• 제목/요약/키워드: Current health expenditure

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18FDG Synthesis and Supply: a Journey from Existing Centralized to Future Decentralized Models

  • uz Zaman, Maseeh;Fatima, Nosheen;Sajjad, Zafar;Zaman, Unaiza;Tahseen, Rabia;Zaman, Areeba
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권23호
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    • pp.10057-10059
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    • 2015
  • Positron emission tomography (PET) as the functional component of current hybrid imaging (like PET/CT or PET/MRI) seems to dominate the horizon of medical imaging in coming decades. $^{18}$Flourodeoxyglucose ($^{18}FDG$) is the most commonly used probe in oncology and also in cardiology and neurology around the globe. However, the major capital cost and exorbitant running expenditure of low to medium energy cyclotrons (about 20 MeV) and radiochemistry units are the seminal reasons of low number of cyclotrons but mushroom growth pattern of PET scanners. This fact and longer half-life of $^{18}F$ (110 minutes) have paved the path of a centralized model in which $^{18}FDG$ is produced by commercial PET radiopharmacies and the finished product (multi-dose vial with tungsten shielding) is dispensed to customers having only PET scanners. This indeed reduced the cost but has limitations of dependence upon timely arrival of daily shipments as delay caused by any reason results in cancellation or rescheduling of the PET procedures. In recent years, industry and academia have taken a step forward by producing low energy, table top cyclotrons with compact and automated radiochemistry units (Lab-on-Chip). This decentralized strategy enables the users to produce on-demand doses of PET probe themselves at reasonably low cost using an automated and user-friendly technology. This technological development would indeed provide a real impetus to the availability of complete set up of PET based molecular imaging at an affordable cost to the developing countries.

성장기 인슐린 의존성 당뇨병 환자의 리보플라빈 영양상태 (The Riboflavin Status in Insulin-Dependent Diabetes Mellitus During Growing Period)

  • 이정희
    • Journal of Nutrition and Health
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    • 제27권7호
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    • pp.729-739
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    • 1994
  • Riboflavin status of 17 insulin-dependent diabetic mellitus(IDDM) patients in growing period was evaluated as a function of energy intake and expenditure, biochemical nutritional status and diabetic control indicators. Compared with recommended dietary allowances for Koreans(RDA, 1989), only 35.3% of subjects was at good levels of all nutrients intakes and 52.9% of subjects was below normal level of height and weight. Nutrients consumed below RDA levels were energy(=88.5% of subjects), niacin(64.7%), iron(52.9%) and protein(23.5%) respectively. The riboflavin status was within normal range by urinary riboflavin excretion but 17.6% of subjects was evaluated as showed riboflavin deficiency by erythrocyte glutathione reductase activity coefficient(EGRAC). Correlation between riboflavin intake, urinary riboflavin excretion, EGRA level and diabetic duration were not statistically significant. Correlation analyses indicated that EGRA level was inversely correlated with thiamin, niacin and cabohydrate intake. No significant correlations were found between the EGRA and glycosylated hemoglobin A1(HbA1) (r=-0.464, p=0.129). From this study, it is suggested that IDDM subjects need to maintain balanced diet containing nutrients above RDA for individual activity during growing period. It needs more study whether the current recommended riboflavin allowance is adequate for diabetic patients.

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Anti-Obesity Drugs: A Current Research Insight

  • Son Eun-hwa;In San-Whan;Kim Byung-Oh;Pyo Suhkneung
    • 대한의생명과학회지
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    • 제11권2호
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    • pp.89-101
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    • 2005
  • Obesity is increasing worldwide and has become a major health burden in Western societies affecting every third American and every fifth European. Obesity makes a major contribution to morbidity and mortality, predisposing individuals to cardiovascular disease and diabetes. Many new substances are currently being investigated for their usefulness in the pharmacotherapy of obesity. Most anti-obesity drugs can be divided into four groups: those that reduce food intake; those that alter metabolism; those that increase thermogenesis; and those that regulate hormone involved in feeding behavior. In this article we review these and other agents available in various countries for the treatment of obesity. Perhaps more importantly, we have focussed on areas of potential productivity in the future. Over the last 5 or so years, this impetus in obesity research has provided us with exciting new drugs targets involved in the regulation of feeding behavior and cellular mechanism involved in energy expenditure. Recent development in the quest for control of human obesity include the discovery of hormones, neuropeptides, receptors and transcription factors involved in feeding behavior, metabolic rate and adipocyte development. For developing new, perhaps even more specific pharmacological agents, further research is needed to understand the individual different genetic and physiological basis of obesity. It remains the hope of research scientists that in the not too distant future we shall see a new class of anti-obesity drugs arising logically from the molecular biology revolutions.

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A Study on the Appropriate Size of Stores and Countermeasures in Decline Commercial Area in the Original Downtown

  • Ryu, Tae-Chang
    • 유통과학연구
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    • 제19권11호
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    • pp.49-57
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    • 2021
  • Purpose: In this study, we try to figure out the appropriate size of commercial districts in the original downtown area through empirical studies targeting the Jinju Central Commercial Area in Gyeongnam and Cheonan Station in Chungnam, which are trying to regenerate a specific space that has been lost through government projects. Research design, data and methodology: The current status and characteristics of the shopping district were examined through on-site surveys of the central business district of Jinju, Gyeongnam Province, and Cheonan Station, Chungnam Province, and the size of the empty stores was determined. In addition, the standard median income was used as the survey data along with the survey of the mobile population in the commercial area. Result: The analysis result shows that 883 stores should be maintained considering the overall expenditure and gross sales profit within Cheonan Station in South Chungcheong Province. Currently, considering spending and margins in the Commercial Area, Jinju Central Commercial Area is a place where 222 stores can be sold excessively, and a proper commercial supply plan is needed. Conclusions: In this study, we conducted a demand prediction study in the commercial sector of the most basic sector to regenerate the commercial sector through major regional commercial districts.

On the models for the distribution of examination score for projecting the demand for Korean Long-Term Care Insurance

  • Javal, Sophia Nicole;Kwon, Hyuk-Sung
    • Communications for Statistical Applications and Methods
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    • 제28권4호
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    • pp.393-410
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    • 2021
  • The Korean Long-Term Care Insurance (K-LTCI) provides financial support for long-term care service to people who need various types of assistance with daily activities. As the number of elderly people in Korea is expected to increase in the future, the demand for long-term care insurance would also increase over time. Projection of future expenditure on K-LTCI depends on the number of beneficiaries within the grading system of K-LTCI based on the test scores of applicants. This study investigated the suitability of mixture distributions to the model K-LTCI score distribution using recent empirical data on K-LTCI, provided by the National Health Insurance Service (NHIS). Based on the developed mixture models, the number of beneficiaries in each grade and its variability under the current grading system were estimated by simulation. It was observed that a mixture model is suitable for K-LTCI score distribution and may prove useful in devising a funding plan for K-LTCI benefit payment and investigating the effects of any possible revision in the K-LTCI grading system.

서울시 지역최저생계비 계측에 관한 연구 (Estimation of the Minimum Cost of Living in Seoul)

  • 김경혜
    • 한국사회복지학
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    • 제38권
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    • pp.7-32
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    • 1999
  • 현재의 생활보호제도는 거택 및 시설보호대상자의 선정기준이 지나치게 낮아 생계 보조를 필요로 하는 많은 집단이 보호대상에 포함되지 못하고 있으며, 급여수준도 최저생계비를 충족시켜 주지 못하는 수준이다. 뿐만 아니라, 전국에 동일한 대상자 선정기준 및 급여수준을 일률적으로 적용하고 있어 지역간물가, 특히 주거비 편차에 따른 최저생계비 차이가 반영되지 못하고 있다. 이 연구는 현재의 생활보호사업이 지역간 편차 및 최저생계비를 충족시키지 못하고 있다는 점에 논의의 초점을 두고, 서울시를 연구대상으로 지역 최저생계비를 계측하였다. 계측된 서울시 최저생계비를 전국기준과 비교함으로써 지역간 편차를 규명하였으며, 현재의 생활보호사업으로부터 보호받지 못하는 실질적인 빈곤인구 규모를 파악하였다. 생활보호사업에서 이용하고 있는 전국기준과의 비교를 위하여 현재 대상자 선정기준 및 급여수준 결정의 근간이 된 1994년 한국보건사회연구원의 <최저생계비 계측조사연구>에서 사용한 데이터 및 계측방법을 이용하여 1994년 서울시 최저생계비를 계측하였다. 계측결과 1994년 서울시 4인 표준가구의 최저생계비는 88만 7,611원으로, 이는 보사연에서 계측한 전국평군 최저생계비보다 약 1.33배 높은 값이다. 이를 빈곤선으로 간주하고 1994년도 도시가계조사데이터 서울시 표본을 이용하여 빈곤인구를 추정한 결과, 서울시 인구의 약 5.9%인 63만 6천여명이 이 기준에 미치지 못하는 것으로 나타났다. 이는 1994년 서울시 생활보호대상자 12만 3천명의 약 5.2배에 이르는 수치이다.

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지방자치단체 자체 복지사업 지출 영향요인 분석 : 사회보장정보시스템을 통한 접근 (Analysis on Factors Influencing Welfare Spending of Local Authority : Implementing the Detailed Data Extracted from the Social Security Information System)

  • 김경준;함영진;이기동
    • 지능정보연구
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    • 제19권2호
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    • pp.141-156
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    • 2013
  • 그 동안 한국 사회에서 지방자치단체(이하 지자체) 복지사업과 재정지출에 대한 연구는 장애인, 노인, 보육 등 복지사업 대상 등을 중심으로 부문별 복지지출에 대한 영향요인 연구가 대부분 이루어져 왔다. 최근 지자체의 자체적인 복지노력도 측면에서 자체 사업에 대한 연구가 특정 지역의 사례를 중심으로 이루어지기는 하고 있지만, 자료에 대한 접근과 조사의 한계로 여러 요인이 실증적으로 고려되지 못하여 정책적 함의를 도출해 내기 어려웠다. 현재 우리사회의 복지예산과 그 지출규모는 국가 예산의 30%에 이를 만큼 높은 비중을 차지하고 있다. 이에 따라 국가적 차원에서 공공복지 전달체계의 효율적 운영과 관리를 위해 사회보장 정보시스템을 구축, 운영하고 있다. 본 연구에서는 기존 연구에서 사용하는 지방재정시스템이 아닌 사회보장 정보시스템을 통하여 지자체 복지재정 지출과 관련, 기존 연구에서 한계점으로 지적되었던 전수데이터에 대한 접근과 조사를 실시하여 학문적이고 정책적인 함의를 도출해 내고자 한다. 사회보장정보시스템은 복지전달체계의 효율화를 위해 구축되었으며, 이를 통해 17개 부처 292개 복지사업이 집행되며, 230개 지자체 4만여 개 복지사업의 정보가 관리되고 있다. 이에 따라 본 연구는 사회보장정보시스템을 통해 관리되는 지자체 복지사업을 중심으로 지자체 복지지출에 미치는 영향요인을 탐색하고자 한다. 이를 위해 지자체 복지노력도로 대변되는 순수 시 군 구 복지예산액을 종속변수로 설정하였으며, 기존문헌 검토를 바탕으로 인구사회학적, 지역 경제적 그리고 지자체 재정적 요인을 독립변수로 설정하였다. 또한 독립변수 요인간 다중공선성 문제를 점검하였고, 다중공선성의 문제가 없는 것으로 확인된 수급자 비율, 영유아 비율, 아동청소년 비율, 복지비 비율, 구인배율, 재정자립도, 재정자주도의 총 7개 독립변수와, 소속 정당을 통제변수로 사용하여 결정요인의 변화를 분석하였다. 연구결과를 살펴보면 기본모델에서는 복지비 비율, 영유아 비율, 재정자립도, 재정자주도, 구인배율이 유의한 영향을 미치는 것으로 분석되었다. 그리고 기존 문헌에서 분석되지 못했던 시 군 구별 복지지출 영향요인의 차이점을 분석하였다. 또한 복지예산 총량 데이터에 근거한 기존 연구들이 논의하지 못했던 자체 복지사업 예산에 미치는 영향요인을 구체적으로 밝혀내는데 의의가 있다.

추후관리가 필요한 만성질환 퇴원환자 가정간호 시범사업 운영 연구 (An Operations Study on a Home Health Nursing Demonstration Program for the Patients Discharged with Chronic Residual Health Care Problems)

  • 홍여신;이은옥;이소우;김매자;홍경자;서문자;이영자;박정호;송미순
    • 대한간호학회지
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    • 제20권2호
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    • pp.227-248
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    • 1990
  • The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

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한국 소아치과의 현재와 전망 - 치아우식증관리 분야를 중심으로 - (PRESENT SITUATION AND PROSPECT OF PEDIATRIC DENTISTRY IN KOREA - FOCUSED ON MANAGEMENT OF DENTAL CARIES -)

  • 이상호
    • 대한소아치과학회지
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    • 제39권2호
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    • pp.206-225
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    • 2012
  • General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.

단체급식실습생 훈련에 대한 조사연구 (A survey of the training of student for future dietitian at various food-service institutions)

  • 심영자
    • 대한가정학회지
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    • 제32권1호
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    • pp.199-210
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    • 1994
  • My purpose in the paper is to research on what is the most productive education method for the Students for Future Dietitian(SFD) to be applied during there field training & practice. Furthermore it is an attempt to elucidate what is the most necessary education program for the field training & practice for SFDs. Five questionnaires were given to SFDs dealing with nutrition purchase hygienic facilities and official management in order to check and evaluate the current situation and problems on the education of field training & practice for SFDs Also I chose 140 SFD's who had been working in the field for at least one week or one month in 1992 and statistical processing were utilized and analyzed by SAS package. One of the most notable problems SDFs faced with during meal planning it is the fact that they had been educated and requested for the cut of food expenditure rather than the supply of scientifically balanced-nutrition meals for working people, SFDs also faced with of information on the quantity and facilities management from the dietitian in the company. my research revealed that dietitian's teaching method for SFDs still remains in a very primitive way and accordingly the efficient way to solve these problems shall be established by a computerized education program through which dietitians can provide well-balanced meals for working people when they are assigned to the company. In this regard we must consider that we have to enact certain law to be applied to a dietitian. In another words we should emphasize actual experiences of SFDs' knowledge accumulated through the field training & practice before they work at the company. Consequently it is a time to reconsider the importance of well-balance dietitian program offering an opportunity for SFD which can contribute to improvement of health's condition for the working people.

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