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국내 문헌정보학 및 기록학 분야 학술지 오픈액세스 출판 전환 사례 연구 (A Case Study on the Converting Journals to Open Access in the field of Library and Information Science and Archival Science in Korea)

  • 정경희;이재윤
    • 한국문헌정보학회지
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    • 제57권2호
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    • pp.271-291
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    • 2023
  • 본 연구는 '문헌정보학 분야 학술단체의 오픈액세스출판 선언'에 참여한 7개 학술지의 오픈액세스 전환 현황과 효과를 파악하여 문제점을 분석하고 개선 방향을 제시하기 위한 것이다. 이를 위하여 '국내 문헌정보학 분야 학술지의 오픈액세스 출판 전환을 위한 로드맵'에 제시된 요소를 근거로 현황을 파악하고 2개 학술지의 인용률을 분석하였다. 드러난 문제점은 다음과 같다. 첫째, 일부 학술지는 CCL을 적용하지 않거나 KJCI에 이를 정확히 등록하지 못하고 있었고 7개 학술지 모두 DOAJ에 등록하지 못하고 있었다. 둘째, 전환 이후 새롭게 사용한 학술지 플랫폼에 과월호를 모두 등록하지 못한 학술지가 많았다. 셋째, 저자부담 논문출판비는 부분적으로 인상된 경향이 있고 편집간사 인건비도 인상된 경향이 있다. 넷째, 전환 이후 인용지수는 두 학술지 모두 이전 4~5년 보다 낮게 측정되었다. 본 연구는 장단기적인 실무 문제를 학회 공동으로 해결하면서 규모의 경제를 살릴 수 있도록 학술지를 공동으로 출판할 필요가 있으며 이를 위하여 또 한 번 로드맵을 개발해야한다고 제안하였다.

Trends and Outcomes of Type 2 Myocardial Infarction During the COVID-19 Pandemic in the United States

  • Harshith Thyagaturu;Nicholas Roma;Aakash Angirekula;Sittinun Thangjui;Alex Bolton;Karthik Gonuguntla;Yasar Sattar;Muchi Ditah Chobufo;Abhiram Challa;Neel Patel;Gayatri Bondi;Sameer Raina
    • Korean Circulation Journal
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    • 제53권12호
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    • pp.829-839
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    • 2023
  • Background and Objectives: There is limited data on the impact of type 2 myocardial infarction (T2MI) during the coronavirus disease 2019 (COVID-19) pandemic. Methods: The National Inpatient Sample (NIS) database from January 2019 to December 2020 was queried to identify T2MI hospitalizations based on the appropriate International Classification of Disease, Tenth Revision-Clinical Modification codes. Monthly trends of COVID-19 and T2MI hospitalizations were evaluated using Joinpoint regression analysis. In addition, the multivariate logistic and linear regression analysis was used to compare inhospital mortality, coronary angiography use, and resource utilization between 2019 and 2020. Results: A total of 743,535 patients hospitalized with a diagnosis of T2MI were identified in the years 2019 (n=331,180) and 2020 (n=412,355). There was an increasing trend in T2MI hospitalizations throughout the study period corresponding to the increase in COVID-19 hospitalizations in 2020. The adjusted odds of in-hospital mortality associated with T2MI hospitalizations were significantly higher in 2020 compared with 2019 (11.1% vs. 8.1%: adjusted odds ratio, 1.19 [1.13-1.26]; p<0.01). In addition, T2MI hospitalizations were associated with lower odds of coronary angiography and higher total hospitalization charges, with no difference in the length of stay in 2020 compared with 2019. Conclusions: We found a significant increase in T2MI hospitalizations with higher in-hospital mortality, total hospitalization costs, and lower coronary angiography use during the early COVID-19 pandemic corresponding to the trends in the rise of COVID-19 hospitalizations. Further research into the factors associated with increased mortality can increase our preparedness for future pandemics.

간호서비스 질에 대한 환자의 인식과 만족도 및 재방문의도와의 관계 (The Relationships among Patient's Perception, Patient's Satisfaction of Nursing Service Quality and Revisiting intention)

  • 이선아
    • 간호행정학회지
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    • 제4권2호
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    • pp.307-319
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    • 1998
  • This study is an empirical investigation and study on the measurement of nursing service quality as perceived by patients. A series of H1. H2. H3 alternative hypotheses were tested using a sample of 250 patients in Taegu City. Korea. HI hypothese were tested for application of five component of service quality (SERVQlTAL and SE RPERF : tangiblity. reliability. responsiveness. accessibility. understandability) in Taegu area Hospitals. Validity test - the five components of service quality were rearranged into two components of service quality (personal factor. nonpersonal factor). Although SERVQUAL was verified in USA. application for five components of service quality in Korea indicated that it need more analytical studies. Nobody can deny the fact that the recent growth of the nursing service quality is one of the most important driving forces of hospital management. In many hospitals. the nursing quality charges more than 50% of the medical service quality. As a result. many hospital managers should be enormous interests in the investment potentiality of the nursing service. However. doesn't many researchers invest their time and effort on the research of the quality control in nursing service. Nursing service management is the process to satisfy customer's desires and expectations through the various service activities. Presently nursing service are being faced with three Common tasks of improving quality of nursing service. competitively differential advantage and productivity because of quantitative expansion of Nursing service. Such a phenomenon is also found in our medical service industry. resulting from increasing demands for medical service owing to national medical insurance policy and consumer's attitude change emphasizing prevention of illness. excessiveness of medical facilities in large cities and increasing medical lawsuits due to influence of consumerism. Therefore. under such circumstances. this research on nursing service is conducted from nursing managements to improve the nursing service quality problems faced by medical institutions. The results of this theoretical/empirical research are as follows: 1. Nursing service Quality is regarded as patients' perceived quality and evaluated on the basis (5 dimension) of technical and functional quality. 2. Nursing service Quality is a concept of patients evaluation on the measurable multi-dimensions intrinsic and extrinsic attributes of service. 3. Nursing service Quality is conceptually defined as the difference between the perceived service and the expected service. 4. Korean consumers trend to evaluate nursing service quality based on such dimensions as responsiveness and reliability. understandability. accessibility. tangibility. 5. After analyzing whether or not there are some differences in respective medical institution. it was found that there are significant difference on understandability. reliability. communicability. courtesy. competence. 6. After analyzing the difference between the expected nursing service and the nursing perceived service, it was found that the expected nursing service is higher than the perceived service in every medical institution. 7. HI hypothesis was tested with regard to the validity test between SERVQUAL and SERVPERF in nursing service quality. The result of validity test between SERVQUAL and SERVPERF was found to have differential result. That is the R2 of SERVPERF is higher than that of SERVQUAL. Therefore. HI was verified in nursing management. H2. H3 hypotheses were tested whether or not the nursing service quality and patient satisfaction is the preceding variable. The result of H2 hypothes is that the nursing service quality is the preceding variable of patient satisfaction and the patient satisfaction is that of revisiting intention. After analyzing whether or not there is any differences on the demographic variable of five nursing service quality factor. it was found that there are statistically significant differences on communicability and courtesy at the sex. understand ability. accessibility and tangibility at the age. understandability at the academic background respectively.

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N- and P-doping of Transition Metal Dichalcogenide (TMD) using Artificially Designed DNA with Lanthanide and Metal Ions

  • Kang, Dong-Ho;Park, Jin-Hong
    • 한국진공학회:학술대회논문집
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    • 한국진공학회 2016년도 제50회 동계 정기학술대회 초록집
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    • pp.292-292
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    • 2016
  • Transition metal dichalcogenides (TMDs) with a two-dimensional layered structure have been considered highly promising materials for next-generation flexible, wearable, stretchable and transparent devices due to their unique physical, electrical and optical properties. Recent studies on TMD devices have focused on developing a suitable doping technique because precise control of the threshold voltage ($V_{TH}$) and the number of tightly-bound trions are required to achieve high performance electronic and optoelectronic devices, respectively. In particular, it is critical to develop an ultra-low level doping technique for the proper design and optimization of TMD-based devices because high level doping (about $10^{12}cm^{-2}$) causes TMD to act as a near-metallic layer. However, it is difficult to apply an ion implantation technique to TMD materials due to crystal damage that occurs during the implantation process. Although safe doping techniques have recently been developed, most of the previous TMD doping techniques presented very high doping levels of ${\sim}10^{12}cm^{-2}$. Recently, low-level n- and p-doping of TMD materials was achieved using cesium carbonate ($Cs_2CO_3$), octadecyltrichlorosilane (OTS), and M-DNA, but further studies are needed to reduce the doping level down to an intrinsic level. Here, we propose a novel DNA-based doping method on $MoS_2$ and $WSe_2$ films, which enables ultra-low n- and p-doping control and allows for proper adjustments in device performance. This is achieved by selecting and/or combining different types of divalent metal and trivalent lanthanide (Ln) ions on DNA nanostructures. The available n-doping range (${\Delta}n$) on the $MoS_2$ by Ln-DNA (DNA functionalized by trivalent Ln ions) is between $6{\times}10^9cm^{-2}$ and $2.6{\times}10^{10}cm^{-2}$, which is even lower than that provided by pristine DNA (${\sim}6.4{\times}10^{10}cm^{-2}$). The p-doping change (${\Delta}p$) on $WSe_2$ by Ln-DNA is adjusted between $-1.0{\times}10^{10}cm^{-2}$ and $-2.4{\times}10^{10}cm^{-2}$. In the case of Co-DNA (DNA functionalized by both divalent metal and trivalent Ln ions) doping where $Eu^{3+}$ or $Gd^{3+}$ ions were incorporated, a light p-doping phenomenon is observed on $MoS_2$ and $WSe_2$ (respectively, negative ${\Delta}n$ below $-9{\times}10^9cm^{-2}$ and positive ${\Delta}p$ above $1.4{\times}10^{10}cm^{-2}$) because the added $Cu^{2+}$ ions probably reduce the strength of negative charges in Ln-DNA. However, a light n-doping phenomenon (positive ${\Delta}n$ above $10^{10}cm^{-2}$ and negative ${\Delta}p$ below $-1.1{\times}10^{10}cm^{-2}$) occurs in the TMD devices doped by Co-DNA with $Tb^{3+}$ or $Er^{3+}$ ions. A significant (factor of ~5) increase in field-effect mobility is also observed on the $MoS_2$ and $WSe_2$ devices, which are, respectively, doped by $Tb^{3+}$-based Co-DNA (n-doping) and $Gd^{3+}$-based Co-DNA (p-doping), due to the reduction of effective electron and hole barrier heights after the doping. In terms of optoelectronic device performance (photoresponsivity and detectivity), the $Tb^{3+}$ or $Er^{3+}$-Co-DNA (n-doping) and the $Eu^{3+}$ or $Gd^{3+}$-Co-DNA (p-doping) improve the $MoS_2$ and $WSe_2$ photodetectors, respectively.

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하악골 후퇴 수술 환자의 연조직 측모 예측의 정확성: Quick Ceph Image $Pro^{TM}$(ver 3.0)와 $V-Ceph^{TM}$(Ver 3.5)의 비교 (Accuracy of soft tissue Profile change prediction in mandibular set-back surgery patients: a comparison of Quick Ceph Image $Pro^{TM}$ (ver 3.0) and $V-Ceph^{TM}$(ver 3.5))

  • 김명균;최용성;정송우;전영미;김정기
    • 대한치과교정학회지
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    • 제35권3호
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    • pp.216-226
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    • 2005
  • 본 연구는 Quick Ceph Image $Pro^{TM}$(ver 3.0)와 국내에서 개발되어 사용 중인 $V-Ceph^{TM}$(ver 3.5) 2 종의 비디오 이미지 예측 프로그램의 수술 후 연조직 측모의 정확성과 신뢰성에 대해서 알아보고자 시행되었다. 골격성 III급 부정교합으로 진단되어 수술 전 교정 치료를 받고. 하악골 후퇴 수술(body osteotomy 또는 SSRO)을 시행한 남녀 환자 각각 20명을 대상으로 하였다. 나이는 평균 $21.4\pm4$세이고, 수술 전 측모두부방사선계측사진은 수술 전 평균 21.1일에 수술 후 측모두부방사선계측사진은 수술 후 평균 335.7일에 촬영되었으며, 예측치와 실측치 차이를 비교하였다. 연구결과 Quick Ceph과 V-Ceph 모두 예측치와 실측치 사이에 크기와 방향에 있어서 오차가 관찰되었으며, 이러한 오차는 상순과 하순. 턱과 연관된 항목에서 크게 나타났다 (p<0.05). Quick Ceph은 A'. Ls, Li의 수평적 위치 및 각 부분에서의 연조직 두께(U1-Ls, L1-Li, Pog-Pog')의 수평거리 예측에서, V-Ceph은 하순의 수직적 위치 예측에서 오차가 컸다 (p<0.05) V-Ceph의 경우 하악골의 이동양이 증가할때 Sn의 수직적 위치, Ls의 수평적 위치 상순의 연조직 두께 (U1 -Ls)처럼 상순과 연관된 계측치에서 예측오차가 컸으며, Quick Ceph의 경우 하악골의 이동양이 증가할 때 하순의 수평위치 및 하순의 두께에서의 예측오차가 작았다 (P<0,05) 또한, 연조직의 두께에 따른 오차를 평가한 결과, Quick Ceph의 경우 상순과 하순의 두께가 두꺼울수록 각각에 관련된 연조직 예측의 오차가 컸으며 (P<0.05). V-Ceph의 경우 하순과 턱의 연조직 두께가 두꺼울수록 턱의 연조직 예측의 오차가 크게 관찰되었다 (p<0.05). 그러나 본 연구에서의 모든 예측오차 값은 3mm 이내로 계측되었으며, 이러한 오차 범주는 임상적으로 허용 가능한 수준인 것으로 생각된다.

Variation of Hospital Costs and Product Heterogeneity

  • Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • 제11권1호
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    • pp.123-127
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    • 1978
  • The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.

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청소년의 휴대폰 중독성에 영향을 미치는 개인, 가족, 학교환경 변인 (The Effects of Personal, Familial, School Environmental Variables on Mobile Phone Addiction by Adolescent)

  • 이연미;이선정;신효식
    • 한국가정과교육학회지
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    • 제21권3호
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    • pp.29-43
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    • 2009
  • 본 연구는 청소년의 개인변인(학교급, 성별, 자아존중감, 자기통제력), 가족변인(모취업유무, 가족건강성), 학교환경변인(또래동조성, 학교생활적응)이 휴대폰 중독성에 미치는 영향력을 살펴봄으로써 가정과 학교에서 청소년의 바람직한 휴대폰 사용과 지도를 위한 기초 자료를 제공하고자 한다. 이를 위해 광주광역시에 거주하는 중학생과 인문계 및 전문계 고등학생 중 휴대폰을 사용하는 666명을 대상으로 구조화된 질문지를 사용하여 조사를 실시하였으며, 수집된 자료는 SPSS/PC WIN 14.0 프로그램을 활용하여 분석하였다. 본 연구의 결과를 요약하면 다음과 같다. 첫째, 청소년이 가장 많이 이용하는 휴대폰의 기능은 문자 메시지였고, 하루 휴대폰 이용 횟수는 41회 이상 이용하는 집단이 가장 많았다. 통화 대상으로는 동성친구가 가장 많았고, 그 다음으로 이성친구가 높게 나타나 휴대폰 이용이 또래관계 형성에 많은 영향을 미침을 알 수 있다. 휴대폰 월 평균 이용 요금은 중학생이 $2{\sim}3$만원 고등학생이 $3{\sim}4$만원에 가장 많이 분포하였고 휴대폰을 주로 이용하는 시간은 하교 후 집이 가장 많았다. 휴대폰 이용에 대한 부모님의 태도는 중학생의 경우 일정 금액 이상 이용하지 못하도록 통제하는 경우가 가장 높았으나 고등학생의 경우는 상관하지 않는 경우가 가장 높았다. 휴대폰 이용에 대한 학교의 규제에 대해 중 고등학생 모두 보통 정도라고 응답한 비율이 가장 높았다. 둘째, 휴대폰 중독성과 관련변인들의 일반적인 경향을 살펴보면, 먼저 휴대폰 중독성의 경우 평균값은 2.39로 중간값보다 낮게 나타났고, 조사대상자들을 집단으로 분류했을 때 비중독군이 32.9%, 중독의존군 59.5%, 중독군 7.5%로 나타났다. 다음으로 청소년의 휴대폰 중독 관련 변인들의 일반적인 경향에서는 자아존중감, 자기통제력, 가족건강성, 또래동조성, 학교생활적응 모두 중간값(3.0)보다 높게 나타났다. 셋째, 청소년의 휴대폰 중독성은 또래동조성이 높을수록, 학교생활적응이 낮을수록, 고등학생이 중학생보다, 남학생보다 여학생이, 자기통제력이 낮을수록 높은 것으로 나타났으며, 이들 변인은 청소년의 휴대폰 중독성을 28% 설명해주고 있다.

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석곡 이규준의 부양론(扶陽論)에 관한 연구(硏究) (A Study on Seok-kok Lee, Kyu-jun's Pu-yang-non)

  • 황원덕
    • 대한한의학원전학회지
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    • 제12권2호
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    • pp.16-53
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    • 1999
  • On the viewpoint of Nae-Kyung and Ju-Yeok, the Seok-Kok's Pu-Yang-Non and other oriental medical doctor's Po-Eum-Eok-Yang, Pu-Yang-Eok-Eum theory which are on the basis of the Kun-Shin-Sang-Wha theory of Nae-Kyung and Myung-Mun theory of Nan-Kyung were compared and studied. The results were as follows : 1. Ju-Yeok and Nae-Kyung said the South is Fire. And explained it as the chief object of life activity by likening to king or saint. And said the North is Water. but didn't mentioned that there exists Fire. The activity of Kun-Wha is regarded as the the chief object of life activity and the Shin-Su can be vatalized by receiving the Shim-Kun-Wha. Therefore, the Seok-Kok's opinion that Shang-Wha is the Fire received by Shin-Su matchs the theory of Nae-Kyung and Nan-Kyung. 2. The Kidney(Shin) in Nae-Kyung means Puk-Bang- Han-Su(The North Cold Water) which has two characters, charging and discharging, ascending and descending. The paragrap "Kam-Ga-Seub(坎加習)" in Ju-Yeok means Puk-Bang-Su(The North Water) which also has two characters, charging and discharging, ascending and descending. The beginning and the end. And One Eum and Two Yang of Ri Sign of divination(離卦) cannot be divided into Su-Jang and Wha-Jang, the same as that, One Yang and Two Eum of Kam Sign of divination(坎卦) is Puk-Bang-Han-Su which cannot be divided into Shin and Myung-Mun. The theory of Choa-Shin-Woo-Myung-Mun of Nan-Kyung is the result that the Shin which has two characters is regarded as two organs. Therefore, from the viewpoint of Nae-Kyung and Ju-Yeok, the Seok-Kok's opinion that the Shin is the Puk-Bang-Han-Su which charges from the right and discharges to the left is more proper. 3. For the first time, the right kidney(Woo-Shin) defined as Myung-Mun in the Nan-Kyung and it is trailblazing theory which dosen't exist in the Nae-Kyung. But from the viewpoint of Nae-Kyung, Myung-Mun-Shang-Wha which some oriental medical doctors thought importantly is considered as Shim-Po which is in charge of the order of Shim(心命). 4. The rush of heat to the upper part(上熱) is raised by blind acting of Shang-Wha which exists in the lower part. This theory is on the basis of the Myung-Mun-Shang-Wha theory of Nan-Kyung. The theory that Wha is in the Shin(Kidney) doesn't exist and only the theory exists that the fever happens by the Kun-Wha not going down but ascending in the Nae-Kyung. Therefore the Shang-Wha blind acting theory of the lower part is not coincided with the theory of Nae-Kyung. 5. When the Vital power(陽氣) is blocked by bad tendencies(邪氣) like uncontrolled joy and anger or too much cold and heat etc, the trapped heat(鬱熱) or Ascending Shang-Wha apper, so Vital power itself cannot have blind activity or excess. Therefore, the theory of oriental medical doctors that the remaining vital power is the fire(氣有餘便是火) cannot be materialized. 6. On the basis of the Woo-Shin-Myung-Mun theroy, oriental medical doctors attached importance to Shin-Eum and Shin-Yang. So they emphasized on Ja-Eum-Gang-Wha or On-Bo-Shin-Yang for curing the Fire. Contrarily, On the viewpoint of siding with the vital power which is the Good and repressing the bad tendency which is the Bad, and another viewpoint that when the vital power which is Shim-Kun-Wha moves through the body consistently and fills up the body, then the enery and blood can be made, the Seok-Kok's theory is coincided with the theory of Nae-Kyung.

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산재환자의 진료비 본인부담 발생 및 크기와 이에 영향을 미치는 요인 (Incidence and magnitude of out-of-pocket payment and factors influencing them in Industrial Accident Compensation Insurance)

  • 박보현;이태진;임화영
    • 보건행정학회지
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    • 제20권1호
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    • pp.103-124
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    • 2010
  • 산재보험의 목표는 업무상 재해 및 질병으로 인한 수입상실에 대한 실질적 보상이 이루어지도록 하는 데 있으나 실제 산재환자들이 요양급여를 제공받는 과정에서 환자본인부담을 지불해오고 있었다. 그럼에도 불구하고 이제까지 산재환자의 본인부담에 대해서는 주의를 기울이지 못하였다. 따라서 본 연구에서는 산재환자 본인부담 발생률 및 본인부담률에 어떤 요인이 영향을 미치는지 파악하고자 하였다. 본 연구는 2009년 5월 퇴원 또는 외래방문 환자 중 의료기관 종별과 지역의 도시화정도를 고려하여 추출된 총 204개(양방 187개 치과, 한방 17개) 의료기관을 대상으로 조사하였다. 회수율이 57.8%(양방 57.2%, 치과, 한방 64.7%)로 총 24,826건(입원 2,457건, 외래 22,369건)이 분석에 이용되었다. 분석결과 본인부담의 발생률은 9.9%였고 본인부담률은 전체건 중에서는 3.5%, 본인부담 발생건 중에서는 8.3%로 나타났다. 본인부담률은 의료기관 종별로 차이를 보였다(산재의료원 : 전체건 0.5%, 본인부담 발생건 2.5%, 종합병원 : 전체건 4.4%, 본인부담 발생건 9.5%, 한방 : 전체건 24.4%, 본인부담 발생건 25.2%). 다수준 분석결과 본인부담의 발생은 주로 종합병원급 이상의 규모가 큰 의료기관과 서울 등 대도시에 소재한 의료기관에서 주도되는 경향을 보였고, 환자의 입원일수가 증가함에 따라 본인부담의 발생이 증가하는 것으로 나타났다. 종합병원급 의료기관에서 발생한 본인부담은 주로 입원료와 선택진료료의 비중이 큰 것으로 나타났다. 따라서 대도시에 소재한 규모가 큰 의료 기관을 우선으로 하여 본인부담 발생률 및 본인부담률을 줄이기 위한 대책이 마련되어야 한다.

가정산소치료의 보험급여 실시 이후 처방 실태: 다기관 조사 -만성기도폐쇄성질환 임상연구센터 제3세부과제 만성기도폐쇄성질환 진료지침 개발/보급 연구- (Long-term Oxygen Therapy for Chronic Respiratory Insufficiency: the Situation in Korea after the Health Insurance Coverage: a Multi-center Korean Survey -Study for the Development and Dissemination of the COPD Guidelines, Clinical Research Center for Chronic Obstructive Airway Disease-)

  • 박명재;유지홍;최천웅;김영균;윤형규;강경호;이승룡;최혜숙;이관호;이진화;임성철;김유일;신동호;김태형;정기석;박용범
    • Tuberculosis and Respiratory Diseases
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    • 제67권2호
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    • pp.88-94
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    • 2009
  • Background: From November 2006, The national health insurance system in the Republic of Korea began to cover prescribed long-term oxygen therapy (LTOT) in patients with chronic respiratory insufficiency. This study examined the current status of LTOT after national health insurance coverage. Methods: Between November 1, 2006 and June 30, 2008, the medical records of patients who were prescribed LTOT by chest physicians were reviewed. The data was collected from 13 university hospitals. Results: 197 patients (131 male and 66 female) were prescribed LTOT. The mean age was 64.3${\pm}$13.0 years. The most common underlying disease was chronic obstructive pulmonary disease (n=103, 52.3%). Chest physicians prescribed LTOT using arterial blood gas analysis or a pulse oxymeter (74.6%), symptoms (14%), or a pulmonary function test (11.2%). The mean oxygen flow rate was 1.56${\pm}$0.68 L/min at rest, 2.08${\pm}$0.91 L/min during exercise or 1.51${\pm}$0.75 L/min during sleep. Most patients (98.3%) used oxygen concentrators. Only 19% of patients used ambulatory oxygen supplies. The oxygen saturation before and after LTOT was 83.18${\pm}$10.48% and 91.64${\pm}$7.1%, respectively. After LTOT, dyspnea improved in 81.2% of patients. The mean duration of LTOT was 16.85${\pm}$6.71 hours/day. The rental cost for the oxygen concentrator and related electricity charges were 48,414${\pm}$15,618 won/month and 40,352${\pm}$36,815 won/month, respectively. Approximately 75% of patients had a regular visit by the company. 5.8% of patients had personal pulse oxymetry. 54.9% of patients had their oxygen saturation checked on each visit hospital. 8% of patients were current smokers. The most common complaint with LTOT was the limitation of daily activity (53%). The most common complaint with oxygen concentrators was noise (41%). Conclusion: The patients showed good compliance with LTOT. However, only a few patients used an ambulatory oxygen device or had their oxygen saturation measured.