• 약학회지
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• 제47권4호
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• pp.244-251
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• 2003

Asthma is a chronic inflammatory disease of the airway and the prevalence rate is increasing. As the burden of asthma to the society is significant due to the increasing hospital admissions and emergency visits, National Heart, Lung and Blood Institute (NHLBI, USA) and World Health Organization (WHO) have developed comprehensive guidelines to help clinicians and patients make appropriate decisions about asthma care. The aim of study was to analyze the pattern of asthma prescriptions based on the national asthma guidelines for the patients visiting primary health care providers. Prescription data for asthma were obtained from the Korean National Health Insurance claims database of January 2002. Ten percent of the primary health care providers were sampled based on their specialty areas, and 20％ of the claim cases were randomly chosen. Study results showed that prescription rate for oral beta-2 agonists was 44.3％, and that for oral theophylline was 46.9％. Oral steroids were prescribed for the 28.2％ of the claims. Utilization of inhalers was low for both bronchodilators (20.3％, beta-2 agonists inhalers), and steroids (8.4％ steroids inhalers). Bronchodilators were more preferred to the longterm anti-inflammatory controllers among the primary health care providers. Prescription rate for antibiotics was 46.0％ for asthmatic patients. Also gastrointestinal drugs were prescribed for 59.0％, antitussives 65.3％, antihistamines 25.3％ and analgesics 29.4％, respectively. This study presented that the prescribing pattern of the primary health care providers for the asthma was quite different from the national and international guidelines. More efforts need to be made to reduce the gap between the present pattern of asthma prescription and the guidelines.

• Journal of Gastric Cancer
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• 제21권3호
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• pp.279-297
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• 2021

Purpose: Various changes in nutrition, metabolism, immunity, and psychological status occur through multiple mechanisms after gastrectomy. The purpose of this study was to predict disease status after gastrectomy by analyzing diseases pattern that occur or change after gastrectomy. Materials and Methods: A retrospective cohort study was conducted using nationwide claims data. Patients with gastric cancer who underwent gastrectomy or endoscopic resection were included in the study. Eighteen target diseases were selected and categorized based on their underlying mechanism. The incidence of each target disease was compared by dividing the study sample into those who underwent gastrectomy (cases) and those who underwent endoscopic resection for early gastric cancer (controls). The cases were matched with controls using propensity score matching. Thereafter, Cox proportional hazard models were used to evaluate intergroup differences in disease incidence after gastrectomy. Results: A total of 97,634 patients who underwent gastrectomy (84,830) or endoscopic resection (12,804) were included. The incidence of cholecystitis (P<0.0001), pancreatitis (P=0.034), acute kidney injury (P=0.0083), anemia (P<0.0001), and inguinal hernia (P=0.0007) were higher after gastrectomy, while incidence of dyslipidemia (P<0.0001), vascular diseases (ischemic heart disease, stroke, and atherosclerosis; P<0.0001, P<0.0001, and P=0.0005), and Parkinson's disease (P=0.0093) were lower after gastrectomy. Conclusions: This study identifies diseases that may occur after gastrectomy in patients with gastric cancer.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권5호
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• pp.461-469
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• 2021

Background: The global population is aging rapidly, and accordingly, the number of patients with dementia is increasing every year. Although the need for dental treatment increases for various reasons in patients with dementia, they cannot cooperate during dental treatment. Therefore, behavioral management, including sedation (SED) or general anesthesia (GA), is required for patients with dementia. Thus, this study aimed to investigate the trends and effects of SED or GA in patients with dementia undergoing dental treatment in South Korea based on the Korean National Health Insurance claims data. Methods: This study utilized customized health information data provided by the Health Insurance Review and Assessment Service. Among patients with records of using sedative drugs during dental treatment from January 2007 to September 2019, patients with the International Classification of Diseases-10 code for dementia (F00, F01, F02, F03, and G30) were selected. We then analyzed the full insurance claims data for dental care. Age, sex, sedative use, and dental treatment of patients were analyzed yearly. In addition, the number of cases of GA or SED per year was analyzed, and changes in behavioral management methods with increasing age were investigated. Results: Between January 2007 and September 2019, a total of 4,383 (male, 1,454; female, 2,929) patients with dementia received dental treatment under SED or GA. The total number of SED and GA cases were 1,515 (male, 528 ; female, 987 ) and 3,396 (male, 1,119 ; female, 2,277) cases, respectively. The total number of cases of dental treatment for 4,383 patients with dementia was 153,051 cases, of which 2.22% were under GA and 0.98% were under SED. Midazolam was the most commonly used drug for SED. Conclusion: Although gingivitis and pulpitis were the most common reasons for patients with dementia to visit the dentist, GA or SED for patients with dementia was frequently used in oral and maxillofacial or periodontal surgery.

• The Korean journal of internal medicine
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• 제33권6호
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• pp.1160-1168
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• 2018

Background/Aims: The Republic of Korea is a country where the hemodialysis population is growing rapidly. It is believed that the numbers of treatments related to vascular access-related complications are also increasing. This study investigated the current status of treatment and medical expenses for vascular access in Korean patients on hemodialysis. Methods: This was a descriptive observational study. We inspected the insurance claims of patients with chronic kidney disease who underwent hemodialysis between January 2008 and December 2016. We calculated descriptive statistics of the frequencies and medical expenses of procedures for vascular access. Results: The national medical expenses for access-related treatment were 7.12 billion KRW (equivalent to 6.36 million USD) in 2008, and these expenses increased to 42.12 billion KRW (equivalent to 37.67 million USD) in 2016. The population of hemodialysis patients, the annual frequency of access-related procedures, and the total medical cost for access-related procedures increased by 1.6-, 2.6-, and 5.9-fold, respectively, over the past 9 years. The frequency and costs of access care increased as the number of patients on hemodialysis increased. The increase in vascular access-related costs has largely been driven by increased numbers of percutaneous angioplasty. Conclusions: The increasing proportion of medical costs for percutaneous angioplasty represents a challenge in the management of end-stage renal disease in Korea. It is essential to identify the clinical and physiological aspects as well as anatomical abnormalities before planning angioplasty. A timely surgical correction could be a viable option to control the rapid growth of access-related medical expenses.

• 한국기록관리학회지
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• 제19권2호
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• pp.77-107
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• 2019

본 연구의 목적은 법원정보공개제도 운영 현황을 분석하여 문제점을 파악한 후, 앞으로 보다 효과적이고 실질적으로 정보공개청구가 이루어질 수 있도록 개선 방안을 제시하는데 있다. 이를 위해 "사법연감"에 공표된 데이터와 법원정보공개청구시스템에 청구된 데이터를 활용하여 2007년부터 2017년까지 법원의 정보공개청구 처리 동향을 살펴보았다. 데이터 분석 결과를 토대로 담당자에 따른 상이한 처리 결과, 높은 취하 및 민원회신 비율, 정보부존재 증가 추세 등을 문제점으로 도출하였는데, 가장 큰 문제점은 낮은 정보공개 처리비율이었다. 이를 향상시키기 위하여 각종 청구제도 안내 강화, 정보공개청구 담당자의 교육 강화, 매뉴얼 발간, 사전정보나 원문정보 제공 확대 등을 개선 방안으로 제안하였다.

• 융합정보논문지
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• 제11권6호
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• pp.270-281
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• 2021

정보기술의 발달로 보험사기의 규모는 매년 급증하고 있고, 그 방법도 공모 형태로 조직화되고 고도화되고 있다. 이를 예측하고 검출하기 위한 다양한 형태의 예측모델이 연구되고 있지만 보험관련 정보는 매우 민감하여 공유와 접근에 위험이 높고 법적인 혹은 기술적인 제약이 많다. 이 논문에서는 최근 4차 산업 혁명의 등장으로 가장 각광받는 기술 중 하나인 블록체인을 기반으로 한 기계학습 보험사기 예측모델을 제안한다. 블록체인 기술을 활용하여 안전하고 신뢰받는 보험청구 정보 공유시스템을 실현하고, 보다 효율적이고 정확한 사기예측을 위하여 사회관계분석이론을 적용하여 각 관계에 가중치를 부여하고 기계학습 사기 예측패턴을 4단계로 나누어 제안하였다. 사기 가능성이 높은 보험청구건은 보다 앞선 단계에서 높은 예측 율로 검출되는 효과를 가지며 가능성이 낮은 청구 건은 사후에 참고하여 관리할 수 있도록 차등 적용하였다. 제안하는 모델의 중요 매커니즘은 이더리움(Ethereum) 로컬 네트워크를 구성하여 검증 하였고, 향후 보다 정교한 성능평가가 요구된다.

• 한국산학기술학회논문지
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• 제22권1호
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• pp.424-430
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• 2021

교통 신호 위반 사고는 운전자의 주장이 서로 상반되면 원인 규명이 어렵다. 본 연구에서는 사례를 중심으로 교통 사고 분석을 위해 사용하는 차량 충돌 해석 시뮬레이션 프로그램인 PC-CRASH을 이용하여 시뮬레이션을 수행하였고, 이를 통하여 교차로에서 신호 위반 차량을 규명하는 과정을 제시하였다. 첫째, 신호 위반의 원인 규명이 분명하지 않은 운전자나 목격자의 진술을 배제한다. 둘째, 사고 차량의 최종 자세, 최종위치, 파손 부위, 조향 여부, 제동 여부, 노면 흔적을 수집하고, 정지선으로부터 충돌지점까지 조사한다. 셋째, 사고 차량의 충돌 상황과 최종 정지 자세에 부합될 때까지 시뮬레이션 자료를 수정 입력한다. 넷째, 시뮬레이션 결과가 충돌 상황과 부합되면 운전자의 진술과 부합되는지 교차 검증하여 사실 규명을 입증한다. 본 연구의 시뮬레이션의 결과는 교차로 내 좌회전 신호에 렉서스는 약 55 km/h로 진입하였고 소나타는 교차로의 차량 직진 신호를 보고 72km/h로 교차로에 진입하여 렉서스와 충돌하였다. 그러므로 소나타의 신호위반으로 규명되고 소나타 운전자, 목격자, 경찰의 주장은 모순이다.

• 지식경영연구
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• 제22권1호
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• pp.57-84
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• 2021

본 연구는 21세기형 초경쟁 환경에서 지속가능한 경쟁우위를 위해 전략적 자원인 기술자원을 보호하기 위한 기업의 시도에 영향을 미치는 요인들을 실증 연구한다. 이를 위해 본 연구는 전략경영의 자원기반관점과 거시 조직이론의 관점에서 기업들이 불확실하고 급변하는 환경에 대응하여 신속하고 강력하게 자신의 혁신적 기술을 보호하는 동시에 경쟁자들의 기술탐색을 제한할 수 있는 제도인 '우선권주장출원'이라는 기술보호전략의 실행에 영향을 미치는 시장 환경요인들을 분석한다. 본 연구에서는 기업들이 특허출원이라는 기술혁신 성과를 보호하기 위한 일반적 전략을 넘어서서, 더 강력한 경쟁전략인 우선권주장출원을 왜 선택하는지, 그리고 이 강화된 기술자원 보호전략이 어떻게 경쟁자들을 견제할 수 있는지에 대해, 대표적인 초경쟁 산업인 대한민국 하이테크 전자기업들 특허데이터와 재무데이터를 이용하여 실증 연구한다. 1994년부터 2008년까지 우리나라 하이테크 전자기업들이 출원한 특허출원 데이터와 재무데이터를 기반으로 한 실증분석의 결과, 기업들의 우선권주장출원전략을 실행하는 것은 외생적 충격과 환경불확실성에 의해 부정적인 영향을 받는 반면, 시장변동성에 의해 긍정적인 영향을 받는 것으로 나타났다. 또한 각 기업의 지위는 위 세 가지 요인들의 영향을 약화시키는 방향으로 조절효과를 가지는 것으로 나타났다.

• 한국임상약학회지
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• 제31권4호
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• pp.268-277
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• 2021

Background: Most antipsychotic drugs studies have been mainly conducted on side effects, randomized clinical trials, utilization rates, and trends. But there have been few studies on the influencing factors in elderly patients. The purpose of this study was to analyze the influencing factors on the outpatient prescription of antipsychotic drugs in the elderly patients. Methods: Active ingredients of antipsychotic drugs in Korea were selected according to the Korean Pharmaceutical Information Center (KPIC)'s classification. Data source was Korean Health Insurance Review and Assessment Service (HIRA) claims data in 2020 and target patient group was the elderly patient group. We extracted patients who have been prescribed one or more antipsychotic drugs and visited only one medical institution. Data were analyzed using descriptive statistics, chi-square, t-test, negative binomial regression. Results: A number of outpatients were 245,197 and prescriptions were 1,379,092. Most characteristics of patients were 75-85 year's old, female, health insurance type, no disease (dementia, schizophrenia), atypical drugs, cci score (>2) and characteristics of medical institution were neurology in specialty, rural region, general hospitals. Results of regression showed that patient's characteristics and medical center characteristics had significant effect on the outpatient prescription of antipsychotic drugs in the elderly patients. Conclusion: This study suggests that national policy of antipsychotic drugs in the elderly patients, with the consideration of the patients' and medical institutions' characteristics, is needed.

• 대한한의학회지
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• 제44권1호
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• pp.1-15
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• 2023

Objectives: National health insurance herbal prescription of Korean medicine has been serving important role in public healthcare in spite of continuous demand on revision of system. However, the categories of insurance herbal prescriptions are not equally distributed throughout the KCD-based major disease categories. We analyzed statistical database of claimed national health insurance classified as major disease categories by years. We classified all 56 herbal prescriptions as per their total medical indications into 22 major disease categories to analyze their distribution. Significant increase of M and S-T code claims were found, whereas decrease of U code claims by years. We figured out that the 56 prescriptions were unequally distributed along with enrichment of certain codes such as K and J. Meanwhile, the insurance claim of each prescription was positively correlated with number of code types of their indications. As a result, we believe that the reform of national health insurance herbal prescription list is necessary to promote use of it in clinic.