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The Study on the Appropriate Workforce Estimation of Clinical Technologists for Job Creation in the Field of Ultrasonic Inspection
Biomed Sci Letters 2019;25:381-389
Published online December 31, 2019;  https://doi.org/10.15616/BSL.2019.25.4.381
© 2019 The Korean Society For Biomedical Laboratory Sciences.

Hyung-Joon Bae1,*, Dae-Sik Kim2,*, Og kyoung Lee3,*, Chul-Seung Kim4,*, Sun Young Choi5,,*, Young-Hoi An6,* *, Eun-Young Kim7,* *, Kun-Woo Kang7,* * and Jin-Yong Jang8,* *

1Department of Biomedical Laboratory Science, Daejeon Institute of Science and Technology, Daejeon 35408, Korea
2Department of Biomedical Laboratory Science, Dongnam Health University, Suwon 16328, Korea
3Department of Clinical Laboratory Science, Daejeon Health Institute of Technology, Daejeon 34504, Korea
4Department of Biomedical Laboratory Science, Mokpo Science University, Mokpo 58644, Korea
5Department of Biomedical Laboratory Science, Daegu Health Colleg, Daegu 41453, Korea
6Seoul National University Hospital, Seoul 03080, Korea
7Sungkyunkwan University Samsung Medical Center, Seoul 06351, Korea
8Sungkyunkwan University Samsung Changwon Hospital, Changwon 51353, Korea
Correspondence to: Sun Young Choi. Department of Biomedical Laboratory Science, Daegu Health College, Yeongsong-ro, Buk-gu, Daegu 41453, Korea.
Tel: +82-53-320-1307, Fax: +82-53-320-1896, e-mail: kmu5041@hanmail.net
*Professor, **Researcher.
Received November 25, 2019; Accepted December 10, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract

The physiological function test is the only patient contact area in the field of clinical laboratory. We need to recruit and encourage the experts due to requiring the expertise and long time for examination. However, there is currently no rule for estimating optimal workforce in the field of physiological function tests. The purpose of this study is to establish the basis of the studies for mid- to long-long term job creation in the field of ultrasound by evaluating the number of appropriate tests and appropriate workforce. We calculated the quantitative and qualitative workload for the number of appropriate tests and appropriate workforce using online questionnaire. All statistical analyses were performed using SPSS version 18.0 (SPSS Inc., Chicago, IL, USA). A total of 216 respondents were 48 (22.2%) male and 168 (77.8%) female. A total of 157 laboratories were 62 (39.5%) for echocardiography, 91 (58.0%) for the transcranial Doppler (TCD) and 4 (5.7%) for the carotid ultrasound. The mean number of appropriate tests was 10 ± 2 in the echocardiography, 9 ± 2 in TCD and 11 ± 2 in the carotid ultrasound. In addition, the number of laboratories required to recruit employees for appropriate workforce was 19 in echocardiography, 18 in TCD, and 0 in carotid ultrasound. The number of hospital required to recruit workforce were 7 primary hospitals, 22 secondary hospitals, 7 third hospitals. This study can be used as an important data as the first study at present time when the data on the workforce status and work environment of the ultrasonic laboratories is insufficient. Based on the quantitative and qualitative workloads, the number of appropriate tests and appropriate workforce can support mid- to long-long term job creation in the field of ultrasound.

Keywords : Echocardiography, Transcranial Doppler, Carotid ultrasound, Workforce
꽌 濡

怨좊졊솕 떆뿉 젒뼱뱾硫댁꽌 끂씤씤援ъ쓽 利앷 븿猿 끂씤꽦 吏덊솚(떖뇤삁愿吏덊솚, 떊寃쎄퀎吏덊솚, 븞怨쇱쭏솚, 룓吏덊솚 벑)씠 湲됯꺽엳 利앷븯怨 엳떎. 씠 뜑遺덉뼱 쓽猷뚯쓽 뙣윭떎엫씠 '移섎즺'뿉꽌 '삁諛 諛 吏꾨떒'쑝濡 諛붾쒖뿉 뵲씪 嫄닿컯寃吏꾩씠 蹂댄렪솕릺怨 엳쑝硫 寃궗 寃곌낵뿉 븳 쓽議대룄媛 利앷븯怨 엳떎. OECD (2015)뿉 뵲瑜대㈃ 슦由щ굹씪뒗 OECD 援媛 以 媛옣 넂 1씤떦 援誘쇱쓽猷뚮퉬瑜 湲곕줉븯怨 엳怨, 씠뒗 쓽猷뚭린湲곗궛뾽 꽦옣뿉 媛옣 醫뗭 湲곕컲쓣 젣怨듯븯뿬 怨좉쓽猷뚯옣鍮꾩쓽 닔媛 OECD 援媛 以 쑀씪븯寃 利앷븯뒗 援媛씠떎. 뵲씪꽌 쓽猷뚯옣鍮꾩쓽 利앷 븿猿 寃궗嫄댁닔 삉븳 利앷븿뿉 뵲씪 寃궗瑜 닔뻾븷 닔 엳뒗 쟾臾 씤젰쓽 솗蹂대룄 븿猿 씠猷⑥뼱졇빞 寃궗 뾽臾댁쓽 吏덉쟻 뼢긽쓣 媛졇삱 닔 엳怨, 젙솗븯怨 슚쑉쟻씤 寃궗媛 닔뻾맆 닔 엳떎.

吏꾨떒寃궗쓽븰 諛 蹂묐━寃궗 遺꾩빞뒗 寃궗옣鍮꾩쓽 옄룞솕 떆뒪뀥 援ъ텞쑝濡 씤젰 솗뿉 븳怨꾧 엳쑝굹, 깮由ш린뒫寃궗 遺꾩빞뒗 엫긽蹂묐━궗쓽 뾽臾댁뿉꽌 쑀씪븳 솚옄젒젏 遺꾩빞濡 湲 寃궗떆媛꾧낵 뭾遺븳 寃쏀뿕뿉 쓽븳 怨좊룄쓽 쟾臾멸린닠씠 슂援щ릺怨, 吏꾨즺怨쇰퀎濡 뿰怨꾨릺뼱 엳쑝誘濡 쟾臾 씤젰씠 젅떎엳 븘슂븯怨, 씤젰 솗蹂닿 쑀由ы븯떎. 蹂묒썝뿉꽌 씪뼱굹怨 엳뒗 솚옄븞쟾愿젴 궗怨좊뒗 뿬윭 썝씤씠 엳쑝굹, 쟾臾몄꽦 엳뒗 씤젰쓽 쟻젅븳 諛곗튂媛 誘명씉븯嫄곕굹 븳젙맂 씤젰씠 뿬윭 뾽臾대 以묐났븯뿬 떆뻾븷 닔諛뽰뿉 뾾뒗 솚寃쎌쟻 由ъ뒪겕媛 留ㅼ슦 겕떎怨 븷 닔 엳떎(꽌씤踰 쇅., 2002; 삤쁺샇 쇅., 2007; 議곗꽍二 쇅., 2007). 듅엳, 궗엺쓣 吏곸젒 긽쑝濡 떆뻾븯뒗 깮由ы븰쟻 寃궗쓽 寃쎌슦뒗 洹 쁺뼢씠 뜑슧 겕誘濡 寃궗瑜 떊냽븯怨 젙솗븯寃 닔뻾븷 닔 엳룄濡 빐떦 遺꾩빞쓽 쟾臾 씤젰쓣 쟻젅븯寃 궛젙븯怨, 솗蹂댄븯뿬 異⑸텇븳 씤봽씪瑜 媛뽰텛뒗 寃껋씠 쓽猷뚯쓽 吏덉쓣 뼢긽븷 닔 엳뒗 媛옣 湲곕낯쟻씤 理쒖쟻쓽 諛⑸쾿씠씪怨 븷 닔 엳떎. 듅엳 珥덉쓬뙆寃궗뒗 떎떆媛꾩쑝濡 쁺긽쓣 쉷뱷븯뒗 寃궗쓽 듅꽦쑝濡 寃궗옄쓽 젙솗븳 뙋떒怨 寃궗쓽 吏덉씠 솚옄쓽 吏꾨떒怨 移섎즺뿉 誘몄튂뒗 쁺뼢씠 留ㅼ슦 겙 寃궗씠떎(New Medical World Weekly, 2008; Department of Health and Ageing, 2011; 젙꽕씗 쇅., 2014).

理쒓렐 웳젏솕릺怨 엳뒗 珥덉쓬뙆寃궗 뾽臾댁쁺뿭뿉 빐 蹂닿굔蹂듭遺뿉꽌 쓽궗쓽 吏떆 븯뿉 엫긽蹂묐━궗쓽 珥덉쓬뙆寃궗媛 媛뒫븯떎뒗 쑀沅뚰빐꽍쓣 諛쏆븯湲곗뿉 쁺뿭 솗 諛 怨좎슜 李쎌텧뿉 븳 媛뒫꽦씠 뿴젮 엳떎. 삉븳, 泥닿퀎쟻씤 씤젰愿由ъ쓽 誘명씉怨 뾽臾댁쁺뿭뿉 븳 遺덈텇紐낇븳 援щ텇쑝濡 吏곸쥌쓽 엫긽蹂묐━궗쓽 怨좎쑀 뾽臾 移⑤쾾뿉 븳 슦젮媛 怨꾩냽릺怨 엳怨, 蹂묒썝 궡 씤젰 異⑹썝쓽 븳怨꾨줈 엫긽蹂묐━궗쓽 떎뾽瑜 삉븳 利앷븯怨 엳뒗 媛슫뜲 뾽臾댁쁺뿭쓽 遺꾨챸븳 援щ텇쓣 넻븳 엫긽蹂묐━궗쓽 怨좎슜 븞젙怨 씤젰 솗蹂닿 븘슂븳 떎젙씠떎.

뵲씪꽌, 蹂 뿰援ъ쓽 紐⑹쟻 珥덉쓬뙆寃궗쓽 쟻젙寃궗嫄댁닔 諛 쟻젙 씤젰쓣 궛젙븯뿬 珥덉쓬뙆寃궗 遺꾩빞쓽 씪옄由 李쎌텧怨 뾽臾댁쁺뿭 솗蹂대 쐞븳 諛쒗뙋쓣 留덈젴븯怨좎옄 븳떎.

긽 諛 諛⑸쾿

븳깮由ш궗븰쉶뿉 媛엯릺뼱 엳怨 珥덉쓬뙆寃궗 遺꾩빞뿉 醫낆궗븯뒗 븫긽蹂묐━궗 216紐낆쓣 긽쑝濡 삩씪씤 꽕臾몄“궗瑜 떎떆븯떎.

뾽臾대웾 遺꾩꽍

뾽臾대웾 遺꾩꽍 源醫낅뱷 쇅 (2012) "吏곷Т遺꾩꽍쓣 넻븳 쟻젙씤젰 궛젙 諛 씤젰슫쁺 슚쑉솕 諛⑹븞 援ъ텞 뿰援"뿉 뵲씪 遺꾩꽍븯떎. 뼇쟻 뾽臾대웾 궛異쒖 몴以 뾽臾대웾 궛젙諛⑸쾿쓣 씠슜븯뿬 궛異쒗븯怨, 吏덉쟻 뾽臾대웾 궛異쒖 뾽臾대퀎 궃씠룄 諛 1嫄닿컯 룊洹 寃궗떆媛꾩뿉 뵲瑜 媛以묒튂瑜 諛섏쁺븯뿬 궛異쒗븯떎(Table 1, 2).

The weight of qualitative workload

Examination time Division Weight
> 90 min Higher 10% 1.25
60~89 min Second higher 20% 1.125
30~59 min Middle 40% 1
15~29 min Second Lower 20% 0.875
< 15 min Lower 10% 0.75

The method of workload analysis

Value Mean Method
몺 Quantitative workload Total annual working hours 몼 + 몾
몼 Standard working hours Annual standard working hours for 1 person (365-holiday) × 8 hours
몾 Overtime Annual overtime for 1 person Mean annual overtime
몿 Qualitative workload Weight of workload ∑ (Weight)
뫀 Final workload Quantitative workload × Qualitative workload 몺 × 몿


쟻젙寃궗嫄댁닔 궛젙

珥덉쓬뙆寃궗쓽 쟻젙寃궗嫄댁닔瑜 遺꾩꽍븯湲 쐞빐 븳援궛뾽젙蹂댁뿰援ъ냼 (2016) "떆뿕, 寃궗湲곌 쟻젙寃궗嫄댁닔 궛젙諛⑸쾿 媛씠뱶"뿉 뵲씪 쟻젙寃궗嫄댁닔瑜 遺꾩꽍븯떎(Table 3).

The method of the appropriate number analysis

Value Mean Method
몺 Standard working hours Standard working hours for 1 day 8 hours
몼 Examination time Examination time for 1 case Real test time + 30 min (lose time)
몾 Tester's share Number of tester 1.0
몿 Appropriate number of ultrasound Appropriate number of ultrasound for 1 day 8 hours/examination time × 몾
뫀 Overtime rate More than 50% (4 hours) of total working day 1.5
뫁 Maximum number of ultrasound Maximum number of ultrasound for 1 day 1 day appropriate number of ultrasound + number of night work


쟻젙씤젰 궛젙

源醫낅뱷 쇅 (2012) "吏곷Т遺꾩꽍쓣 넻븳 쟻젙씤젰 궛젙 諛 씤젰슫쁺 슚쑉솕 諛⑹븞 援ъ텞 뿰援"뿉 뵲씪 뾽臾대웾 遺꾩꽍쓣 넻빐 룄異쒕맂 珥덇낵떆媛꾧낵 遺議깆떆媛꾩쓣 湲곕컲쑝濡 쟻젙 씤젰쓣 궛젙븯怨 뼇쟻 뾽臾대웾怨 吏덉쟻 뾽臾대웾쓣 씠슜븯뿬 positioning map쓣 옉꽦븯뿬 씤젰슫쁺쓽 슚쑉솕 諛⑹븞쓣 젣떆븯떎(Fig. 1).

Fig. 1. Positioning map of workload.

A region: Overtime hours are relatively high, and the level of difficulty is high. Therefore, this region should be required the recruitment. B region: Overtime hours are relatively low, and the level of difficulty is high. Therefore, focus on quality improvement such as education. C region: There are many hours of work, but the level of difficulty is relatively low, using administrative interns and contract workers. D region: Since both working hours and task difficulty are relatively low, the size of the workforce should be considered when adjusting the capacity.



뾽臾 遺꽌 씪룊洹 珥덇낵洹쇰Т떆媛=뾽臾 遺꽌 씪룊洹 洹쇰Т떆媛(뼇쟻×吏덉쟻)-쟾泥 遺꽌 씪룊洹 洹쇰Т떆媛

遺議깆씤썝=(씪룊洹 珥덇낵洹쇰Т떆媛()×쁽옱 씤썝)÷踰뺤젙 洹쇰Т떆媛(480遺)

넻怨꾩쟻 遺꾩꽍

珥덉쓬뙆寃궗 愿젴빐, 쓳떟옄쓽 湲곕낯젙蹂, 궛뾽泥 듅꽦, 뾽臾대웾, 쟻젙씤젰 궛異쒖뿉 愿븳 젙蹂, 뾽臾댁쁺뿭 솗蹂댁뿉 愿븳 젙蹂대뒗 湲곗닠넻怨(descriptive analysis)瑜 떎떆븯쑝硫, 쓽猷뚭린愿蹂 쓳떟옄쓽 湲곕낯젙蹂, 궛뾽泥 듅꽦, 뾽臾대웾, 쟻젙씤젰 궛異쒖뿉 愿븳 젙蹂, 뾽臾댁쁺뿭 솗蹂댁쓽 李⑥씠뒗 援먯감遺꾩꽍(cross tab analysis) 諛 遺꾩궛遺꾩꽍(ANOVA)瑜 닔뻾븯떎. 珥덉쓬뙆寃궗 醫낆궗옄쓽 끂룞 媛뺣룄뿉 쁺뼢쓣 誘몄튂뒗 슂씤쓣 遺꾩꽍븯湲 쐞빐 Logistic regression쓣 떎떆븯쑝硫 醫낆냽蹂닔뒗 끂룞 媛뺣룄(1: 留롮쓬, 留ㅼ슦 留롮쓬, 0: 留ㅼ슦 쟻쓬, 쟻쓬, 蹂댄넻씠떎), 룆由쎈닔뒗 湲곕낯 쓳떟 듅꽦(6媛), 궛뾽泥 듅꽦(3媛), 뾽臾대웾(16媛)쑝濡 꽕젙븯떎. 遺꾩꽍 젅李⑤뒗 癒쇱, 떒蹂웾 濡쒖뒪떛쉶洹遺꾩꽍쓣 떎떆븯硫 뿬湲곗꽌 쑀쓽닔以5%뿉꽌 쑀쓽븳 蹂닔瑜 꽑젙븯硫 떒蹂웾 濡쒖뒪떛쉶洹遺꾩꽍뿉꽌 쑀쓽븳 蹂닔瑜 씠슜븯뿬 떎蹂웾 濡쒖뒪떛쉶洹遺꾩꽍쓣 떎떆븯떎. 紐⑤뱺 넻怨꾨텇꽍 SPSS version 18.0 (SPSS Inc., Chicago, IL, USA)쓣 씠슜븯떎.

寃 怨

湲곕낯젙蹂댁“궗

蹂 뿰援ъ뿉 李몄뿬븳 쓳떟옄쓽 듅꽦쓣 Table 4 媛숇떎. 쟾泥 쓳떟옄 216紐 以 뿬옄뒗 168紐(77.8%)濡 굹궗怨, 뿰졊뒗 30媛 98紐(45.4%)쑝濡 媛옣 넂寃 굹궗떎. 洹쇰Т뿰닔뒗 5뀈 씠긽~10뀈 誘몃쭔쓽 쓳떟옄媛 52紐(24.1%)쑝濡 媛옣 넂寃 굹궗쑝硫, 洹쇰Т吏뿭쑝濡쒕뒗 꽌슱 73紐(33.8%), 寃쎄린룄 57紐(26.4%), 寃쎌긽룄 47紐(21.8%), 異⑹껌룄 20紐(9.3%) 닚쑝濡 굹궗떎. 쓽猷뚭린愿 쑀삎蹂꾨줈뒗 1李 쓽猷뚭린愿 21紐(9.7%), 2李 쓽猷뚭린愿 95紐(44.0%), 3李 쓽猷뚭린愿 96紐(44.4%), 寃吏꾩꽱꽣 4紐(1.9%) 닚쑝濡 굹궗떎. 寃궗醫낅쪟뒗(以묐났 쓳떟 媛뒫) 떖옣珥덉쓬뙆 88紐(40.7%), 뇤삁瑜섏큹쓬뙆 91紐(42.1%), 寃쎈룞留μ큹쓬뙆 75紐(34.7%) 닚쑝濡 굹궗떎. 뾽臾댁쑀삎쑝濡쒕뒗 寃궗 뾽臾대쭔 닔뻾 50紐(23.1%), 寃궗 뾽臾 쇅 떎瑜 뾽臾 븿猿 닔뻾 166紐(76.9%)쑝濡 굹궗떎.

Baseline characteristics

Value Total (n=216)
Age
20~29 61 (28.2)
30~39 98 (45.4)
40~49 53 (24.5)
50~59 4 (1.9)
Female 168 (77.8)
Position
Seoul 73 (33.8)
Gyeonggi-do 57 (26.4)
Gyeongsang-do 47 (21.8)
Chungcheong-do 20 (9.3)
Jeolla-do 17 (7.9)
Gandwond-do 1 (0.5)
Jeju Island 1 (0.5)
Type of hospital
Primary hospital 21 (9.7)
Second hospital 95 (44.0)
Tertiary hospital 96 (44.4)
Examination center 4 (1.9)
Type of ultrasound
Echocardiography 88 (40.7)
Transcranial Doppler 91 (42.1)
Carotid ultrasound 75 (34.7)
Type of work
Only ultrasound 50 (23.1)
Not only ultrasound 166 (76.9)

Values are n (%) or mean ± standard deviation



뾽臾대웾 遺꾩꽍

1씪 룊洹 寃궗嫄댁닔, 뼇쟻 뾽臾대웾, 吏덉쟻 뾽臾대웾 Table 5 媛숇떎. 1씪 룊洹 寃궗嫄댁닔뒗 떖옣珥덉쓬뙆 12嫄, 뇤삁瑜섏큹쓬뙆 6.5嫄, 寃쎈룞留μ큹쓬뙆 4.5嫄댁쑝濡 遺꾩꽍릺뿀怨, 젙긽 솚옄 1嫄대떦 룊洹 寃궗냼슂떆媛꾩 떖옣珥덉쓬뙆 17.0遺, 뇤삁瑜섏큹쓬뙆 24.9遺, 寃쎈룞留μ큹쓬뙆 17.1遺꾩쑝濡 遺꾩꽍릺뿀떎. 삉븳, 鍮꾩젙긽 솚옄 1嫄대떦 룊洹 寃궗냼슂떆媛꾩 떖옣珥덉쓬뙆 31.3遺, 뇤삁瑜섏큹쓬뙆 37.3遺, 寃쎈룞留μ큹쓬뙆 27.1遺꾩씠怨 1씪 룊洹 鍮꾩젙긽 솚옄 鍮꾩쑉 42.0%濡 遺꾩꽍릺뿀떎. 삉븳, 1씪 룊洹 30遺 씠긽~60遺 誘몃쭔 냼슂릺뒗 寃궗嫄댁닔뒗 떖옣珥덉쓬뙆 5.1嫄, 뇤삁瑜섏큹쓬뙆 4.4嫄, 寃쎈룞留μ큹쓬뙆 2.5嫄댁쑝濡 遺꾩꽍릺뿀怨, 1씪 룊洹 60遺 씠긽 냼슂릺뒗 寃궗嫄댁닔뒗 떖옣珥덉쓬뙆 1.7嫄, 뇤삁瑜섏큹쓬뙆 2.2嫄, 寃쎈룞留μ큹쓬뙆 2.3嫄댁쑝濡 遺꾩꽍릺뿀떎. 1씪 룊洹 寃궗嫄댁닔뒗 쓽猷뚭린愿蹂 넻怨꾩쟻 李⑥씠뒗 뾾뿀吏留, 젙긽 솚옄 1嫄대떦 룊洹 寃궗냼슂떆媛 諛 鍮꾩젙긽 솚옄쓽 寃쎈룞留μ큹쓬뙆쓽 1嫄대떦 룊洹 寃궗냼슂떆媛꾩 1李 쓽猷뚭린愿뿉꽌 넻怨꾩쟻쑝濡 쟻寃 遺꾩꽍릺뿀떎. 뼇쟻 · 吏덉쟻 뾽臾대웾 뇤삁瑜섏큹쓬뙆, 떖옣珥덉쓬뙆, 寃쎈룞留μ큹쓬뙆 닚쑝濡 뇤삁瑜섏큹쓬뙆媛 뼇쟻 · 吏덉쟻 뾽臾대웾씠 媛옣 넂寃 遺꾩꽍릺뿀떎. 쓽猷뚭린愿 쑀삎蹂꾩뿉꽌뒗 1李 쓽猷뚭린愿怨 寃吏꾩꽱꽣뿉꽌 3醫낅쪟 珥덉쓬뙆寃궗뿉 븳 뼇쟻 뾽臾대웾씠 넻怨꾩쟻쑝濡 媛옣 留롮 寃껋쑝濡 遺꾩꽍릺뿀怨(P<0.001), 3李 쓽猷뚭린愿뿉꽌뒗 寃쎈룞留μ큹쓬뙆뿉 븳 吏덉쟻 뾽臾대웾씠 넻怨꾩쟻쑝濡 媛옣 넂寃 遺꾩꽍릺뿀떎(P=0.002). 븯吏留 떖옣珥덉쓬뙆 뇤삁瑜섏큹쓬뙆쓽 吏덉쟻 뾽臾대웾 쓽猷뚭린愿 쑀삎蹂꾨줈 넻怨꾩쟻 쑀쓽븳 李⑥씠뒗 뾾뿀떎.

The analysis of workload

Value Ultrasound Total (n=216) Primary hospital (n=21) Secondary hospital (n=95) Tertiary hospital (n=96) Examination center (n=4) P-value
Mean number of ultrasound for 1 day Echo 12.0±5.02 7.8±4.88 11.9±5.17 12.6±4.63 14.0±8.49 0.163
TCD 6.5±4.67 6.6±5.02 6.0±5.02 6.7±3.85 12.0±11.31 0.333
Carotid 4.5±3.98 4.4±3.12 4.6±4.3 4.6±4.00 - 0.999

Normal test time Echo 17.0±7.46 15.8±3.76 15.9±7.06 18.5±8.16 12.5±3.54 0.318
TCD 24.9±11.03 20.2±8.40 27.4±13.1 24.0±8.57 15.0±7.07 0.073
Carotid 17.1±9.63 12.50±6.57 13.8±9.34 20.4±9.22 - 0.001

Abnormal test time Echo 31.3±10.32 30.8±6.65 29.8±9.15 32.9±11.94 30.0±0.00 0.584
TCD 37.3±15.78 32.1±14.64 41.2±18.20 35.3±12.53 25.0±7.07 0.088
Carotid 27.1±12.34 20.0±6.03 24.38±12.62 30.5±12.04 10.0±0.00 0.005

Number of tests (30~59 min) for 1 day Echo 5.1±6.48 5.0±2.16 4.6±7.04 5.8±6.48 15.0±0.71 0.764
TCD 4.4±7.51 10.0±16.79 4.5±8.24 3.3±2.17 - 0.137
Carotid 2.5±1.90 3.8±1.64 2.1±1.60 2.49±2.00 - 0.239

Number of tests (≥ 60 min) for 1 day Echo 1.7±1.05 - 1.9±1.36 1.6±0.89 - 0.504
TCD 2.2±1.62 3.0±2.16 1.9±1.23 2.3±1.74 - 0.429
Carotid 2.3±1.73 3.5±2.12 1.5±1.07 2.6±1.91 - 0.229

Annual quantitative workload (hour) Echo 1.631±151 1,721±91 1,645±148 1,603±172 1,725±74 <0.001
TCD 1,652±214 1,723±144 1,672±243 1,598±133 - <0.001
Carotid 1,626±117 1,746±35 1,639±123 1,589±119 - <0.001

Annual qualitative workload Echo 0.87±0.09 0.84±0.06 0.88±0.08 0.86±0.10 0.81±0.09 0.672
TCD 0.95±0.11 0.90±0.09 0.97±013 0.92±0.06 - 0.162
Carotid 0.84±0.08 0.75±0.09 0.82±0.08 0.88±0.08 - 0.002

Values are mean ± standard deviation. TCD, transcranial Doppler



쟻젙寃궗嫄댁닔 궛젙

珥덉쓬뙆寃궗 1씪 룊洹 쟻젙寃궗嫄댁닔 궛젙 Table 6怨 媛숇떎. 쟾泥 쓽猷뚭린愿뿉꽌뒗 떖옣珥덉쓬뙆 10±2嫄, 뇤삁瑜섏큹쓬뙆 9±2嫄, 寃쎈룞留μ큹쓬뙆 11±2嫄댁쑝濡 遺꾩꽍릺뿀떎. 쓽猷뚭린愿 쑀삎蹂 떖옣珥덉쓬뙆(P=0.696), 뇤삁瑜섏큹쓬뙆(P= 0.174)쓽 1씪 쟻젙寃궗嫄댁닔뒗 넻怨꾩쟻쑝濡 쑀쓽븳 李⑥씠뒗 뾾뿀怨, 寃쎈룞留μ큹쓬뙆뒗 1李 쓽猷뚭린愿 12±1嫄, 2李 쓽猷뚭린愿 11±2嫄 3李 쓽猷뚭린愿 10±1嫄댁쑝濡 넻怨꾩쟻쑝濡 쑀쓽븳 李⑥씠뒗 엳뿀떎(P=0.006).

The analysis of appropriate number of ultrasound

Value Ultrasound Total Primary hospital Secondary hospital Tertiary hospital Examination center P-value
Mean appropriate number for 1 day Echo 10±2 11±1 10±2 10±2 11±1 0.696
TCD 9±2 10±2 9±2 9±1 0.174
Carotid 11±2 12±1 11±2 10±1 0.006

Values are mean ± standard deviation. TCD, transcranial Doppler



쟻젙씤젰 궛젙

珥덉쓬뙆寃궗 醫낅쪟뿉 뵲瑜 뾽臾대꽌蹂 諛 쓽猷뚭린愿 쑀삎蹂 遺議깆씤썝 궛젙 寃곌낵뒗 Table 7怨 媛숇떎. 珥 154媛 뾽臾 遺꽌뿉꽌 42媛(27.6%)쓽 遺꽌媛 0~1紐 遺議깊븯怨, 꽭遺 遺꽌濡쒕뒗 떖옣珥덉쓬뙆 14媛, 뇤삁瑜섏큹쓬뙆 28媛 遺꽌濡 遺꾩꽍릺뿀떎. 쓽猷뚭린愿 쑀삎쑝濡쒕뒗 1李 쓽猷뚭린愿 9媛 2李 쓽猷뚭린愿 15媛, 3李 쓽猷뚭린愿 17媛, 寃吏꾩꽱꽣 1媛 遺꽌뿉꽌 0~1紐 遺議깆쑝濡 遺꾩꽍릺뿀떎. 쟻젙 씤젰쓣 蹂댁쑀븳 遺꽌뒗 101媛(65.1%), 怨쇱엵 씤젰쓣 蹂댁쑀븳 遺꽌뒗 10媛(6.6%)濡 遺꾩꽍릺뿀떎.

The analysis of appropriate workforce

Type Ultrasound 0 < Excess ≤ 1 0 0 < Lack ≤ 1 1 < Lack ≤ 2 Total





n (%) 10 (6.58) 101 (65.13) 42 (27.63) 1 (0.66) 154
Laboratory Echo 6 (10.2) 38 (64.4) 14 (23.7) 1 (1.7) 59
TCD 3 (3.3) 60 (65.9) 28 (30.8) 0 91
Carotid 1 (25.0) 3 (75.0) 0 0 4

Hospital Primary hospital 0 10 (52.6) 9 (47.4) 0 19
Secondary hospital 2 60 15 0 77
Tertiary hospital 8 30 17 1 56
Examination center 0 1 1 0 2

Values are n (%).TCD, transcranial Doppler



Positioning map뿉 뵲瑜 씤젰슫쁺 슚쑉솕 諛⑹븞

珥덉쓬뙆寃궗 醫낅쪟뿉 뵲瑜 뾽臾 遺꽌蹂 諛 쓽猷뚭린愿 쑀삎蹂 뾽臾대웾 쁽솴 Table 8, 씤젰슫쁺 슚쑉솕 諛⑹븞 Table 9 媛숇떎. 珥 154媛 遺꽌뿉꽌 뼇쟻 뾽臾대웾 諛 吏덉쟻 뾽臾대웾씠 紐⑤몢 留롮븘 씤젰 異⑹썝씠 븘슂븳 遺꽌뒗 37媛(24.0%)濡 떖옣珥덉쓬뙆 19媛, 뇤삁瑜섏큹쓬뙆 18媛, 寃쎈룞留μ큹쓬뙆 0媛쒕줈 遺꽌濡 遺꾩꽍릺뿀쑝硫, 쓽猷뚭린愿 쑀삎쑝濡쒕뒗 1李 쓽猷뚭린愿 7媛, 2李 쓽猷뚭린愿 22媛, 3李 쓽猷뚭린愿 7媛, 寃吏꾩꽱꽣 1媛쒕줈 遺꽌濡 遺꾩꽍릺뿀떎. 뼇쟻 뾽臾대웾씠 留롪퀬 吏덉쟻 뾽臾대웾씠 쟻뼱 怨꾩빟吏 솢슜씠 븘슂븳 遺꽌뒗 37媛(24.7%)濡 떖옣珥덉쓬뙆 11媛, 뇤삁瑜섏큹쓬뙆 27媛, 寃쎈룞留μ큹쓬뙆 2媛쒕줈 遺꾩꽍릺뿀쑝硫, 쓽猷뚭린愿 쑀삎쑝濡쒕뒗 1李 쓽猷뚭린愿 10媛, 2李 쓽猷뚭린愿 20媛, 3李 쓽猷뚭린愿 9媛, 寃吏꾩꽱꽣 1媛쒕줈 遺꾩꽍릺뿀떎. 寃궗쓽 궃씠룄媛 넂 吏덉쟻 뾽臾대웾 뼢긽씠 븘슂븳 遺꽌뒗 47媛(30.5%)濡 떖옣珥덉쓬뙆 22媛, 뇤삁瑜섏큹쓬뙆 23媛, 寃쎈룞留μ큹쓬뙆 2媛쒕줈 遺꾩꽍릺뿀쑝硫, 쓽猷뚭린愿 쑀삎쑝濡쒕뒗 1李 쓽猷뚭린愿 2媛, 2李 쓽猷뚭린愿 22媛, 3李 쓽猷뚭린愿 23媛, 寃吏꾩꽱꽣 0媛쒕줈 遺꾩꽍릺뿀떎. 뼇쟻 뾽臾대웾 諛 吏덉쟻 뾽臾대웾씠 紐⑤몢 쟻뼱 씤젰 異뺤냼媛 븘슂븳 遺꽌뒗 30媛(19.5%)濡 떖옣珥덉쓬뙆 7媛, 뇤삁瑜섏큹쓬뙆 23媛, 寃쎈룞留μ큹쓬뙆 0媛쒕줈 遺꾩꽍릺뿀쑝硫, 쓽猷뚭린愿 쑀삎쑝濡쒕뒗 1李 쓽猷뚭린愿 0媛, 2李 쓽猷뚭린愿 13媛, 3李 쓽猷뚭린愿 17媛, 寃吏꾩꽱꽣 0媛쒕줈 遺꾩꽍릺뿀떎. 씤젰슫쁺 슚쑉솕瑜 쐞븳 positioning map Fig. 2, 3怨 媛숇떎.

The distribution of workload

Type Quantitative workload

Echo TCD Carotid



Small Many Small Many Small Many
Qualitative workload Total Low 7 11 23 27 0 2
High 22 19 23 18 2 0

Primary hospital Low 0 1 0 9 0 0
High 1 4 1 3 0 0

Secondary hospital Low 4 8 9 12 0 0
High 10 11 12 11 0 0

Tertiary hospital Low 3 2 14 5 0 2
High 11 3 10 4 2 0

Examination center Low 0 0 0 1 0 0
High 0 1 0 0 0 0

Values are n. TCD, transcranial Doppler


The efficiency of the workforce management

Type Ultrasound Recruitment Improvement of
qualitative workload
Use of interns or
contract worker
Reduction
Laboratory Echo 19 22 11 7
TCD 18 23 27 23
Carotid 0 2 2 0

Hospital Primary hospital 7 2 10 0
Secondary hospital 22 22 20 13
Tertiary hospital 7 23 9 17
Examination center 1 0 1 0

Total=154 Total 37 47 40 30

Fig. 2.

Positioning map of workload according to laboratory.


Fig. 3.

Positioning map of workload according to hospital


怨 李

蹂 뿰援щ뒗 겕寃 2媛吏濡 슂빟븷 닔 엳떎. 珥덉쓬뙆寃궗 1씪 쟻젙寃궗嫄댁닔뒗 떖옣珥덉쓬뙆 룊洹 10嫄, 뇤삁瑜섏큹쓬뙆 룊洹 9嫄, 寃쎈룞留μ큹쓬뙆寃궗 룊洹 11嫄댁쑝濡 遺꾩꽍릺뿀떎. 쟾泥 127媛 쓽猷뚭린愿쓽 154媛 遺꽌뿉꽌 씤젰 異⑹썝씠 븘슂븳 遺꽌뒗 37媛(24.0%)濡 떖옣珥덉쓬뙆 19媛, 뇤삁瑜섏큹쓬뙆 18媛, 寃쎈룞留μ큹쓬뙆 0媛쒕줈 遺꽌濡 遺꾩꽍릺뿀쑝硫, 쓽猷뚭린愿 쑀삎쑝濡쒕뒗 1李 쓽猷뚭린愿 7媛, 2李 쓽猷뚭린愿 22媛, 3李 쓽猷뚭린愿 7媛, 寃吏꾩꽱꽣 1媛쒕줈 遺꽌濡 遺꾩꽍릺뿀떎. 씠泥섎읆 珥덉쓬뙆寃궗 빆紐⑸퀎 뾽臾대웾쓣 뙆븙븯怨 쟻젙 씤젰쓣 궛異쒗븯뿬 씪옄由щ 李쎌텧븿쑝濡쒖뜥 뾽臾 遺꽌蹂 씤젰슫쁺쓽 슚쑉꽦쓣 洹밸솕븯뿬 寃궗쓽 吏덉쓣 뼢긽떆궎怨, 엫긽蹂묐━궗쓽 珥덉쓬뙆寃궗 遺꾩빞 怨좎슜 븞젙怨 뾽臾댁쁺뿭 솗蹂대 諛쒗뙋쓣 留덈젴븯뒗뜲 쓽誘멸 엳떎怨 깮媛곷맂떎.

蹂닿굔쓽猷 씤젰 媛옣 빑떖쟻씤 蹂닿굔쓽猷 옄썝쑝濡 븳 援媛쓽 蹂닿굔쓽猷 씤젰쓽 뼇怨 吏덉 洹 援媛쓽 쓽猷 닔以쓣 媛뒫븷 닔 엳뒗 寃곗젙쟻 湲곗쑝濡 씠슜릺怨 엳쑝硫, 떒湲곌컙뿉 닔湲됱쓣 議곗젅븷 닔 뾾뒗 蹂닿굔쓽猷 씤젰쓽 듅꽦긽 옒紐삳맂 닔湲 젙梨낆 옣湲곌컙뿉 嫄몄퀜 援媛 쓽猷뚯떆뒪뀥쓽 鍮꾪슚쑉꽦쓣 珥덈옒븷 닔 엳떎. 삉븳, 쓽猷 씤젰쓽 닔 吏덉 쓽猷뚭났湲됱쓽 二쇱슂 寃곗젙 슂씤씠 릺怨 엳뼱 쓽猷 씤젰쓽 쟻젙 닔以 쑀吏뒗 援誘 嫄닿컯沅 솗蹂대 쐞빐 븘닔쟻씠떎. 듅엳 援誘쇱냼뱷怨 援먯쑁 닔以 諛 깮솢 닔以씠 뼢긽릺硫댁꽌 援誘쇱쓽 嫄닿컯뿉 븳 愿떖씠 怨좎“릺怨, 룊洹좎닔紐낆쓽 뿰옣쑝濡 씤븳 씤援ъ쓽 怨좊졊솕 異붿꽭, 嫄닿컯蹂댄뿕쓽 蹂댁옣꽦 솗 벑쑝濡 쓽猷 닔슂뒗 怨꾩냽 利앷릺怨 엳湲 븣臾몄뿉 씠뿉 쓳븯뒗 쟻젙 꽌鍮꾩뒪쓽 怨듦툒怨 솗蹂대뒗 援誘 蹂듭 李⑥썝뿉꽌 븘닔쟻씤 슂냼媛 릺뿀떎(삤쁺샇 쇅., 2016). 씤援ъ쓽 怨좊졊솕 吏덈퀝援ъ“쓽 蹂솕, 쓽븰湲곗닠쓽 諛쒕떖怨 쓽猷뚯꽌鍮꾩뒪쓽 떎뼇솕 怨좊룄솕 븿猿 쓽猷뚮 諛쏆븘뱾씠뒗 삤뒛궇쓽 쓽猷 솚寃 蹂솕뿉 쓽猷뚭젴 吏곸쥌 쟾泥닿 쓳븯湲 쐞빐꽌뒗 쓽猷뚭젴 吏곸쥌媛꾩쓽 슚쑉쟻씠怨 쟻젙븳 뿭븷遺꾨떞怨 냼넻씠 븘슂븯떎. 蹂닿굔쓽猷뚭났湲됱껜怨꾧 젣濡 솗由쎈릺湲 쐞빐꽌뒗 븵쑝濡쒖쓽 궗쉶 蹂솕뿉 쓳븷 닔 엳怨 蹂닿굔쓽猷뚯꽌鍮꾩뒪 媛곴컖쓽 쁺뿭뿉꽌 븘슂븳 씤젰씠 뮮諛쏆묠릺뼱빞 븯硫 湲곗〈 씤젰쓽 뿭븷怨 湲곕뒫쓣 뾽洹몃젅씠뱶떆궎怨 깉濡쒖슫 씤젰쓣 媛쒕컻빐빞 븳떎.

쓽猷 씤젰쓽 怨듦툒 痢〓㈃怨 닔슂 痢〓㈃쓽 諛⑹븞뱾씠 슚쑉쟻씠湲 쐞빐꽌뒗 愿젴 踰뺢낵 젣룄瑜 媛쒖꽑븯怨 씤봽씪瑜 援ъ텞븷 븘슂媛 엳쑝硫, 씠윭븳 踰뺢낵 젣룄쟻 媛쒖꽑 쓽猷뚯쟻 떦꽦 諛 씤젰닔湲 쁽솴쓣 몢猷 怨좊젮빐 씤젰怨좎슜쓣 넻빐 쓽猷뚯꽌鍮꾩뒪쓽 吏덉씠 뼢긽맆 닔 엳뒗 諛⑺뼢쑝濡 寃넗릺뼱빞 븳떎. 삉븳, 蹂닿굔쓽猷뚰솚寃쎌쓽 蹂솕뿉 쟻젅븯寃 쓳븯怨 쓽猷뚯꽌鍮꾩뒪쓽 吏덉쓣 넂씠湲 쐞빐꽌뒗 쁽옱쓽 쓽猷뚰솚寃 쁽솴 遺꾩꽍 諛 蹂닿굔쓽猷 씤젰쓽 떎깭뙆븙怨 닔湲됱쟾留앹쓣 넻븯뿬 蹂닿굔쓽猷 씤젰쓣 쟻젙븯寃 뼇꽦븯怨 쟻옱쟻냼뿉 諛곕텇븯뒗 寃껋씠 븘슂븯떎(諛뺤슜泥 쇅., 2015). 뵲씪꽌 蹂 뿰援щ뒗 珥덉쓬뙆 遺꾩빞뿉 醫낆궗븯뒗 엫긽蹂묐━궗뱾쓣 긽쑝濡 꽕臾몄“궗瑜 떎떆븯뿬 뾽臾대웾 諛 洹쇰Т떎깭瑜 뙆븙븯怨 쟻젙寃궗嫄댁닔 諛 쟻젙 씤젰쓣 궛異쒗븿쑝濡쒖뜥 씪옄由 李쎌텧쓣 쐞븳 洹쇨굅瑜 留덈젴븯怨 엳뼱 쓽誘 엳뒗 뿰援щ씪怨 븷 닔 엳떎. 珥덉쓬뙆寃궗떎쓽 슚쑉쟻씤 슫쁺 떒닚븳 寃쎌젣쟻씤 痢〓㈃ 쇅뿉 援誘쇨굔媛뺤뿉 以묒슂븳 쁺뼢쓣 二쇰濡 寃궗쓽 吏덈룄 留ㅼ슦 以묒슂븯떎. 寃궗떎쓽 슚쑉쟻씤 슫쁺뿉 븳 룊媛뒗 슚쑉꽦怨 깮궛꽦쑝濡 룊媛븷 닔 엳怨, 꽑뻾 뿰援(삤쁺쉶 쇅., 2007)뿉꽌 쓽猷 씤젰 以 쓽궗, 媛꾪샇궗, 媛꾪샇議곕Т궗뿉 鍮꾪븯뿬 쓽猷뚭린궗쓽 룊洹 깮궛꽦씠 媛옣 넂떎怨 諛쒗몴븳 諛 엳쑝硫 寃쎌쁺옄뒗 슚쑉꽦 諛 깮궛꽦 痢〓㈃뿉꽌 寃궗떎쓽 뾽臾 닔뻾뿉 엳뼱꽌 쟻젅븳 씤젰쓣 蹂댁쑀븯怨 엳뒗吏, 寃궗옄媛 寃궗쓽 궃씠룄뿉 異⑸텇븳 寃쎈젰怨 뭾遺븳 寃쏀뿕쓣 媛吏怨 엳뒗吏쓽 뿬遺瑜 怨좊젮빐빞 븳떎.

슦由щ굹씪 쓽猷뚭린愿쓽 珥덉쓬뙆寃궗 옣鍮 蹂댁쑀 쁽솴 蹂묒썝湲 씠긽 쓽猷뚭린愿 遺遺 珥덉쓬뙆寃궗 옣鍮꾨 蹂댁쑀븯怨 엳뒗 寃껋쑝濡 굹궗떎(젙꽕씗 쇅., 2014). 씠泥섎읆 珥덉쓬뙆寃궗 옣鍮꾩쓽 솗궛씠 留롮씠 씠猷⑥뼱吏 긽솴뿉꽌, 珥덉쓬뙆寃궗 옣鍮 궗슜쓽 蹂댄렪꽦, 옣鍮 諛쒖쟾쑝濡 씤븳 寃궗 쟻슜踰붿쐞쓽 솗, 쁺긽吏꾨떒寃궗 鍮 졃븳 鍮꾩슜 벑뿉 옒엯뼱 愿젴 닔슂뒗 怨꾩냽 利앷븷 寃껋쑝濡 쟾留앸릺誘濡 珥덉쓬뙆寃궗쓽 吏 愿由ш 留ㅼ슦 븘슂븳 떆젏씠떎. 珥덉쓬뙆寃궗뒗 寃궗옄媛 寃궗瑜 떆뻾븿怨 룞떆뿉 떎떆媛 쁺긽쓣 뙋룆븯뿬 吏꾨떒뿉 븘슂븳 쁺긽쓣 쉷뱷븯湲 븣臾몄뿉 寃궗옄뿉 븳 쓽議대룄媛 넂怨, 寃궗옄쓽 吏떇怨 寃쏀뿕뿉 뵲씪 洹 李⑥씠媛 諛쒖깮븷 닔 엳떎(New Medical World Weekly, 2008; Department of Health and Ageing, 2011; 젙꽕씗 쇅., 2014). 寃궗옄쓽 뿭웾뿉 뵲瑜 씠윭븳 李⑥씠뒗 寃궗 寃곌낵瑜 겕寃 醫뚯슦븷 닔 엳湲 븣臾몄뿉 젣怨 씤젰쓽 吏 愿由ш 以묒슂븯硫, 듅엳 寃궗옄쓽 吏냽쟻씤 援먯쑁씠 留ㅼ슦 以묒슂븯떎. 蹂 뿰援ъ쓽 寃곌낵뿉꽌룄 吏덉쟻 뾽臾대웾씠 넂 쓽猷뚭린愿쓽 吏 愿由ш 듅엳 以묒슂븷 寃껋쑝濡 궗猷뚮맂떎.

뿰援 븳怨꾩젏

蹂 뿰援щ뒗 꽕臾몄“궗諛⑸쾿쑝濡 吏꾪뻾맂 뿰援щ줈뜥 떎쓬怨 媛숈 븳怨꾩젏씠 엳떎. 泥レ㎏, 쟾泥 珥덉쓬뙆寃궗옄뱾쓽 쓽寃 諛 뾽臾댄솚寃쎌쓣 蹂븯吏 紐삵븯怨, 꽕臾몄“궗 떦떆 二쇨쟻 寃ы빐媛 諛섏쁺릺뿀쓣 媛뒫꽦쓣 諛곗젣븯吏 紐삵븳떎뒗 젏씠 엳떎. 몮吏, 쟻젙寃궗嫄댁닔 諛 쟻젙씤젰 궛異 떆, 珥덉쓬뙆寃궗 뾽臾대쭔쓣 닔뻾븳떎뒗 媛젙 븯뿉 遺꾩꽍븯怨, 媛 쓽猷뚭린愿쓽 遺꽌 듅꽦긽 珥덉쓬뙆寃궗 쇅 寃궗 뾽臾 諛 떎瑜 뾽臾대 닔뻾븯뒗 寃쎌슦, 洹 뾽臾대뱾쓽 뾽臾대웾쓣 諛섏쁺븯吏 紐삵븯湲 븣臾몄뿉 蹂 뿰援 寃곌낵뿉 궛異쒕맂 쟻젙寃궗嫄댁닔 諛 쟻젙 씤젰쓣 쟻슜븯湲곗뿉 븳怨꾧 엳떎. 뀑吏, 쓽猷뚭린愿쓽 遺꽌 듅꽦긽 珥덉쓬뙆寃궗냼슂떆媛 諛 寃궗쓽 궃씠룄媛 떎뼇븯뿬 룊洹 쟻젙寃궗嫄댁닔 諛 쟻젙씤젰 닔뒗 쓽猷뚭린愿 듅꽦긽 李⑥씠媛 엳쓣 닔 엳떎. 꽬吏, 蹂 뿰援ъ쓽 쓽猷뚭린愿 쑀삎 1李 蹂묒썝 10%, 2李 蹂묒썝 44%, 3李 蹂묒썝 44%濡 遺꾩꽍릺뿀쑝誘濡 1李 蹂묒썝쓽 뾽臾댄솚寃쎌쓣 異⑸텇엳 諛섏쁺븯吏 紐삵븯떎.

寃곕줎쟻쑝濡, 뼇쟻 · 吏덉쟻 뾽臾대웾쓣 諛뷀깢쑝濡 쟻젙 씤젰쓣 궛異쒗븯뿬 뾽臾 遺꽌蹂 씤젰슫쁺쓽 슚쑉꽦쓣 洹밸솕븿쑝濡쒖뜥 寃궗쓽 吏덉쓣 뼢긽떆궗 닔 엳쑝硫, 씪옄由щ 李쎌텧븯뿬 珥덉쓬뙆寃궗 遺꾩빞 怨좎슜 븞젙怨 뾽臾댁쁺뿭 솗蹂댁쓽 諛쒗뙋쓣 留덈젴븯뒗뜲 蹂 뿰援ъ쓽 쓽誘멸 엳떎怨 깮媛곷맂떎. 삉븳, 珥덉쓬뙆寃궗떎쓽 씤젰 援ъ“ 諛 뾽臾댄솚寃쎌뿉 븳 옄猷뚭 誘명씉븳 쁽 떆젏뿉꽌 以묒슂븳 옄猷뚮줈 솢슜맆 닔 엳쓣 寃껋쑝濡 궗猷뚮맂떎.

ACKNOWLEDGEMENT

蹂 뿰援щ뒗 븳엫긽蹂묐━궗삊쉶쓽 뿰援ш낵젣 뿰援щ퉬濡 吏꾪뻾릺뿀떎.

꽕臾몄“궗뿉 쓳빐二쇱떊 븳엫긽蹂묐━궗삊쉶 쉶썝遺꾨뱾猿 吏꾩떖쑝濡 媛먯궗뱶由쎈땲떎.

CONFLICT OF INTEREST

The author declares no conflict of interest.

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