• 한국병원경영학회지
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• 제23권1호
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• pp.28-40
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• 2018

Purpose: The purpose is to understand the perception of medical providers at tertiary hospitals in Seoul on the importance-performance of the reform on a doctor-designation system, and to provide the policy suggestion of the perception on such a system. Methodology: To achieve the purpose, this study utilized structured survey tools to conduct a questionnaire survey of nursing, administrative and medical technology professionals at six tertiary hospitals in Seoul. An importance-performance analysis was utilized for an analysis that showed the perception of the reform on a doctor-designation system. Findings: First, it was identified that those medical providers had the highest perception of the importance about the performance of the reform on a doctor-designation system. Second, according to the result of action grid of an importance-performance analysis (IPA), it can be identified that in the 2nd stage of 'Concentrate here' included are the items as to design and effect of medical care quality and subsidies & patient infection and safety and control fees, effect of income security of the method for compensating for loss established by the government and offering sufficient information on general medical services and doctor-designation medical services. In the 1st stage of 'Keep up the Good Work', and the 2nd stage of 'Concentrate here' included is the item as to the performance of patients of the reform on a doctor designation system. Practical Implications: There could be identified the effect of the reform bill on the perception of medical providers. It is expected that a better environment would be provided for patients to use a hospital and for medical providers to offer medical services, if the goverment makes efforts to improve methods for compensating for loss and continuous monitoring of the performance of patients.

• 한국컴퓨터정보학회논문지
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• 제19권8호
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• pp.169-176
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• 2014

어떤 정책을 원만히 정착시켜 시행하기 위해서는 충분한 검토와 대화, 사회적 합의가 필수적 요소이다. 정부에서도 국민의 건강과 직결되는 원격의료를 의료산업발전을 통한 국가의 신성장 정책을 추진하기 위한 밀어붙이기식의 보건정책은 큰 사회적 부작용을 낳을 수 있다. 또한 의료계에서도 그들만의 이기적 주장을 탈피하고 어떠한 시스템이 국민의 건강과 생명을 담보할 수 있고, 급변하는 의료기술의 발달에 발맞춰 국민에게 최상의 의료서비스가 가능하도록 변화해야 한다. 급변하는 정보통신기술의 발전과 의료산업분야의 과학화는 분명 우리에게 많은 편의성과 국민건강 향상에 기여할 것이다. 그러나 원격의료 활성화 이전에 국민의 건강과 생명을 담보할 수 있는 안전성 및 유효성의 검토가 필요하고 어떠한 제도를 시행하기 전에 충분한 검토와 사회적 합의가 반드시 선결되어야 한다. 이에 원격의료 활성화를 위한 선결과제로 외국의 원격의료 현황과 우리나라의 현황 등을 살펴보고, 원격의료 활성화를 위해서 선결 되어야할 문제들을 제시하고자 한다.

• Journal of Acupuncture Research
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• 제27권2호
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• pp.43-49
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• 2010

Objectives : Among young generation, the prevalence of spinal disorders is known to be increasing. This study aimed to analyze the clinical data of spinal disorder in young ages in Korea. Methods : Number of patient, kinds of disorder, and medical cost were analyzed for patients(7~18 years) underwent spinal disorders using computerized database of Health Insurance Review and Assessment Service(HIRAS) from 2004 to 2008. We included dorsopathies as spinal disorder according to Korean Classification of Diseases(KCD) and excluded spinal disorder caused by trauma. We compared the data of traditional Korean medicine treatment with that of western medical care. Results : 4.8% of the children and adolescents had medical treatment with spinal disorder in 2008. The claim number and medical cost for both traditional Korean medicine and western medicine treatment are increasing 1.8 and 1.3 times respectively over 5 years. Total medical spent of western clinic was 2.1 times than those of traditional Korean clinic. The most common spinal disorder was dorsalgia(31.8%) and scoliosis(13.5%) in western clinics while back pain(29.0%) and neck pain(10.8%) in oriental clinic. Conclusions : We first reported the clinical tendency of spinal disorder in Korean children adolescents from 2004 to 2008. This study will support the development of a strategy for traditional Korean medicine-based prevention or treatment of spinal disorders in young generation.

• 한국치위생학회지
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• 제11권5호
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• pp.791-799
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• 2011

Objectives : This study aimed at examining the aspects of utilization of the dental services in some regions and analyzing the related factors with a view to helping the old solve the dental problems and overcome the difficulties. Methods : This investigation was intended for 422 old people living in Jeon-ju city and Jang-su county from July 18, 2006 to August 25 by direct interviewing posing questions. The survey data sets were analyzed by chi-square, correlation, multiple regression and logistic regression. Results : 1. The average number of the existing teeth per an old person was 13.6 and the 28.8% of the old who didn't use denture called for dentures. 2. The annual coefficient of utilization in dental services for an old person was 52.3% and the annual average visits to dental clinics were 3.12 days while 38.6% of the old experienced illegal dental treatments. 3. The affecting factors on the dental utilization for treatment were as follows: family income, dental clinics available, the number of existing teeth, the days of dental trouble, the recognition of the prevention of the dental disease, the knowledge for the dental treatment and the oral health judged by himself. 4. The major variables influencing the utilization of dental services were spouse presence, form of family, income, having a regular dental care, denture presence and the experience of inconvenience in living. Conclusions : To conclude, the following suggestions could be made. First, It was necessary that enforcement practice of free dental prosthesis service and application to the national health insurance in old people's prosthetic therapy for government support because the economic factor was barrier to utilization of the dental services. Second, Dental clinic was required to the health center because availability of common dental services was big impact in utilization of the dental services.

• 응용통계연구
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• 제33권3호
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• pp.239-256
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• 2020

최근 기대수명의 증가로 건강에 대한 관심이 늘어나고 있으며 이에 따라 건강관련 산업 및 서비스에 대한 수요도 증가하고 있다. 개인의 건강상태를 다양한 요소들을 이용하여 평가하고 분류할 수 있는 방법을 통해 다양한 건강관련 프로그램 및 서비스를 보다 합리적으로 운영할 수 있을 것이다. 본 연구에서는 기존 연구를 통해 잘 알려진 건강상태 관련 요인들을 이용하여 건강수준을 측정하고 평점화하는 방안을 제시하였다. 이를 위해 신용평가모형의 변수 선정과 범주화, 모형 도출, 평점화로 이어지는 일련의 과정에서 사용하는 방법론을 도입하였고 모형의 적합을 위해서 국민건강보험공단에서 제공하는 표본 코호트 DB를 이용하였다. 본 연구에서 도출된 건강수준 평가모형은 헬스케어 및 건강관련 서비스에 대한 구조 설계 및 운영에 적절하게 활용될 수 있을 것으로 기대된다.

• 보건행정학회지
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• 제26권3호
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• pp.233-241
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• 2016

Background: This study purposed to analyze and understand how spatial accessibility of patients influenced the number of outpatient visits for the internal medicine of a hospital. Methods: A hospital with 100 beds in Seoul, South Korea provided data from 2013 January 1 to 2013 June 30. Euclidean distance and road ares were used to represent the spatial accessibility. Patient level data and dong level data were collected and used in spatial analysis. Dong level data was converted into grid level ($500{\times}500m$) for the multivariate analysis. Hot-spot analysis and generalized linear model were applied to the data collected. Results: Hot-spots of outpatient visits were found around the study hospital, and cold-spots were not found. Number of outpatient visits was varied by the distance between patient resident and hospitals, and about 80% of total outpatient visits was occurred in within the 5 km from study hospital, and 50% was occurred in within 1.6 km. Spatial accessibility had significant influences on the outpatient visits. Conclusion: Findings provide evidences that spatial accessibility had influences on the patients' behaviors in utilizing the outpatient care of internal medicine in a hospital. Results can provide useful information to health policy makers as well as hospital managers for their decision making.

• 의료법학
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• 제12권1호
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• pp.11-39
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• 2011

[ ${\S}27$ ]Abs. 3 das Gesuntheitsdienstgesetz (the Medical Service Act) in Korea lautet: Niemand in der Absicht, sich oder einem Dritten einen $Verm{\ddot{o}}gensvorteil$ zu verschaffen, der Medizininstitut bzw. dem Mediziner (die Medizinerin) den Patienten vorstellen, ${\ddot{u}}bweweisen$, verleiten oder einen anderen zu dieser Handlung anstiften darf, wie z.B. die Selbstbeteiligung des Patienten nach dem Krankenkassengesetz (the National Health Insurance Act) oder dem Gesetz ${\ddot{u}}ber$ Beistand der ${\ddot{a}}rztlicher$ Betreuung (the Medical Care Assistance Act) skontieren oder befreien, Geld offerieren oder dem Allgemeinheit das Verkehrswesen anbieten usw. Nach dem Wortlaut ist jedoch unklar, ob unter diese Vorschriften der Fall subsumiert werden kann, wenn eine Medizininstitut bzw. ein(e) Mediziner(in) in der Absicht, sich einen $Verm{\ddot{o}}gensvorteil$ zu verschaffen, sich den Patienten verleitet. Nach dem Korean Supreme Court ist eine Medizininstitut bzw. ein(e) Mediziner(in) nur dann das Subjekt der Verleitungshandlung, wenn sie bzw. er ein Mittel gegen fairen oder $ordungsm{\ddot{a}}{\beta}ien$ Medizinmarkt verwendet oder dem Patienten eine ${\ddot{a}}rztlich$ rechtswidrige Behandlung (z.B. einen rechtswidrigen Schwangerschaftsabbruch) verspricht. In diesem Beitrag wird dagegen die Auffassung mittels der teleologischen Reduktion vertritt und argumentiert, dass ein ${\ddot{a}}rztlich$ rechtswidriges Behandlung nach dem Rechtsgut und dem Normzweck unter ${\S}27$ Abs. 3 das Gesuntheitsdienstgesetz nicht subsumiert werden, sondern allein nach eigenem Unrecht bestraft werden kann.

• 보건행정학회지
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• 제22권1호
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• pp.65-84
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• 2012

Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.

• 한국전자통신학회논문지
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• 제13권1호
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• pp.207-212
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• 2018

빅데이터 시대에 각광받고 있는 데이터 분석 도구인 R은 강력한 통계 분석 기능과 데이터 가시화 기능을 제공함으로 인해 그 사용자를 급속히 넓혀 가고 있다. 오픈소스 기반으로서의 다양한 기능 확장성이 R의 강점인데 반해 규모 확장성이 미흡함으로 인해 대용량 데이터 처리에서의 성능 제약이 발생한다. 이를 보완하기 위한 확장 패키지 중 하나인 RHadoop은 R로 작성된 코드에 대해 하둡 플랫폼 기반 병렬 분산 처리를 지원하므로 데이터 분석 성능을 높일 수 있다. 본 논문에서는 인터넷을 통해 공개되는 실제 보건의료 빅데이터를 이용한 데이터 분석에서 RHadoop을 활용할 때 얻을 수 있는 성능 개선을 평가함으로써 RHadoop의 유효성을 검증한다. 본 연구를 통해 R과 RHadoop에서 국민건강보험 진료내역정보를 각각 분석한 결과 8개의 데이터 노드로 구성된 RHadoop 클러스터가 R과 비교하여 최대 8배 이상 성능을 개선시킬 수 있음을 입증하였다.

• 대한안전경영과학회지
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• 제12권2호
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• pp.35-40
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• 2010

This study collected 217 cases of court ruling statements for the cases over which administrative litigations were made regarding the acknowledgment of cerebral and cardiovascular diseases arising out of duty against Korea Labor Welfare Corporation and analyzed the factors of occurrence of cerebral hemorrhage and infarction and the Court cases of cancelation and dismissal of the litigation. As a result, due to seasonal factors, cerebral hemorrhage occurred more in the winter while cerebral infarction, in spring. The incidences for each age group were the higest in people in their 40s for cerebral hemorrhage while in those in their 50s for cerebral infarction, it turned that the incidence inside the places of business was the highest. The average days from application for care and family benefits until the confirmation of the case was 31 months on average for 34 canceled cases while 23 months for 183 dismissed ones, and the average number of months working until the occurrence of accident was 80.8 months for the 34 canceled cases while 77.6 for the 183 dismissed ones. This study has a significance in that it analyzed leading cases of confirmed administrative litigations in some cases applied for diseases due to occupational cases after the occurrence of cerebral and cardiovascular diseases but not approved, through which it is expected to be used as the basic data to reduce time and economic loss generated by the litigations to judge the acknowledgment of diseases due to occupational cases.