• 한국정보처리학회:학술대회논문집
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• 한국정보처리학회 2018년도 추계학술발표대회
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• pp.235-237
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• 2018

The Internet has allowed many things to move fast, including sharing of data, files and others within a second. Many domains use applications range from IoT, smart cities, healthcare, and organizations to share the data when necessary. However, there are some challenges faced by existing systems that works on centralized nature. Such challenges are data breach, trustiness issue, unauthorized access and data fraud. Therefore in this work, we focus on using a smart contract which is used by blockchain platform and works on decentralized form. Furthermore, in this work our contract provides an access to the file uploaded onto the decentralized storage such as IPFS. By leveraging smart contract-role based which consist of a contract owner who can manage the users when access the certain resources such as a file and as well as use of decentralized storage to avoid single point of failure and censorship over secure communication channel. We checked the gas cost of the smart contract since most of contracts tends to be a high cost.

• Korean Journal of Neurotrauma
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• 제13권1호
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• pp.9-14
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• 2017

Cranioplasty is an in evitable operation conducted after decompressive craniectomy (DC). The primary goals of cranioplasty after DC are to protect the brain, achieve a natural appearance and prevent sinking skin flap syndrome (or syndrome of the trephined). Furthermore, restoring patients' functional outcome and supplementing external defects helps patients improve their self-esteem. Although early cranioplasty is preferred in recent year, optimal timing for cranioplasty remains a controversial topic. Autologous bone flaps are the most ideal substitute for cranioplasty. Complications associated with cranioplasty are also variable, however, post-surgical infection is most common. Many new materials and techniques for cranioplasty are introduced. Cost-benefit analysis of these new materials and techniques can result in different outcomes from different healthcare systems.

• 한국융합학회논문지
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• 제8권2호
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• pp.53-62
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• 2017

이 연구는 중국 대학생들의 한국 의료관광 융합서비스 이용에 대한 선호와 만족에 영향을 미치는 요인들을 파악하여 중국 의료관광객 유치를 위한 방안을 마련하는데 필요한 기초자료를 제공하기 위한 것이다. 이 연구를 위하여 구조화된 설문지를 개발하여 2015년 5월 1일부터 15일 사이에 중국 국제대학생 175명을 대상으로 자료를 수집하였다. 한국 의료 서비스에 대한 기대와 평가를 비교하기 위하여 t-검정을 실시하였다. 한국 의료관광 서비스 이용에 대한 만족도에 영향을 미치는 요인들을 파악하기 위하여 선형회귀모형을 추정하였다. 다양한 회귀모형을 추정하였으며, 그 중에서 간결하면서 한국 의료서비스에 대한 만족도의 변량을 비교적 잘 설명해주는 최선의 모델을 선정하였다. 회귀모형 추정 결과 기술, 의료관광서비스의 질, 의료비용은 한국 의료서비스 이용에 대한 만족도와 유의하게 연관되어 있었다. 이 연구결과에 따르면, 중국 대학생들을 대상으로 한국의 의료서비스에 대한 이해를 높일 수 있는 전략이 필요하다. 중국 의료관광객 유치 활성화를 위해서는 기술수준의 제고, 의료서비스의 질 향상, 합리적인 비용의 설정도 중요하다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제24권2호
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• pp.15-25
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• 2018

Purpose: The important things in space plan of a screening center are improving the spatial awareness by space systemization and minimizing the examination time for customers, and reducing the required time of screening work and maximizing the capacity for the screening center. Therefore, we tried to solve the problem of improving spatial awareness and reducing the examination time by using the pedestrian based discrete event simulation at the minimum cost. Methods: We have analyzed the drawbacks and the supplement points by comparing the floor plan at the time of opening and the current floor plan. Based on the analysis, we propose an improved plan which changes the location of the examination rooms and the number of services, and we also verify the improved plan based on simulation analyses. Results: 1) Through the analyses, we derived the drawbacks of the floor plan at the time of opening, and we realized that the current floor plan reflects the drawbacks. 2) The major reasons of the long examination time are the human traffic jam and the occurrence of queues due to unreasonable allocation of services. 3) Through the discrete event simulation analyses, it was possible to specify the place of the queues manually so as to use the given space fairly. 4) Using the discrete event simulation, it was possible to reduce the examination time and to improve the spatial awareness effectively at the minimum cost. Implications: Although the proposed simulation methodology in this paper is an analysis of the existing screening center, we expect that the proposed methodology will be used to develop a more efficient architectural design process by pre-applying the method to the course of designing a screening center and finding the suitability of the proposed method with the matched number of services.

• Imaging Science in Dentistry
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• 제35권4호
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• pp.185-190
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• 2005

Purpose: Once the decision has been made to adopt an integrated medical information system (IMIS), there are a number of issues to overcome. Users need to be aware of the impact the change will make on end users and be prepared to address issues that arise before they become problems. The purpose of this study is to investigate the benefits and unexpected problems encountered in the implementation of IMIS and to determine a useful framework for IMIS. Materials and Methods: The Yonsei University Dental Hospital is steadily constructing an IMIS. The vendor's PACS software, Piview STAR, supports transactions between workstations that are approved to integrating the healthcare enterprise (IHE) with security function. It is necessary to develop an excellent framework that is good for the patient, healthcare provider and information system vendors, in an expert, efficient, and cost-effective manner. Results : The problems encountered with IMIS implementation were high initial investments, delay of EMR enforcement, underdevelopment of digital radiographic appliances and software and insufficient educational training for users. Conclusions: The clinical environments of dental IMIS is some different from the medical situation. The best way to overcome these differences is to establish a gold standard of dental IMIS integration, which estimates the cost payback. The IHE and its technical framework are good for the patient, the health care provider and all information systems vendors.

• 보건행정학회지
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• 제27권3호
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• pp.247-255
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• 2017

Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권3호
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• pp.9-17
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• 2017

Purpose : The easiest and most cost-effective way to prevent medical-related infections is known as proper hand washing of health care workers. The experience of MERS in domestic medical institutions has increased the importance of hand hygiene for medical workers to prevent infections in hospitals. It is necessary to investigate the level of hand hygiene practice by type of medical institutions and the factors influencing the infection prevention. Methods : Domestic and overseas hand hygiene related business cases and literature data were collected and analyzed in order to investigate the hand hygiene status of medical institutions in Korea. Result : As a result of hand hygiene monitoring of all hospital-level medical institutions in 2016, the total number of observations was 24,328 and the hand hygiene performance rate was 75.9%. The hand hygiene performance rate of hospitals was 71.5% for general hospitals, 75% for general hospitals, and 81.3% for hospitals. Implications : In general hospitals and hospitals, the HR(Hand Rubbing) method is preferred as a way of performing hand hygiene, whereas the HW(Hand Washing) method is relatively high in the small hospitals. It is estimated that the HW system is preferred because of the cost burden at the hospital medical institution. Therefore, it is necessary to compensate the related expenses to improve the hand hygiene performance of the physicians who are engaged in the hospitals.

• 보건행정학회지
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• 제32권3호
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• pp.282-292
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• 2022

Background: Aging societies face social problems of increased medical expenses for older adults due to increased geriatric diseases. This study aims to analyze the relationship between the state change of multiple chronic conditions (MCC) and out-of-pocket medical expenses in the elderly aged 60 or older. Methods: The 2014-2018 Korean Longitudinal Study of Aging data were used for 2,202 elderly people. Four status change groups were established according to the change in the number of chronic diseases. The association between the change of MCC and the out-of-pocket medical cost was analyzed using the generalized estimating equation model analysis. Results: The average out-of-pocket total medical costs were 1,384,900 won for participants with MCC and 542,700 won for those without MCC, which was a statistically significant difference (p<0.0001). Compared to the reference group (simple chronic disease, SCD→SCD), the change in multiple chronic conditions significantly increased the total out-of-pocket medical expenses in MCC→MCC and SCD→MCC groups (MCC→MCC: 𝛽=0.8260, p<0.0001; SCD→MCC: 𝛽=0.6607, p<0.0001). Conclusion: In this study, it was confirmed that the prevalence of MCC increased with age, and the out-of-pocket medical cost increased in the case of MCC. Continuity of treatment can be achieved for patients with MCC, and the system and management of treatment for MCC are required to receive appropriate treatment.

• 한국병원경영학회지
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• 제27권3호
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• pp.26-38
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• 2022

Purposes: We analyzed the profitability determinants of regional public hospitals during the entire period between 2010 and 2020 and the period before and after COVID-19. We intended to provide fundamental data for developing publicness evaluation index and task of establishing and expanding regional public hospitals. Methodology: The financial and non-financial information of the regional public hospitals were used as the main analysis data; The financial data was established by the Center for Public Healthcare Policy of National Medical Center, and the non-financial data by the Health Insurance Review and Assessment Service. T-test and regression analysis were used. Findings: The results can be summarized in two. First, the main determinants of profitability of the regional public hospitals were appeared to be the total asset turnover rate and the labor cost rate. Second, during the COVID-19 pandemic in the regional public hospitals, the number of sickbeds, the number of isolation rooms, the total asset turnover rate and the labor cost rate appeared to be the factor worsening the profitability. Practical Implication: The results of this study suggests that the management of the regional public hospitals is not aiming for the profit making, but it performs the functions as the community healthcare safety net such as controlling infectious diseases.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.3-10
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• 2014

The Japan National Committee for the Union for International Cancer Control (UICC) and UICC-Asia Regional Office (ARO) organized an international session as part of the official program of the 72nd Annual Meeting of the Japanese Cancer Association to discuss the topic "What is cost-effectiveness in cancer treatment?" Healthcare economics are an international concern and a key issue for the UICC. The presenters and participants discussed the question of how limited medical resources can be best used to support life, which is a question that applies to both developing and industrialized countries, given that cancer treatment is putting medical systems under increasing strain. The emergence of advanced yet hugely expensive drugs has prompted discussion on methodologies for Health Technology Assessment (HTA) that seek to quantify cost and effect. The session benefited from the participation of various stakeholders, including representatives of industry, government and academia and three speakers from the Republic of Korea, an Asian country where discussion on HTA methodologies is already advanced. In addition, the session was joined by a representative of National Institute for Health and Care Excellence (NICE) of the United Kingdom, which has pioneered the concept of cost-effectiveness in a medical context. The aim of the session was to advance and deepen understanding of the issue of cost-effectiveness as viewed from medical care systems in different regions.