• 한국산업보건학회지
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• 제24권4호
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• pp.436-445
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• 2014

Objectives: Time-activity studies have become an integral part of comprehensive exposure assessment and personal exposure modeling. The aims of this study were to estimate exposure levels to nitrogen dioxide($NO_2$) and volatile organic compounds(VOCs), and to compare estimated exposures by using time-activity patterns and indoor air concentrations. Methods: The major microenvironments for office workers were selected using the Time-Use Survey conducted by the National Statistical Office in Korea in 2009. A total of 9,194 and 6,130 workers were recruited for weekdays and weekends, respectively, from the Time-Use Survey. It appears that workers were spending about 50% of their time in the house and about 30% of their time in other indoor areas during the weekdays. In addition, we analyzed the time-activity patterns of 20 office workers and indoor air concentrations in Daegu using a questionnaire and time-activity diary. Estimated exposures were compared with measured concentrations using the time-weighted average analysis of air pollutants. Conclusions: According to the time-activity pattern for the office workers, time spent in the residence indoors during the summer and winter have been shown as $11.12{\pm}2.20$ hours and $12.48{\pm}1.77$ hours, respectively, which indicates higher hours in the winter. Time spent in the office in the summer has been shown to be 1.5 hours higher than in the winter. The target pollutants demonstrate a positive correlation ($R^2=0.076{\sim}0.553$)in the personal exposure results derived from direct measurement and estimated personal exposure concentrations by applying the time activity pattern, as well as measured concentration of the partial environment to the TWA model. However, these correlations were not statistically significant. This may be explained by the difference being caused by other indoor environments, such as a bar, cafe, or diner.

• 한국사회복지학
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• 제57권3호
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• pp.5-30
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• 2005

세계화는 제약정책에 모순적인 영향을 미친다. 세계화에 따른 '국민적 경쟁국가'로의 변화는 약제비 절감 정책을 강화하는 한편 다국적 제약자본의 영향에 의한 WTO TRIPS 협정은 신약에 대한 특허 보호를 강화하여 약제비를 증가시킨다. 현재 다국적 제약자본의 이해를 반영하는 초국적 기구(예로, 유럽연합)가 산업적 목표 때문에 국민국가 제약정책에 규제를 가함으로써 국민국가의 약제비 절감 정책의 자율성이 침해당하고 있는 실정이다. 우리나라도 예외는 아니다. 1990년대 후반까지 우리나라 제약정책의 특징은 성장제일주의 이데올로기에 의한 원가수준의 약제비 통제 정책이었으며 이는 우리나라의 고유한 발전국가적 정책수단이었다. 그러나 세계화로 인한 다국적 제약자본의 힘의 강화는 우리나라 제약정책 자율성을 침해하고 있다. 값비싼 수입의약품은 건강보험 급여 목록에서 제외되었으나 미국 정부의 오랫동안의 압력에 의해 1999년부터 수입의약품도 건강보험 급여 목록에 등재되었다. 또한 의약분업 실시 이후 값비싼 고가약 사용이 증가하자 건강보험 재정절감 차원에서 참조가격제 도입 방안이 마련되었으나 미국 정부 및 다국적 제약회사의 압력에 의해 제도 실시가 유보되어졌다. 뿐만 아니라 미국 정부의 압력에 의해 우리나라 보건의료정책 결정 과정에 영향을 미치는 워킹그룹이 만들어지게 되었다. 지금까지 세계화와 관련된 논의들은 주로 세계화에 따른 국민적 경쟁국가로의 변화가 복지지출을 축소시켰는가에 관한 것들이었다. 그러나 본 연구는 세계화가 약제비 절감정책을 통해 보건의료비 지출을 감소시킨 측면 뿐만 아니라 세계화가 민간영리 복지서비스 제공자인 다국적 제약자본의 힘을 강화시켜 복지지출을 증가시키는 측면에도 주목하였다. 본 연구는 세계화가 일국의 제약정책에 미치는 모순적인 측면에 주목하면서 이 모순이 어떻게 다국적 제약자본의 이해로 관철되는지를 우리나라의 사례를 통해 살펴보았다.

• 대한지역사회영양학회지
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• 제24권4호
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• pp.300-308
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• 2019

Objectives: This research was conducted to identify the consumers' food choice factors that affect the consumers' replacement of soft drinks with carbonated water. Methods: The present study used secondary data from a consumer panel survey conducted by the Rural Development Administration of Korea, and the data included the panel members' purchase records based on their monthly spending receipts. The survey asked the participants about their food choice factors and their personal responsibility for their health. This survey included independent variables for the consumers' food purchase factors. As a dependent variable, two types of groups were defined. The replacement group included those people who increased their purchase of carbonated water and decreased their purchase of soft drinks. The non-replacement group included those people who did not change their purchase patterns or they increased their purchase of soft drinks and they decreased their purchase of carbonated water. Logistic regression analysis was conducted to determine the consumers' food choice factors that were associated with replacing soft drinks with carbonated water. Results: The replacement group was significantly associated with (1) a younger age (OR=0.953), (2) being a housewife (OR=2.03), (3) higher income (OR=1.001) and (4) less concern about price (OR=0.819) when purchasing food. This group also showed (5) higher enjoyment (OR=1.328) when choosing food and (6) they took greater responsibly for their personal health (OR=1.233). Conclusions: This research is the first study to mainly focus on soft drinks and carbonated water. The result of this research showed that young, health-conscious consumers with a higher income and who are more interested in food have more possibilities to replace soft drinks with carbonated water. These research findings may be applied to consumers who have characteristics that are similar to the young health-conscious consumers and the results can help to suggest ways to reduce sugar intake and improve public health. However, this research has a limitation due to the application of secondary data. Therefore, a future study is needed to develop detailed survey questions about food choice factors and to extend these factors to all beverages, including soft drinks made with sugar substitutes, so as to reflect the growth of alternative industries that use artificial sweeteners or different types of sugar to make commercially available drinks.

• 한국치위생학회지
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• 제11권2호
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• pp.197-211
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• 2011

Objectives : OHIP-14 and EQ-5D were used, targeting the residents of farming communities to identify the elements that influence oral cavity's health and quality of life due to health and to identify the importance of oral cavity's health in order to increase health of adults' oral cavity and quality of life via improved health. Methods : This research was conducted from July 17th, 2010 to August 16th, 2010 targeting 600 residents in Goryeong-gun, Gyeongsangbuk-do, aging over 40. The data has been analyzed using Mann-Whitney U test, Kruskal-Wallis test and hierarchical multiple regression through SPSS Win Program 18.0 version. Results : 1. OHIP-14 and EQ-5D based on general characteristics showed lower oral health-related quality of life and health-related quality of life on the following cases: women (p=0.004, p<0.001), older (p<0.001, p<0.001), lower scholastic ability (p<0.001, p<0.001), lower average of average spending money (p<0.001, p<0.001), higher number of chronic disease (p<0.001, p<0.001), less drinking (p=0.012, p=0.008), lower perceived oral health and health status (p<0.001, p<0.001) and non smoking showed only EQ-5D (p<0.001). 2. OHIP-14 and EQ-5D based on oral health behavior showed lower oral health-related quality of life and health-related quality of life on the following cases: no periodic oral check-up (p<0.001, p<0.001), less experience of oral health education (p<0.001, p<0.001), horizontal tooth-brushing method(p<0.001, p<0.001) and lower frequency of tooth-brushing showed only OHIP-14 (p=0.042). OHIP-14 and EQ-5D based on oral health status and subjective oral symptom showed lower oral health-related quality of life and health-related quality of life on following cases: number of existing tooth less than 20 (p<0.001, p<0.001), the number of missing teeth more than 9 (p<0.001, p=0.044), DMFT (Decay, Missing, Filling Teeth) index more than 18 (p<0.001, p<0.001), wears denture (p<0.001, p<0.001), edentulous (p<0.001, p=0.002), have xerostomia (p<0.001, p<0.001) and have chewing discomfort (p<0.001, p<0.001). 3. Factors affecting OHIP-14 were gender, age, perceived oral health status, perceived health status, number of existing teeth, dental status, xerostomia and chewing discomfort, and the of reliability (how well it explains) the final model was 48.7%. EQ-5D showed relevance on gender, age, presence of chronic disease, perceived health status, xerostomia, chewing discomfort and oral health-related quality of life, and the reliability of the final model was 42.9%. Conclusions : In order to improve the quality of life of ruralists, oral health needs to be improved or remained by increasing the rate of possession of the existing teeth and preventing the loss of teeth. In order to do so, improvement of accessibility of dental clinic, change of direction from treatment-centered to prevention-centered health care system, development of oral health education program and various oral health care policies which would vitalize continuous oral health care system are considered to be necessary.

• 한국정보컨버전스학회논문지
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• 제6권2호
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• pp.23-44
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• 2013

본 연구는 대구광역시에 소재하고 있는 D대학교 대학생 519명을 대상으로 개인재무관리역량을 측정하고 측정된 결과를 통해서 일반사회적 특성이 개인재무관리역량에 어떠한 차이가 있는지 알아보고자 했다. 먼저 대학생들의 재무관리태도에 대한 개인재무관리역량 평균 점수는 남학생이 72.24점, 여학생이 71.65점으로 비교적 높게 나타났으며, 남학생이 여학생보다 평균점수가 조금 높게 나타났다. 통장개설 경험이 있는 대학생, 용돈기입장을 작성하는 대학생의 평균점수가 높게 나타났다. 또한 모의 학력이 중졸이하인 대학생의 평균점수가 73.67로 가장 높게 나타났으며, 모의 학력이 대학원 이상인 대학생의 평균점수는 63.35로 낮게 나타났다. 다음으로 재무관리지식에 대한 대학생들의 개인재무관리역량 평균점수를 살펴보면 남학생의 평균점수가 63.26점이며, 여학생의 평균점수는 63.43점으로 나타나 거의 차이가 없었다. 다만 통장개설 경험이 있는 대학생, 용돈기입장을 작성하는 대학생, 신용카드개설 경험이 있는 대학생에게서 높은 평균점수가 나타났으며, 전공계열 간에도 차이가 나타났다. 공학계열 대학생이 재무관리 지식에 대한 평균점수가 66.88점으로 가장 높게 나타났으며, 예체능계열의 대학생의 평균점수는 53.39점으로 가장 낮게 나타났다. 마지막으로 재무관리기능에 대한 대학생들의 개인재무관리역량 평균점수를 살펴보면 남학생의 평균은 64.26점으로 나타났고, 여학생의 평균점수는 63.58로 조금 낮게 나타났다. 재무관리 기능에 대한 대학생들의 평균점수는 용돈기입장을 작성하는 대학생, 부모의 월평균소득이 300만원이상 400만원이하의 대학생 평균점수가 65.26점으로 가장 높게 나타났으며, 부모의 월평균 소득이 200만원 미만인 대학생의 평균점수는 60.43점으로 가장 낮게 나타났다. 또한 전공계열간에도 대학생의 평균점수에 차이가 나타났다. 공학계열의 대학생 평균점수는 69.67점으로 가장 높게 나타났고, 보건계열 대학생의 평균점수는 63.21점으로 가장 낮게 나타나 대학생 전공계열 간에도 재무관리기능 평균점수에 차이가 나타났다.

• 보건행정학회지
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• 제27권4호
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• pp.273-275
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• 2017

It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

• 한국보건간호학회지
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• 제14권2호
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• pp.415-430
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• 2000

From March 10 to April 3, 1999. questionnaires were sent to 157 students at an university located in Hongsong. South Choongchung Province in order to find out their eating habits and exercise patterns. The analysis of the questionnaires collected reveals the followings. 1. Eating Habits 1) 76 out of total 157 respondents (48.4%) said that they skipped breakfast. The significant difference was shown in the frequency of breakfast eating based on respondents' sex. Male students had higher rate of going without breakfast (73.92%) than their female counterparts (28.41%). 2) Most respondents finished eating their meals within 20 minutes. with 58.5% spending 10 to 20 minutes. followed by 28.0% taking less than 10 minutes. 3) With respect to the frequency of eating snacks. 1 to 2 times per day came on top with 63.7%. Significant difference was shown based on sex. with male students having more frequent snacks than female students. 40.1% of those surveyed said they ate snacks because they were either bored or hungry, respectively, 67.5% took snacks after school followed by 23.6% who had snacks after dinner. 4) Concerning the frequency of taking food. 1 to 2 times per week recorded the highest mark for beta-carotine. fruits. fish. beans. milk. seaweeds and fries. As for vegetables. 6 to 7 times a week received the highest points. Males showed significantly higher frequency of taking fruits than females. while the opposite was true for beans. 5) More than 50% of the respondents chose rice and fruits as the food they could eat really well. All those surveyed ate fruits and vegetables. More than 10% of students said they did not eat donut. chocolate. candies. fries. coke and clear carbonated beverage. milk. ham and sausage. The food that revealed significant difference based on sex included ramyon, coke and clear carbonated beverages, ham and sausage, yogurt and milk, with males showing greater preference than their female counterparts. 6) The most preferred by respondents was spicy taste (49.04%), followed by sour (36.31%), sweet (25.48%), and salty tastes(21.1%). Those surveyed shunned sweet taste the most (21.02%), followed by sour (14.65%), spicy (8.92%), salty (5.10%) tastes. 2. Workout Patterns 1) 14.01% of the respondents said they took exercise. Based on sex, males showed significantly higher rate of 21.74% than 7.95% of females. Those who took exercise did so mostly three times a week. With regard to the time spent on workout. 'within 2 hours' received the highest points. Soccer was found to be the most popular sport among the respondents. The above analysis demonstrated that the students surveyed selected relatively sound answers in the categories of the food preference and taste. However. some skipped breakfast and liked eating snacks. and most did not take exercise, which may raise health problems including the weight increase. Therefore, ways should be devised to tackle such problems to ensure healthy lives.

• 한국전문물리치료학회지
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• 제12권4호
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• pp.48-57
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• 2005

The purpose of this study was to evaluate the general characteristics, complications and level of social adaptation of spinal cord injured patients. The subjects were one hundred forty five members who were inpatients or outpatients from October 1, 2004 to April 30, 2005 in general hospitals and municipal welfare centers for the handicapped located in the metropolitan city of Gwangju. The following results were obtained using Modified Barthel Index (MBI). 1) Gender distribution was 77.9% male and 22.1% female. The mean age at the time of injury was 35.4 and the mean age during the study was 44.2. 2) The degree of paralysis among the subjects was as follows: 49.0% had complete paralysis and 51.0% suffered incomplete paralysis. The most frequently injured lesion among the subjects was cervical (49.0%), followed by thoracic (35.9%), and lumbar (15.2%). 3) The mean MBI score was 63.5. There was statistically significant difference in the MBI score in the relation between complete and incomplete paralysis, the relation between cervical, thoracic, and lumbar injury, and the relation between a recovery period of less than three years and more than three years according to the characteristics of injury (p<.05). 4) There was statistically significant difference in the MBI score of subjects who had complications concerning spasticity, deformity, urinary tract infection, and sexual dysfunction (p<.05). 5) The most serious emotional pain after spinal cord injury resulted from economic issues, which affected 35.2% of the subjects. The group having a shorter recovery period after spinal cord injury complained of psychological matters, the group having a longer recovery period complained about the surrounding environment (lack of convenient facilities), suggesting statistically significant difference (p<.05). 6) The most common activities of the group with injuries more than ten years old included meeting schoolmates and working, while most common activities of the group with injuries less than three years old included attending religious functions and miscellaneous others (watching TV, spending time with family), suggesting statistically significant difference (p<.05).

• 경영과정보연구
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• 제16권
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• pp.139-159
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• 2005

In many countries the demographics clearly informs us that an aging population represent a serious problem. To this extent senior citizens welfare does matter it has developed into a public debate and genuine concern. it seems that the social issues are focused on how the socity views the social welfare policies. In a modern welfare state where the emphasis lies in pursing a high standard of living and thereby high quality of life. This does not cover the very well the old people in society, but the government clearly carries an obligation to look after and care for the retired & old people in the society. This obligation the social and economic impact that an old person faces as he/she grows old. it is important ensure that their lives carries a meaning and that they as a group will not be estranged from the mainstream of society just because they are considered to be part of the aging population. The key issues that must be addressed are 1) The impact of reduced spending power from less income. a lower income stream; 2) increasing health problems and costs; 3) the natural degradation of ones physical & mental powers; 4) and thereby an isolation from the public in general. So clearly the social policy related to the old people in society should be developed with the consent of what they believe is important to them. To ensure their minimum income level that a beneficiary of an old person's pension will receive, the monthly pension should be reflected by the official price index and be adjusted accordingly. by making the job market open for the senior citizens, expending the mandatory retirement age, give companiesincentives to hire senior citizens, there maybe an opportunity to extend to the aging population the possibility to continue to participate in the society at large.

• 한국융합학회논문지
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• 제8권12호
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• pp.149-157
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• 2017

입원기간동안 적절하지 않거나 불필요한 처치로 발생될 수 있는 재입원관련 질지표는 질스크리닝 뿐만 아니라 입원환자의 적절하지 못한 지출을 파악할 수 있어서 중요하다. 이 연구는 예방할 수 있는 재입원으로 인해 발생되는 진료비 규모를 파악하고자 한다. 건강보험심사평가원의 2014년도 청구 데이터를 활용하여 종합병원이상 의료기관에 입원한 18세 이상 성인을 대상으로 분석하였다. 입원 유형을 1회 입원군과 재입원군으로 분류하였고, 재입원군은 다시 계획된 재입원과 계획되지 않은 재입원으로 분류하였다. 재입원 간격은 28일 이내로 설정하였다. 암질환, 동반질환, 전문재활 환자의 경우 1회 입원군보다 재입원군의 분포가 더 많았다. 계획되지 않은 재입원 유형 중 동일 기관, 동일 진료과목, 동일 질병군 입원의 경우 재입원에 지출된 총 진료비가 전체 재입원 진료비의 50%가량을 차지하였다. 불필요한 재입원으로 인해 발생되는 진료비는 2014년 1년간 9,990억원 정도였다. 재입원이 잦은 지역, 진료과목, 질병군 등의 패턴을 활용하여 재입원을 줄이려는 노력이 필요하다.