• 보건행정학회지
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• 제29권2호
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• pp.206-219
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• 2019

This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2018 constructed according to the SHA2011, which is a manual for System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analyzing health accounts of OECD member countries. Particularly, scale and trends of the total CHE financing as well as public-private mix are parsed in depth. In the case of private financing, estimation of total expenditures for (revenues by) provider groups (HP) is made from both survey on the benefit coverage rate of National Health Insurance (by National Health Insurance Service) and Economic Census and Service Industry Census (by National Statistical Office); and other pieces of information from Korean Health Panel Study, etc. are supplementarily used to allocate those totals into functional classifications. CHE was 144.4 trillion won in 2018, which accounts for 8.1% of Korea's gross domestic product (GDP). It was a big increase of 12.8 trillion won, or 9.7%, from the previous year. GDP share of Korean CHE has already been close to the average of OECD member countries. Government and compulsory schemes' share (or public share), 59.8% of the CHE in 2018, is much lower than the OECD average of 73.6%. 'Transfers from government domestic revenue' share of total revenue of health financing was 16.9% in Korea, lower than the other social insurance countries. When it comes to 'compulsory contributory health financing schemes,' 'transfers from government domestic revenue' share of 13.5% was again much lower compared to Japan (43.0%) and Belgium (30.1%) with social insurance scheme.

• 융합정보논문지
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• 제10권8호
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• pp.187-193
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• 2020

본 연구는 우리나라 종합병원을 대상으로 경영의 위험요인이 운전자본 관리에 어떻게 영향을 미치는지를 분석하였다. 자료는 의료기관회계정보공시 시스템을 이용하여 271개 종합병원 3개연도(2016년, 2017년, 2018년)의 회계정보를 이용하였다. 도입변수는 종속변수로 운전자본 수준과 현금순환주기, 독립변수로 운영위험과 시장위험, 통제변수로 운전자금 구성요인(현금, 매출채권, 재고자산, 매입채무)을 선정하였다. 연구결과, 우리나라 종합병원들은 운영위험이 낮을수록 운전자본 수준은 높았으며, 운전자본 결정에는 운영위험, 현금, 재고자산, 매입채무가 작용하는 것으로 확인되었다. 그리고 시장위험(의료이익률)이 낮을수록 현금순환주기가 높았다는 것을 알 수 있었다. 따라서 의료기관들도 운영의 특수성을 고려하여 경기대응능력을 갖출 수 있도록 운전자본 결정요인으로 확인된 운영위험, 현금, 재고자산, 매입채무의 적절한 관리방안에 대한 검토의 필요성이 제기된다.

• 보건행정학회지
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• 제29권3호
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• pp.374-378
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• 2019

After the announcement of Moon Jae-in Government's plan (Moon's Care) for Benefit Expansion in National Health Insurance in August 2017, it is necessary to monitor the effects of the policy, especially household out-of-pocket payments (OOP). This paper aims to observe the current status and trend of OOP in Korea. Current health expenditure (CHE) was 144.4 trillion won in 2018, which accounts for 8.1% of gross domestic product (GDP) increased 9.7% from the previous year. Although GDP's share of CHE has been close to the average of the Organization for Economic Cooperation and Development (OECD) countries, the public fund's share was 59.8% of the total in 2018, which was lower than the OECD average of 73.5%. OOP's share was 32.9% in 2018, which decreased from 37.4% in 2008. The share of OOP of non-covered services was 20.0% in 2018, which decreased from 22.9% in 2008. The share of cost-sharing with third-party payers was 12.9% in 2018, which decreased from 14.5% in 2008. The OOP of non-covered services was significantly decreased in hospital and inpatient curative care, but the OOP of non-covered services was significantly increased in the medical clinic. The effect of Moon's Care was not showed in OOP through the results of 2017 and 2018, but further monitoring is needed because the Moon's Care is progressing and the observational period is short.

• 지역사회간호학회지
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• 제29권3호
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• pp.257-266
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• 2018

Purpose: The study has been conducted to identify factors affecting the participation in leisure activities by elderly women living alone. Methods: Data were collected through a questionnaire survey among 150 elderly women in Seoul and Gyeong-gi Province. The measurement tools that were used include participation in leisure activities, perceived health status, Geriatric Depression Scale Short Form-Korea (GDSS-K), psychological well-being scale, and loneliness scale. The data were analyzed by using the Pearson correlation coefficients, t-test, analysis of variance ANOVA, and stepwise multiple regression with the SPSS/windows version 21.0 program. Results: The analysis shows that the affection for participation in leisure activities of the elderly women living alone who participated in the questionnaire survey is significant (F=14.6, p<.001). The value of the adjusted $R^2$ is 0.55, which accounts for the explanatory power of 55.4%. The predictor that has been found to have the greatest influence on the participation in leisure activities by the elderly women living alone include perceived health status, followed by monthly allowance (10,000 won), psychological well-being, economic status, religion, depression, family structure, and loneliness. Conclusion: The results suggest that in developing nursing interventions and practice for the participation in leisure activities by elderly women living alone, perceived health status, psychological well-being, depression, and loneliness should be considered.

• 보건행정학회지
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• 제31권1호
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• pp.100-113
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• 2021

Background: This study aims to figure out the gaps in health status by estimating amenable mortality rate by region, reflecting the characteristics of Korea, and estimating the years of life lost (YLL) per capita by disease. Methods: People who died from amenable diseases between 2008 and 2018 were extracted from the cause of death statistics provided by Statistics Korea. The age-standardized amenable mortality rates were estimated to compare the health status of 229 regions. YLL per capita was calculated to compute the burden of diseases caused by treatable deaths by region. The YLL per capita by region was calculated to identify the burden of disease caused by amenable deaths. Results: First, while the annual amenable mortality rate in Korea is on a steady decline, but there is still a considerable gap between urban and rural areas when comparing the mortality rates of 229 areas. Second, YLL per capita due to the amenable deaths is approximately 14 person-years during the analysis period (2008-2018). Conclusion: Although the health status of Koreans has continuously improved, there is still a gap in health status region by region in terms of amenable mortality rates. Amenable death accounts for a loss of life equivalent to 14 person-years per year. Since the amenable mortality rate is an indicator that can measure the performance of the health care system, efforts at each local area are required to lower it.

• 응용통계연구
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• 제31권4호
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• pp.507-516
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• 2018

결측치를 대치하는 여러가지 단일대치법 중에서 다변량 정규성 등의 모수적 모형이 만족되지 않을 때에도 강건성(robustness)을 지니는 k-최근접 이웃 대치법(k-nearest neighbors; KNN)이 널리 활용된다. KNN대치법에서 자료의 국소적 특징을 반영한 적응 최근접 이웃(adaptive nearest neighbors; ANN) 대치법과 k개의 최근접 이웃들 중 극단값이나 이상값이 있는 경우 이들의 영향에 덜 민감한 가중 k-최근접 이웃(weighted KNN; WKNN) 대치법의 장점을 결합한 가중 적응 최근접 이웃(weighted ANN; WANN) 대치법을 제안하였다. 또한 모의실험을 통하여 기존의 방법들과 제안한 방법을 비교하였다.

• 한국건설관리학회논문집
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• 제19권6호
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• pp.79-85
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• 2018

정부와 안전보건공단에서는 건설현장의 안전사고 저감을 위하여 감독 점검, 기술지도 재정지원 등의 안전활동을 지속적으로 수행하여 왔으나, 건설현장의 재해자수는 매년 증가추세에 있으며, 특히 소규모 건설공사를 위주로 전체 재해자수의 80%이상을 차지하고 있다. 본 연구에서는 소규모 건설공사 현장에서의 안전 보건관리의 이행현황을 조사하고 해당 사업장에 정부의 적정한 기술지도 방안을 마련할 필요성이 있으며, 소규모 건설공사 현장에서의 재해를 줄이고 기술지도사업의 실효성을 확보하기 위한 건설현장에 부합하는 기술지도 최적안을 개발하는 것을 목적으로 한다.

• Journal of Preventive Medicine and Public Health
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• 제51권5호
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• pp.242-247
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• 2018

Objectives: To examine survivorship disparities in demographic factors and risk status for non-muscle-invasive bladder cancer (NMIBC), which accounts for more than 75% of all urinary bladder cancers, but is highly curable with early identification and treatment. Methods: We used the US National Cancer Institute's Surveillance, Epidemiology, and End Results registries over a 19-year period (1988-2006) to examine survivorship disparities in age, sex, race/ethnicity, and marital status of patients and risk status classified by histologic grade, stage, size of tumor, and number of multiple primary tumors among NMIBC patients (n=29 326). We applied Kaplan-Meier (K-M) and Cox proportional hazard methods for survival analysis. Results: Among all urinary bladder cancer patients, the majority of NMIBCs were in male (74.1%), non-Latino white (86.7%), married (67.8%), and low-risk (37.6%) to intermediate-risk (44.8%) patients. The mean age was 68 years. Survivorship (in median life years) was highest for non-Latino white (5.4 years), married (5.4 years), and low-risk (5.7 years) patients (K-M analysis, p<0.001). We found significantly lower survivorship for elderly, male (female hazard ratio [HR], 0.96), Latino (HR, 1.20), and unmarried (married HR, 0.93) patients. Conclusions: Survivorship disparities were ubiquitous across age, sex, race/ethnicity, and marital status groups. Non-white, unmarried, and elderly patients had significantly shorter survivorship. The implications of these findings include the need for a heightened focus on health policy and more organized efforts to improve access to care in order to increase the chances of survival for all patients.

• Tuberculosis and Respiratory Diseases
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• 제81권1호
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• pp.19-28
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• 2018

Cancer is the leading cause of death in the Republic of Korea and cancer death accounts for 27.8% of the total deaths, which is not only a social issue but also a concern for the public. Among the cancer death rates, lung cancer mortality account for 34 deaths per 100,000 populations, making it the number one cancer death rate. In a preliminary report on cancer death in 2012, the lung cancer mortality ratio showed the regional variation indicating that there were differences in the qualitative level and the structure among the medical care benefit agency and in the assessment of the treatment process. Therefore, the Health Insurance Review and Assessment Service (HIRA) had begun evaluation of the assessment of lung cancer treatment since 2014 to improve the quality of lung cancer care through evaluation and feeds back the results of lung cancer care process. In this report, authors described the current Indicators for the lung cancer adequacy assessment proposed by HIRA and results of the evaluation reported in 2017.

• 대한임상검사과학회지
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• 제50권4호
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• pp.511-524
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• 2018

본 연구는 임상병리사 인력의 인력의 수급전망을 추계하여 인력계획 수립에 필요한 정책자료를 제공하는 것을 목적으로 한다. 공급은 기초추계(baseline projection) 모형에 근거한 인구학적 방법(demographic method)을 이용하여 추계하였으며, 수요추계는 임상병리사가 검사하는 임상병리검사 건수를 이용하는 의료수요에 의한 방법을 적용하였다. 전반적인 임상병리사 인력수급 추계결과는 생산성의 시나리오에 따라 공급이 과잉되기도 하고 부족하기도 할 것으로 전망되었다. 이렇게 임상병리사의 수급 비교 결과는 임상병리사의 생산성 가정에 따라 달라지지만, 어느 시나리오를 선택할 것인가는 궁극적으로 정부의 정책방향에 따라 달라진다. 즉 임상병리사의 생산성을 현재보다 높게 채택하는지 혹은 낮게 책정하는지는 보험재정 여건 등을 고려해야 하는 정부 정책에 달려있는 것이다. 이에 본 연구에서 정부의 정책방향이 고려되지 않은 2012년 현재의 생산성을 기준으로 한 '생산성 시나리오 3'을 살펴보면, ARIMA모델을 적용한 수요시나리오를 중심으로 보면 근무일수에 따라 2030년에는 2821명에서 4,530명의 임상병리사 공급이 과잉될 것으로 전망된다. 이러한 공급과잉은 전체에서 차지하는 비중이 10%미만이기 때문에 크게 문제가 되지 않을 것으로 판단된다. 그러나 임상병리사사 취업률이 60%대인 점을 감안하면 미취업자를 활용하는 정책도 함께 고려해야한다. 이러한 대책으로는 미취업인력에 대한 취업기회를 확대하는 방향으로 나아가야 할 것이고, 이를 위해서는 보건소 검사실의 기능강화 및 임상병리사 정원증원 및 신분보장, 통원치료 환자를 위한 상설 검사체제 확립, 산업재해 분야 및 의원급 검사기능 강화, 무면허 검사요원의 통제, 해외인력수출 확대 등이 필요할 것으로 사료된다.