures gradually increased thereafter. In 2010, 41.5% of septoplasty procedures were performed in general hospitals, 7.3% in hospitals, and 47.3% in clinics. However, the proportion of these procedures performed in general hospitals subsequently decreased, while the corresponding proportion in hospitals and clinics increased. Both septoplasty and ITS were performed more than twice as often in men than in women. The number of patients under the age of 19 decreased, while the number of female patients aged 20–29 increased. The number of septoplasty procedures performed by plastic surgeons increased.Conclusion: Since the introduction of nasal valve surgery, the number of septoplasty procedures performed by plastic surgeons has increased.

Classification of healthcare facilities: national approach and foreign experience

The article is devoted to the definition, taking into account foreign experience, of the classification of health care institutions, the analysis of their main types, the outline of problems and shortcomings of the national systematization of medical institutions, the determination of factors influencing the types of medical institutions on their architectural planning. The purpose of the publication is the study of the classification of medical institutions in Ukraine and in foreign countries, the analysis of the main types of medical institutions, the determination of the level of influence of the variety and the purpose of the medical institution on its architectural and planning solution. The article examines the classifications of medical institutions in Ukraine and in foreign countries, emphasizes the dependence of the design of the architectural and planning organization of health care institutions on the purpose, scope and type of medical institution. In Ukraine, despite the approval of the new DBN V.2.2-10:2022 "Health care facilities", the list of types of health care facilities is determined by the order of the Ministry of Health of Ukraine dated 10.28.2002 No. 385. At the same time, an analysis of the normatively approved classification of health care institutions is evidenced by its shortcomings, lack of systematicity, lack of clearly defined relevant classification criteria, in some places, the obsolescence of some of its provisions and inappropriate detailing. In this aspect, it is emphasized the need to revise the classification of health care facilities, which was approved by the mentioned order, taking into account modern realities and foreign experience, their functional purpose and architectural and design solution.

The Trend of Clostridioides difficile Infection in Korean Hospitals with the Analysis of Nationwide Sample Cohort

Background: Clostridioides (Clostridium) difficile is an important pathogen that causes diarrhea in people who take antibiotics. The recent status of C. difficile infection is not well known in Korea. Methods: The long-term trend of C. difficile infection in Korean hospitals was analyzed using a nationwide sample cohort. The data also included sociodemographic characteristics, disease severity, and healthcare facilities. C. difficile infection was defined by the prescription of oral vancomycin or all metronidazole prescriptions under C. difficile infectious disease code (A047). Results: The rate of C. difficile infection has steadily increased from 0.030% in 2006 to 0.317% in The increased rate correlated to age (0.033% for < 50 years,0.421% for 70–79 years, and 0.758% for > 80 years of age) and the Charlson comorbidity index score (0.048% for zero versus 0.378% for three or more points). It differed by the type of medical institution (0.270% at referral hospitals versus 0.056 % at general hospitals and mental hospitals). Conclusion: The rate of C. difficile infection in Korea is significant in patients with advanced age and disease severity. The results show that C. difficile infection trend has been increasing steadily in Korea.

Analysis of Factors Affecting the Awareness of the Health Care System

Objectives: This study was to analyze whether the factors affecting the awareness of the health care system appear differently. Methods: This study used the 2020 Medical Service Experience Survey, and 12,133 people were selected as the study subjects. Demographic characteristics, chronic disease treatment experience, and type of medical institution were designed as independent variables that affect health care system awareness, and education level, age, perceived health status, income quintile, chronic disease type, and medical service use experience were composed as sub-factors. Results: As a result of analyzing the multiple regression model, it was found that education level, income quintile, age, occupation, perceived health status, and private health insurance subscription were important factors influencing the awareness of the health care system. This showed a positive effect in the higher the education, the higher the income quintile, the higher the age from under 60, the better the perceived health status, the occupation is ‘paid work’, and the private health insurance subscription. Conclusions: It is meaningful that it was found that the awareness of the health care system was low in the low-educational and low-income groups, and that it empirically analyzed and proposed the need for a policy to improve awareness.

Analysis of Dental Antibiotic Prescriptions for Children and Adolescents in South Korea

Antibiotics are used for the prevention and treatment of infections. This study aimed to investigate the patterns of dental antibiotic prescription in children and adolescents. The Health Insurance Review and Assessment Service provided data on patients who visited medical institutions. It was categorized according to year, sex, age, insurance type, dental institution, and region. Chi-square tests, Fisher’s exact tests, and one-way analyses of variance were performed. Statistical analyses were performed using SAS software (ver. 9.2; SAS Institute, Cary, NC, USA). Amoxicillin and cephalosporins, the most commonly used antibiotics, accounted for approximately 96% of the prescriptions. The younger the child, the more antibiotics were prescribed for trauma, pulpitis, and dental abscesses. However, closer to adolescence, the antibiotics were primarily prescribed to manage impacted teeth and periodontal problems. Antibiotics were prescribed for 3.13 days on average. There were significant differences in the prescription rates according to age, sex, type of insurance, type of medical institution, and region (<i>p</i> < 0.05). This study suggested that antibiotic prescriptions should be closely monitored to ensure appropriate usage of antibiotics.

Analysis of Factors Related to Domestic Patient Safety Incidents Using Decision Tree Technique.

To address the increasing number of patient safety incidents, their scope and extent should be assessed and the situations in which they occur determined. This study employed a decision tree analysis based on patient safety incident cases to identify groups at high risk for adverse patient safety incidents and provide data to develop prevention strategies for minimizing their occurrence or recurrence. In total, 8934 patient safety incidents were analyzed using the "2021 Patient Safety Report Data", which were systematically collected by the Korea Institute for Healthcare Accreditation. A decision tree analysis (Chi-square Automatic Interaction Detection) was employed to identify the characteristics associated with the degree of risk for patient safety incidents. The groups most vulnerable to adverse events were those who experienced healthcare-associated infections (HAI) in long-term care facilities, followed by those experiencing HAI in tertiary hospitals, general hospitals, or clinics, and those experiencing fall-related events in neuropsychiatry departments of tertiary hospitals, general hospitals, or clinics. The most important factor in the degree of harm in patient safety accidents was the type of accident, followed by the type of medical institution, and then the treatment department. Particularly, HAI and falls are the most important factors determining the degree of harm in patient safety accidents.

Dental professionals' use of personal protective equipment during COVID-19: a cross-sectional study in China.

Appropriate use of personal protective equipment (PPE) could significantly reduce the risk of viral transmission and infection. This study aimed to assess the use of PPE among dentists during the COVID-19 pandemic in China, explore its influencing factors, and provide some practical recommendations. An online cross-sectional survey was conducted among 384 Chinese dentists in September 2022. The questionnaire comprised a series of questions about demographic characteristics, compliance with proper PPE use, personal barriers to use, and exposure risk estimation. Of the 384 respondents, 57.3% had unacceptable compliance with the proper use of PPE during COVID-19. Medical surgical mask is the most common for dental professionals to wear (93.8%), followed by goggles or face shield (63.8%), and isolation gown (53.1%). Unexpectedly, only 63.3% of respondents always change masks with guidelines. The condition for changing goggles/face shields and isolation gowns is even worse (45.6 and 37.0%, respectively). Visual barriers, physical discomfort, complex procedures, and heavy workload were the most common personal barriers to use. According to the results of Chi-square test and correlation analysis, PPE use compliance was associated with age, years of practice, medical institution type, and exposure risk estimation. Chinese dental professionals need to improve their compliance with the proper use of PPE, especially those in the 31-40 age group, with 11-15 experience years and working in private dental clinics. Increasing compliance with PPE may be achieved by addressing personal barriers to use, human resource shortages, and perceptions of exposure risk.

Epidemiology of carbapenem-resistant Enterobacteriaceae in Jeju Province, Korea, using national surveillance data, 2018–2021

Carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) infections have increased rapidly over the past decade and are recognized as a severe health threat in Korea and worldwide. This study aimed to identify the status and characteristics of CRE infection in Jeju province and provide important basic data for the prevention and management of CRE infection. A descriptive epidemiological analysis was performed on reported cases of CRE infection in Jeju Province between 2018 and 2021 using the integrated management system for disease, an infectious disease reporting system from the Korea Disease Control and Prevention Agency. The annual difference and distribution trends of CRE infection were analyzed using CRE isolates, carbapenemase-producing CREs (CP-CRE) and their genotypes, and the type of medical institution in Jeju Province. CRE infections steadily increased in Jeju from 2018 to 2021, and the proportion of CP-CRE among the CREs also showed a statistically significant increase each year. Among the CRE isolates, <i>Klebsiella pneumoniae</i> (KPC, 62.13%) was the most common, and among the CP-CRE genotypes, KPC (81.62%) showed the highest distribution and increased each year. As the distribution of CP-CRE in have increased over the past 4 years, measures to prevent the spread and outbreak of CRE infections are warranted. The results of this study are expected to be used as basic data for prevention and management of CRE infections in the province.

Women education in the Soviet prophylactoria and the care homes for sexually transmitted disease patients in the Soviet Occupation Zone of Germany.

In the 1920s, so-called prophylactoria were established in the USSR. In these institutions, sex workers with sexually transmitted diseases (STDs) were treated. After the end of World War II, care homes for patients with STDs were established in the Soviet Occupation Zone of Germany (SOZ). These institutions were also intended to treat people suffering from STDs. This article compares these two types of medical institutions. Sources from the State Archive of the Russian Federation in Moscow, the German Federal Archives in Berlin and the City Archive Zwickau were used. The analysed sources were evaluated by using the historical-critical method. The prophylactoria were novel institutions that combined education and medical treatment of people with STDs. Similar strategies were followed in the care homes for STD patients. In both institutions, the sick persons had to follow a regular daily routine and work every day. The political indoctrination served to educate 'socialist personalities'. Nevertheless, various differences can be found between the facilities: the length of stay was different. The women in Soviet prophylactoria were cared for there for up to 2 years. However, the standard duration of stay in the care homes for STD patients was 3-6 months. The prophylactoria had a long-term programme not only to treat sick women but also to reeducate them. The aim was to enlighten and integrate them into the new Soviet society. The care homes for STD patients had a short-term programme of combating venereal diseases. Their main goal was to treat patients with STDs as quickly as possible, while education was an additional measure. Whether both institutions were successful in educating and treating these patients can hardly be assessed from today's perspective.

Influencing factors of knowledge, attitude and behavior in children’s palliative care among pediatric healthcare workers: a cross-sectional survey in China

BackgroundPalliative care has become a key medical field worldwide. Although research relating to adult palliative care is well-established, less is known about children’s palliative care (CPC). Therefore, this study investigated the knowledge, attitude and behavior of pediatric healthcare workers (PHWs) regarding CPC and analyzed the influencing factors for the implementation and development of CPC.MethodsA cross-sectional survey of 407 PHWs was carried out in a Chinese province from November 2021 to April 2022. The questionnaire consisted of two parts: a general information form and questions on the knowledge, attitude and behavior of PHWs about CPC. Data were analyzed using t-test, ANOVA and multiple regression analysis.ResultsThe total score of the PHWs’ knowledge, attitude and behavior about CPC was 69.98, which was at a moderate level. PHWs’ CPC knowledge, attitude, and behavior are positively correlated.The most important influencing factors were working years, highest education, professional title, job position, marital status, religion, grade of hospital (I, II or III), type of medical institution, experience of caring for a terminally ill child/kinsfolk and total hours of CPC education and training received.ConclusionsIn this study, PHWs in a Chinese province had the lowest scores on the knowledge dimension of CPC, with moderate attitude and behavior and various influencing factors. In addition to professional title, highest education and working years, it is also worth noting that the type of medical institution and marital status also affected the score. Continuing education and training of PHWs in CPC should be emphasized by the administrators of relevant colleges and medical institutions. Future research should start with the above-mentioned influencing factors and focus on setting up targeted training courses and evaluating the post-training effects.

КОМУНІКАЦІЙНІ ІНСТРУМЕНТИ БРЕНДИНГУ МЕДИЧНИХ УСТАНОВ У СОЦІАЛЬНИХ МЕРЕЖАХ

<p><strong><em>The purpose of the study</em></strong><em> is to represent communication tools for the </em><em>development of a branding strategy for a medical institution in social networks.</em></p><p><strong><em>Research methodology.</em></strong><em> To understand the phenomenon of branding, methods of analysis and synthesis, and descriptive method were used; ascertainment of the specifics of medical institutions branding required the use of monitoring, content analysis, comparison and survey methods.</em></p><p><strong><em>Results.</em></strong><em> The trends and specifics of branding </em><em>in the medical field («medical marketing»/«medical services marketing») were represented. Modern ways of updating content for information and communication interaction with the audience of a medical institution, in particular a maternity hospital, were described. The dominant communication tools for establishing contact with clients through social networks were characterized, in particular: video stories about the institution and its employees; materials with expert comments of specialists (doctors); live broadcasts with medical workers of the institution. The designed and implemented concept of content strategy in social networks for the maternity hospital number 9 of Zaporizhzhia was presented. The main components of corporate style and their implementation on the pages of the «Ninth» in social networks were revealed. As a result of the conducted online survey, a high assessment of the quality of the page information content on the Instagram platform was observed. It was found that the basic share of the target audience of the maternity hospital pages in social networks is pregnant women and women who have given birth, and therefore, in order to expand the circle of interested people, it is necessary to increase the percentage of content for those who are at the stage of pregnancy planning.</em></p><p><strong><em>Novelty of the research</em></strong><em> consists in studying the specifics of </em><em>branding such a type of medical institution as a maternity hospital; formation and implementation of the content strategy concept for organizing its pages in social networks, as well as studying the effectiveness of their content for information and communication interaction with the target audience.</em></p><p><strong><em>Practical significance.</em></strong><em> The conducted research contributed to the generalization of the main areas of information support for clients of medical institutions, in particular the regional maternity hospital, as well as to the identification of dominant trends in the development and implementation of the concept and content strategy of pages in social networks of such institutions.</em></p><p><strong><em>Key words:</em></strong><em> brand, branding, medical branding,</em><em> medical marketing, marketing of medical services, content strategy, social networks, information and communication interaction.</em></p>

Knowledge and Attitudes towards Human Papillomavirus Vaccination (HPV) among Healthcare Providers Involved in the Governmental Free HPV Vaccination Program in Shenzhen, Southern China.

No research has been conducted to explore the variables associated with healthcare providers' (HCPs) knowledge and attitudes toward the human papillomavirus vaccine (HPV) since the vaccine was approved for free use in some Chinese cities. In Shenzhen, southern China, a convenience sample strategy was used to distribute questionnaires to HCPs involved in the government's HPV vaccination program from Shenzhen. There were 828 questionnaires collected in total, with 770 used in the analysis. The mean HPV and HPV vaccine knowledge score was 12.0 among HCPs involved in the government HPV vaccination program (with a total score of 15). the average scores for HPV and HPV vaccine knowledge varied among different types of medical institutions. District hospitals had the highest mean score of 12.4, while private hospitals ranked fourth with a mean score of 10.9. Multivariate logistic regression results revealed significant disparities in the type of license and after-tax annual income across HCPs (p < 0.05). The future education and training for HCPs should focus on private community health centers (CHCs), HCPs whose license type is other than a doctor, and HCPs with low after-tax annual income.

Medical disputes related to advanced endoscopic procedures with endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography for the management of pancreas and biliary tract diseases.

This study aimed to evaluate the characteristics of endoscopic retrograde cholangiopancreatography (ERCP) or endoscopic ultrasonography (EUS)-related adverse events (AEs) that eventually lead to medical disputes or claims on medical professional liability. Medical disputes for ERCP/EUS-related AEs filed in the Korea Medical Dispute Mediation and Arbitration Agency between April 2012 and August 2020 were evaluated using corresponding medical records. AEs were categorized into three sections: procedure-related, sedation-related, and safety-related AEs. Among a total of 34 cases, procedure-related AEs were 26 (76.5%; 12 duodenal perforations, 7 post-ERCP pancreatitis, 5 bleedings, 2 perforations combined with post-ERCP pancreatitis); sedation-related AEs were 5 (14.7%; 4 cardiac arrests, 1 desaturation), and safety-related AEs were 5 (8.8%; 1 follow-up loss for stent removal, 1 asphyxia, 1 fall). Regarding clinical outcomes, 20 (58.8%) were fatal and eventually succumbed to AEs. For the types of medical institutions, 21 cases (61.8%) occurred at tertiary or academic hospitals, and 13 (38.2%) occurred at community hospitals. The ERCP/EUS-related AEs filed in Korea Medical Dispute Mediation and Arbitration Agency showed distinct features: duodenal perforation was the most frequent AE, and clinical outcomes were fatal, resulting in at least more than permanent physical impairment.