• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1259-1275
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• 2015

Background: This study reviewed the published evidence as to how prostate cancer outcomes vary across geographical remoteness and area level disadvantage. Materials and Methods: A review of the literature published from January 1998 to January 2014 was undertaken: Medline and CINAHL databases were searched in February to May 2014. The search terms included terms of 'Prostate cancer' and 'prostatic neoplasms' coupled with 'rural health', 'urban health', 'geographic inequalities', 'spatial', 'socioeconomic', 'disadvantage', 'health literacy' or 'health service accessibility'. Outcome specific terms were 'incidence', 'mortality', 'prevalence', 'survival', 'disease progression', 'PSA testing' or 'PSA screening', 'treatment', 'treatment complications' and 'recurrence'. A further search through internet search engines was conducted to identify any additional relevant published reports. Results: 91 papers were included in the review. While patterns were sometimes contrasting, the predominate patterns were for PSA testing to be more common in urban (5 studies out of 6) and affluent areas (2 of 2), higher prostate cancer incidence in urban (12 of 22) and affluent (18 of 20), greater risk of advanced stage prostate cancer in rural (7 of 11) and disadvantaged (8 of 9), higher survival in urban (8 of 13) and affluent (16 of 18), greater access or use of definitive treatment services in urban (6 of 9) and affluent (7 of 7), and higher prostate mortality in rural (10 of 20) and disadvantaged (8 of 16) areas. Conclusions: Future studies may need to utilise a mixed methods approach, in which the quantifiable attributes of the individuals living within areas are measured along with the characteristics of the areas themselves, but importantly include a qualitative examination of the lived experience of people within those areas. These studies should be conducted across a range of international countries using consistent measures and incorporate dialogue between clinicians, epidemiologists, policy advocates and disease control specialists.

• 디지털융복합연구
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• 제10권5호
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• pp.289-299
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• 2012

본 연구는 경남지역 손상환자의 타 지역 의료이용과 관련된 요인을 규명하여 의료의 접근성을 높이기 위한 기초자료를 제시하고자 하였다. 질병관리본부의 2008년 퇴원손상환자조사 8,225건의 자료 뿐 아니라, 인구센서스 및 보건의료자원 실태조사자료를 이용하였으며, 분석방법은 빈도분석, 교차분석, 로지스틱 회귀분석을 실시하였다. 분석결과 첫째, 손상환자의 의료이용은 대도시 중심으로 집중화 현상이 뚜렷하였다. 둘째, 군지역의 손상환자 타 지역 이용률이 시 지역에 비해 높았다. 본 연구를 통하여 의료기관 및 병상수를 공급하는 일 뿐만 아니라 지방에서의 의료의 질적 수준을 올리는 정책과 의료의 접근성을 위해 군지역의 손상환자를 위한 대책이 요구된다.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2017년도 춘계학술대회
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• pp.727-729
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• 2017

통계청과 보건복지가족부에 따르면 우리나라는 65세 이상 고령인구 비율이 세계 평균치보다 높게 추정되며 이미'고령화 사회(Ageing Society)'에 접어든 것으로 나타났다. 또한, 예상보다 이른 시기에 정보사회에 도달하여 국민들의 삶의 질이 개선되었을 것으로 추정된다. 그러나 고령층은 젊은 층과 달리 새로운 기계에 선뜻 접근하기 어려워 정보의 접근 및 이용에 있어 뚜렷한 차이를 보이고 있어 세대 간 정보 격차(Digital Divide) 현상을 야기 시키고 있다. 이러한 현상을 해결하기 위해 고령층을 위한 음성인식 기반의 스마트 미러 시스템을 구현하였다. 구현한 시스템은 음성인식을 통하여 조명제어 및 날씨, 지하철 시간 정보 조회 서비스를 제공할 수 있다. 구현한 시스템을 통하여 고령층에게 새로운 기계에 대한 접근 용이성을 제공하여 새로운 시대 변화에 동참하는 느낌을 주고 정보를 얻어 생활이 편리하게 만들어 준다는 효과가 기대된다.

• 보건행정학회지
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• 제19권2호
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• pp.71-84
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• 2009

Objectives : The purpose of this study is to analyze the proportion of admission via the emergency room(the rest is ER) in an emergency medical center and to examine the factors related to admission. Methods : This study used 2005 National Health Insurance claims data for admitted patients of 112 hospitals having emergency medical centers in Korea. The study sample had 2,335,610 patients. The data was classified into emergency admission and non-emergency admission. To investigate the factors affecting the type of admission, the following were included as independent variables: type of health assurance_(national health insurance beneficiaries or medical aid beneficiaries), demographic characteristics_ (sex, age), cause of admission_ (disease or injury), whether an operation was performed or not, DRG severity level, the number of beds, and the location of the hospital. Data were analyzed using the Chi-square test for the differences in emergency admission rates for each variables, and multiple logistic regression analysis was used for identifying the factors affecting admission type. Results : The proportion of admission via the ER accounted for 40.6% of the total admission among hospitals having emergency medical centers. The risk of admission via ER was relatively high for patients who were male, the aged, the injured, the surgical patients, the patients having more severe symptoms, and the patients admitted the hospitals located in metropolitan areas, and the patients admitted the hospitals having 300-699 beds. Medical aid patients were more likely admitted through the emergency room than health insurance patients after other variables ware adjusted. Conclusions and Discussion : We analyzed the proportion of admission via the ER for the total admission rate of hospitals having an emergency medical center in Korea. And we explored the factors related to admission via the ER. This proportion may be used as an indicator of the adequacy of medical utilization or low accessibility to hospitals of patients with low socioeconomic status.

• 대한불안의학회지
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• 제6권1호
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• pp.55-64
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• 2010

Objective : Depression is a significant and growing problem among college students. Depression contributes to numerous academic, social, and health problems, including suicide. This study surveyed depression awareness and the need for establishing a depression support program through Kyunghee University. Methods : We used the Kyunghee University Mail delivery system for college students to conduct this survey on depression and depression. Results : All of the students who responded to the survey, 41.86% reported that they had experienced depression. Among students experiencing depression, 27.27% experienced suicidal ideation, and 56.56% said they wanted to receive mental health counseling or treatment. All the respondents, 47.04% of respondents said they would to go to the external medical center, not school's internal counseling center of school, for such treatment. All the respondents, 73.75% said the student depression/suicide problem was serious. In addition, 71.34% of respondents required a depression support program. Conclusion : The university's depression support program needs to improve its accessibility by developing content focused on the early detection of, and improved awareness of, depression.

• 한국보건간호학회지
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• 제10권2호
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• pp.146-161
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• 1996

This study was purposed to find health promotion and care needs of the elderly in rural area of Korea. As the rural elderly are limited in accessibility to health care resources and could not immediately solve their health care needs when they need. health promotion and care services are expected to bring better and more practical solutions of their health care needs. Thus, the type of health care services to be developed in Korea rural area is discussed to have emphasis on health care service component in addition to health promoting components. Methods of this study was based on survey data analysis : total 322 persons aged older than 55 living at one 'Kun' in Korea administrative unit were interviewed by health workers working at the region and also get trained for this study data collection. The data collection interview was continued from February till May in 1996. The interview questions were modified with adjustment to Korea situation. with basis of the WHO's health promotion program components. The collected data were analyzed using SAS program for frequency, correlation, regressions. The major findings were as follows : (1) $74.8\%$ of the surveyed were sick at the survey time point. and $95.9\%$ known the diagnosis name of the disease. The most frequently complained diseases were Muscular-Skeletal diseases $(43.7\%)$. $34\%$ of those sick had never treated or discontinued therapeutic procedures. so that shown the necessity of systematic and usual health care services with health promotion program development for the elderly. (2) The percent of those who make social participation was $95.3\%$. and the activities were visiting neighbors $(70.4\%)$ and lack of qualified social activity programs. (3) $78.1\%$ of the surveyed had health counseling and education from professional health workers. Those ceased smoking and drinking were $59.6\%,\; 60.3\%$. respectively. Those had no application of therapeutic drugs or nutrion supplements was $40.7\%\;and\;94.1\%$ had regular meals. Those practiced exercises was low remarking $17.7\%$. (4) Positive health behaviors were better carried out by sick groups than by the healthier. except smoking. regular meals. and exercise. $17.5\%$ of sick group smoke more than one case of cigarettes. in contrast to $9.5\%$ of the healthier. (5) Mental health status was heathier among positive health behavior earners. Health counseling and education shown better score of mental health than those never counseled. (6) Positive health behavior practice frequency did not show significant differences when crossed by social activity participation status. (7) Health behaviors of the rural elderly people were carried out better when they had positive 'continuency in therapeutic procedure' 'health status'. 'familial relationship'. 'Health Status' of the rural olderly were explained by 'exercise'. 'drinking'. 'familial relationship'. 'activities of daily living'. Thus, health behaviors practice mutually interact with health status. In conclusion. the health promotion and care program component are recommended to include ation on the necessity of positive health promotion active social acitivities. pleasant life style, adaption into changes on the elderly, safety in residential area. community acitivity and resource utilization. etc .. in addition to the elderly's disability and sickness caring services.

• 디지털융복합연구
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• 제12권3호
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• pp.289-297
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• 2014

본 연구는 선택병의원제도 이후 변수들을 이용하여 의료급여수급권자의 의료이용 만족에 대하여 살펴보면서 지속적으로 수급권자의 의료이용 만족 및 건강증진을 향상시킬 수 있는 기초자료를 제공하는 데 그 의의가 있다. 조사기간은 2013년 8월 16일부터 8월23일까지이며, 결론적으로 선택병의원제도 실시 후 의료급여 수급권자의 의료이용 만족을 향상 시킬 수 있도록 하기 위해서는 의료수급권자의 의료서비스의 효과 및 미 충족 의료 욕구에 대한 보다 충분하고 정밀한 파악하는 것이 무엇보다 중요하며, 적정한 의료이용 도모를 위해 효과적인 의료접근성 파악, 행정절차의 비효율성 극복, 적정진료 보장으로 인한 합리적인 의료전달체계 확립 및 건강관리의 향상을 위해 의료기관의 적극적인 협조 및 정부의 다양한 정책 대안이 필요하다.

• 한국도서관정보학회지
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• 제51권3호
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• pp.1-25
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• 2020

유엔 산하의 전문기구인 세계보건기구(WHO)는 지구촌 장애인이 10억 명(또는 세계 인구의 15%)을 상회하는 것으로 추정하였다. 장애인의 지식정보 욕구는 비장애인과 동일함에도 세계시각장애인연합(World Blind Union)에 따르면 장애인이 접근할 수 있는 자료포맷은 선진국마저 연간 출판된 도서의 10% 미만으로 추산되고 있다. 어느 국가를 불문하고 장애인 정보접근성을 개선하려면 국가도서관 역할이 매우 중요하다. 이에 본 연구는 대륙별로 장애인을 위한 국가도서관 및 전국 도서관서비스를 대표하는 미국의 의회도서관(Library of Congress), 스웨덴의 매체접근기구(Myndigheten fö Tillgägliga Medier), 일본의 국립국회도서관(NDL), 남아프리카공화국의 SALB(The South African Library for the Blind)를 대상으로 역사와 발전, 법적 근거와 조직, 주요 업무 및 자아앤서비스의 특징을 정밀 분석·비교하고 시사점을 도출하였다. 그 결과를 바탕으로 2019년 국립중앙도서관 소속에서 문화체육관광부 1차 소속기관으로 격상된 국립장애인도서관의 역량강화 방안을 제언하였다.

• Journal of Periodontal and Implant Science
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• 제47권5호
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• pp.264-272
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• 2017

Purpose: This study evaluated trends in tooth extraction due to acute and chronic periodontal disease (PD) using data from the National Health Insurance Service-National Sample Cohort for 2002-2013. Methods: A random sample of 1,025,340 individuals was selected as a representative sample of the population, and a database (DB) of diagnostic and prescription codes was followed up for 12 years. We used multivariate logistic regression analysis to assess the incidence of total extraction (TE), extraction due to periodontal disease (EPD), and immediate extraction due to periodontal disease (IEPD) according to sociodemographic factors (sex, age, household income, health status, and area of residence). Results: The incidence of tooth extraction was found to be increasing, and at a higher rate for TE in PD patients. In 2002, 50.6% of cases of TE were caused by PD, and this increased to 70.8% in 2013, while the number of cases of IEPD increased from 42.8% to 54.9% over the same period. The incidence rates of extraction due to acute and chronic PD increased monotonically. We found that the incidence rates of TE, EPD, and IEPD were all 2-fold higher among patients with high income levels and those who were not beneficiaries of health insurance. Conclusions: The rates of TE, EPD, and IEPD have been steadily increasing despite dental healthcare policies to expand public health insurance coverage, increasing the accessibility of dental clinics. Moreover, the effects of these policies were found to vary with both income and education levels. Consistent patient follow-up is required to observe changes in trends regarding tooth extraction according to changes in dental healthcare policies, and meticulous studies of such changes will ensure optimal policy reviews and revisions.

• KDI Journal of Economic Policy
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• 제12권3호
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• pp.47-69
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• 1990

한국(韓國)의 의료보험제도(醫療保險制度)는 일본제도(日本制度)를 거울삼아 서둘러 적용대상자(適用對象者)를 확대하여 1989년 전국민의료보험(全國民醫療保險)을 달성하였으나 제도(制度)와 효율적(效率的) 운영(運營)을 위한 장치가 결여되어 있고 직장(職場), 공교(公敎), 지역의보간(地域醫保間)에 형평문제(衡平問題) 제기되는 등 구조적인 과제를 안고 있다. 앞으로 제도(制度)의 개혁추진(改革推進) 노력으로 이 분야의 정책수립(政策樹立)과 집행(執行) 에 있어서 경직성을 줄이고 비용효과적(費用效果的)인 의료이용(醫療利用)을 도모해 나가지 못할 경우 낭비요인(浪費要因)이 점점 더 크게 불어나 국민의료비(國民醫療費)가 계속적으로 급속히 증대될 전망이다. 이와 같은 제도(制度)의 질적개선(質的改善)의 필요성에 비추어 최근 네덜란드가 시도하고 있는 제도개혁(制度改革)은 우리에게 여러가지 귀중한 교훈을 던져주고 있다고 판단된다. 네덜란드의 개혁안은 시장경쟁원리(市場競爭原理)를 폭넓게 수용하여 제도(制度)의 능률(能率)을 높이고 의료비(醫療費)를 절감하려는 취지를 담고 있다. 특히 의보가입자(醫保加入者)가 보험자(保險者)를 선택할 수 있고 또한 보험자(保險者)가 의료기관(醫療機關)을 선택할 수 있도록 관계(關係) 집단간(集團間) 상호경쟁(相互競爭)을 유도함으로써 효율(效率)을 증진시켜 나가겠다는 정책방향이 뚜렷히 제시되고 있어 우리의 주목을 끌고 있다.