• 한국콘텐츠학회논문지
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• 제17권11호
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• pp.435-445
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• 2017

본 연구는 단순 의료이용의 차이를 확인하거나 제한적인 의료필요와 의료이용지표를 활용하여 의료이용의 형평성을 연구한 선행연구의 한계를 극복하기 위하여 수행되었다. 구체적으로 의료필요지표로 활동제한여부, 만성질환이환여부와 수, 주관적 건강상태를 활용하였고 의료이용지표로 외래와 입원, 응급이용횟수와 진료비를 활용하였다. 아울러 의료필요를 고려한 의료이용의 형평성을 분석하기 위하여 집중지수와 집중곡선, Le Grand계수를 활용하였다. 주요 분석결과, 첫째 단순한 의료이용 집중정도로 볼 때 저소득층의 의료이용량이 고소득층에 비해서 많은 것이다. 특히, 저소득층 입원이용이 외래나 응급이용에 비해서 크게 많았다. 둘째, 저소득층에게 의료필요가 집중된 것으로 나타났다. 즉, 저소득층의 건강상태가 좋지 않은 것이다. 셋째, 의료필요를 고려한 의료이용의 형평성을 확인하기 위하여 Le Grand계수를 산출하였다. 의료필요를 고려하더라도 고소득층의 의료이용량이 많았다. 즉, 단순한 양적인 의료이용은 저소득층의 이용이 많았지만, 의료필요를 고려한 의료이용횟수는 고소득층이 많은 것이다. 또한, 전체진료비는 활동제한여부와 만성질환수를 고려했을 때는 고소득층의 의료이용이 많았으며 주관적 건강상태와 만성질환이환여부를 고려하였을 때는 저소득층의 의료이용이 많았다. 따라서 대체로 저소득층이 건강상태에 비해 의료이용을 충분히 하지 못하는 것을 알 수 있었다. 한편, 저소득층의 주관적 건강상태와 만성질환이환여부 관련 의료필요에 비해 의료비지출이 많았는데 이는 저소득층이 스스로의 건강상태와 만성질환이환에 대한 인식을 소극적으로 함으로써 의료필요가 과소평가된 것이 원인으로 사료된다.

• 의료관련감염관리
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• 제21권2호
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• pp.50-56
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• 2016

ESBL을 생성하는 균주에 의한 요로 감염에서 카바페넴 계열 이외의 항생제를 사용할 수 있는 지를 후향적으로 평가한 연구이다. 만약 in vitro 결과에서 감수성이 있다면 사용이 가능하다는 결과이나 환자의 중증도가 높다면 실패할 수 있음을 강조하였다. 이번 연구 결과를 바탕으로 전향적 연구를 기대해 본다.

• 보건행정학회지
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• 제24권2호
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• pp.109-119
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• 2014

In accordance with the government's plan to expand the national health insurance (NHI) coverage for severe diseases such as cancer, heart disease, cerebrovascular disease, and rare and incurable disease, the diagnostic ultrasound services have been covered by NHI from October 1, 2013. The quality is very important factor in providing diagnostic services because they influence on the diagnosis, treatment, and outcome of diseases. In particular, equipments and health care providers plays an important role in providing qualitative services. The purpose of this paper is to examine the major feature of ultrasound services covered by health security system and to review quality assurance policies in other countries such as Australia, Japan, the USA, and Canada. In addition, we assessed the implication of those policies. We especially put emphasis on the types and qualifications of healthcare professionals and measures to manage equipments. All countries have reviewed on policies to promote the quality such as educational requirements of professionals or restrictions on the duration of equipment usage. Various measures should be implemented to assure the qualitative ultrasound service.

• 한국환경과학회지
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• 제22권2호
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• pp.205-213
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• 2013

This is made of domestic and foreign coal activated carbon of five species, physicochemical adsorption efficient about sterilize products and micro harmful substances and is a result of the economic evaluation. The most well-developed micropores bed volume 123,409 of AC-1 activate carbon appeared to be the best next AC-2, AC-3, AC-4, AC-5 followed by activated carbon was investigated. PFOA and PFOS in the BV 96,000 when evaluating foreign types of adsorption activated carbon adsorption capacity was greater when more than PFOA, PFOS showed that the adsorption well. The economic evaluation of activated carbon usage in chloroform (CUR) was most excellent as a AC-1 4.3 g/day, the next AC-2, AC-3, AC-4, AC-5 there are two types of foreign economic order appears to have appeared, but the current domestic market when applying the price AC-1, AC-3, AC-2, AC-4, AC-5 order was investigated.

• 정보처리학회논문지:컴퓨터 및 통신 시스템
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• 제4권8호
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• pp.253-258
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• 2015

u-헬스케어 관점에서 볼 때, 심박수(heart rate)는 아픈 사람의 질환을 관리하는 일리스(illness)나 건강한 사람의 건강을 지속적으로 관리하는 웰니스(wellness) 분야에 모두 유용하게 사용된다. 이는 심박수가 질환의 증상을 판단하거나 운동 부하의 지표로서 모두 사용될 수 있기 때문이다. 최근에 착용형 센서(wearable sensors)를 이용하여 상시적으로 심박수를 모니터링하여 이에 기반하여 현재 몸 상태를 점검해볼 수 있는 다양한 심박계(heart rate monitor)와 이와 연동하여 심박수를 이용한 다양한 운동관리 스마트폰 앱이 개발되어 출시되고 있다. 그러나 이러한 스마트폰 앱은 모두 개인 용도로 제한된다. 논문에서는 여러 사람들의 심박수를 동시에 실시간으로 모니터링할 수 있는 시스템을 설계하고, 이를 적용할 수 있는 안드로이드 앱을 개발한다. 개발된 앱의 주요 기능은 다수 이용자에 대한 동시적 심박수 모니터링으로 피트니스 센터에 효과적으로 적용 가능하다.

• 한국임상약학회지
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• 제22권1호
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• pp.81-86
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• 2012

This study was aimed to examine the prescribing patterns of antivirals in outpatients with chronic hepatitis B (CHB), using National Health Insurance adjudicated claims data (total 1,426,065 claims) dated March 19, 2008 submitted from nationwide healthcare providers to Health Insurance Review and Assessment Service. From the data, there were 2,965 claims with CHB diagnosis (ICD-10 code B18.0 and B18.1), and 44.2% (1,311 claims) of the CHB related claims included antivirals such as lamivudine, clevudine, adefovir and entecavir. Lamivudine, adefovir, clevudine and entecavir shared 54.9%, 19.9%, 13.2% and 11.9%, respectively, among antiviral prescriptions. Adefovir and entecavir 1mg presumed as the 2nd line therapy for HBV resistant cases were shared 23.3% of overall antiviral prescriptions. There were statistically significant difference in prescription patterns according to age and institution type: Lamivudine usage was higher in younger (< 20 years old) and older age group (> 70 years old) than the others (p = 0.016), and adefovir and entecavir, which were relatively newer antivirals, had higher prescription rates in higher level of institutions such as tertiary hospitals than the others (p < 0.001). This study would be of help to make an appropriate drug therapy plan for patients with CHB.

• 대한방사선기술학회지:방사선기술과학
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• 제41권5호
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• pp.397-403
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• 2018

Mobile X-ray generators are used not in the radiation area but in open space, which causes the exposure of secondary radiation to the healthcare professionals, patients, guardians, etc., regardless of their intentions. This study aimed to investigate the shielding effect of the developed radiation restrictor to block the secondary radiation scattered during the use of mobile X-ray generator. Upon setting the condition of mobile X-ray generator with chest AP, spatial doses were measured by the existence of human equivalent phantom and radiation restrictor, and measured by the existences of phantom and radiation restrictor at the same length of 100 cm. Measurements were taken at intervals of 10 cm every $30^{\circ}$ from $-90^{\circ}$ (head direction) to $+90^{\circ}$ (body direction). Upon the study results, spatial doses in all direction were increased by 45% on average when using phantom in the same condition, however, they were decreased by 64% on average when using the developed radiation restrictor. The dose at 100 cm from the center of X-ray was $3.0{\pm}0.08{\mu}Gy$ without phantom and was increased by 40% with $4.2{\pm}0.08{\mu}Gy$ after phantom usage. The dose when using phantom and the developed radiation restrictor was $1.4{\pm}0.08{\mu}Gy$, which was decreased by 66% compared to the case without using them. Therefore, it is considered the scattered radiation can be shielded at 100-150 cm, the regulation of the distance between beds, effectively with the developed radiation restrictor when using mobile X-ray generators, which can lower the radiation exposure to the people nearby including healthcare professionals and patients.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제21권3호
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• pp.69-77
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• 2015

Purpose: Under a trend of hospitals that repeated expansion in line with fast increasing factors of medical demands in the past, medical buildings where clinic businesses have regularly gathered in one building have exponentially increased since separation of prescribing and dispensing in 2000. Thus, this study aims at analyzing characteristics of architectural plan of the current medical buildings, identifying strengths and weaknesses through Post Occupancy Evaluation and suggesting an architectural planning method of medical buildings to be planned in the future. Methods: Scope of study has been limited to 23 medical buildings that are registered in the building register as medical buildings out of the Class 1 neighborhood facilities build as 5 floors or more in Cheongju region since 2000 and being actually used for the usage. Study method is to define concepts of the medical buildings through literature review and advanced researches, analyze characteristics of architectural plan through drawing analysis and site survey. Results: General characteristics of architectural plans for the medical buildings in Cheongju have been analyzed. There are the most frequencies in general commercial area and semi-residential area, most of them are reinforced concrete structure and the Class 1 neighborhood facilities. Average land area is $482.68m^2$, gross floor area $3720.8m^2$, the number of underground floors level 1.16, the number of floors level 7.76, total number of floors 8.92, the building-to-land ratio 67.28%, floor area ratio 452.6%, height 31.44m, and the number of parked vehicles 24.16. Implications: This research will contribute to the establishment of the planning methods which increase the quality of Medical Buildings in Cheongju.

• 임상간호연구
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• 제21권2호
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• pp.154-168
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• 2015

Purpose: This study aimed to adapt the previously developed, high-quality oral care guideline for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by National Evidence-based Healthcare Collaborating Agency (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The adapted oral care guideline was consisted of 10 domains and 85 recommendations. The number of recommendations in each domain were: 4 general issues, 2 oral care indications, 10 oral assessment 16 general oral care, 15 oral care for critically ill, 15 oral care for cancer patients, 14 oral care for cancer patients withoral complications, 5 oral careeducation, 2 oral care referral, and 2 documentation and report. Ten point six percent of the recommendations were rated as grade A, 20.0% as grade B grade, and more than half (69.4%) were rated as grade C. Conclusion: The adapted oral care practice guideline is expected to included the evidence-based practice guidelines as fundamentalss of nursing practice. Dissemination of the developed guideline nationwide would contribute improving the efficiency of oral care practice.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권2호
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• pp.37-46
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• 2017

Purpose: Recently accomodations are required to apply universal designs to all the types of rooms in order to increase accessibility to everyone. Especially universal designs are considered as one of the important methods to help disabled users utilizing accomodations with minimizing difficulties. The current research attempted to apply universal designs to ordinary rooms for promoting usage of rooms in accomodations. Methods: The field study were executed about all the types of rooms and shared spaces in 42 accomodations in 14 cities, Also, the managers working in the studied accomodations were asked to answer the online survey about awareness in universal design. Results: In many cases, ordinary rooms are partially renovated for the disabled with adding some convenient facilities. This raises negative recognition for the rooms specially designed for the disabled as well as absence of needs for universal designed rooms. Meanwhile, universal designed rooms have been required not only for the ordinary but also for the disabled. Implications: Regarding adopting universal design to rooms in accomodations, it should be reviewed throughout all the processes from designing to planning.