• 보건행정학회지
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• 제19권3호
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• pp.92-108
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• 2009

This study suggests a model for continuing and comprehensive management of hypertension or Type 2 diabetes mellitus (T2DM) in Korea. Moreover, this paper computed the contribution cost of hypertension or T2DM management using the healthcare medical cost, which could have occurred from stroke, myocardial infarction (MI), and end-stage renal disease (ESRD) that were successfully prevented from the effective hypertension or T2DM management. Additionally, these costs were compared with the cost of implementing the hypertension or T2DM management model suggested in this study. This study used the medical fee summary of the health insurance claims submitted to National Health Insurance Corporation by medical facilities for services provided during the period from January 1st 1999 to December 31st 2006. The prevalence rate with treatment referred to cases in which patients submitted their medical claims at least once during the period, along with an accordant diagnosis. The incidence rate with treatment referred to cases in which patients who never submitted claims for the accordant disease during the five years from 1999 to 2003 submitted claims for the accordant disease in 2004 and 2005. The relative risk of the occurrence of stroke, MI and ESRD was 11.0, 13.6, and 30.3, respectively. The attributable risk of hypertension or T2DM for stroke was 0.730, and that for MI and ESRD were 0.773 and 0.888, respectively. Based on these, the contribution cost of hypertension or T2DM is estimated to be 986.3 billion Korean Won(KRW) for stroke patients, 330.5 billion KRW for MI patients, and 561.7 billion KRW for ESRD patients as in 2005. Hence, the total contribution cost of hypertension or T2DM to stroke, MI, and ESRD is 1.878 trillion KRW. The estimate for operational costs included an annual expenditure of 50,000 KRW per each recipient and an annual subsidy of 0.22 million KRW per person for the 1.6 million low.income individuals with hypertension or T2DM to cover their out.of.pocket medical expenses. Under this assumption, it took approximately 0.6 trillion KRW to manage 5 million high.risk patients in the low. and mid.income range, coverings up to 50% of costs. In conclusion, considering the potential benefits of preventing stroke, MI, and ESRD, the costs seems to be reasonable.

• 대한지역사회영양학회지
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• 제17권3호
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• pp.341-352
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• 2012

It is well established that excessive sodium intake is related to a higher incidence of chronic diseases such as hypertension, stroke, coronary heart disease, cardiovascular disease and gastric cancer. Although the upper limit of the current sodium intake guideline by WHO is set at 2,000 mg/day for adults, sodium intake of Koreans is well over 4,700 mg/capita/day implying an urgent need to develop and implement sodium intake reduction policy at the national level. This study investigated the cost-effectiveness of the sodium intake reduction policy, for the first time, in Korea. Analyses were performed using most recent and representative data on national health insurance statistics, healthcare utilization, employment information, disease morbidity/mortality, etc. The socioeconomic benefits of the policy, resulting from reduced morbidity of those relevant diseases, included lower medical expenditures, transportation costs, caregiver cost for inpatients and income losses. The socioeconomic benefits from diminished mortality included reductions in earning losses and welfare losses caused by early deaths. It is estimated that the amount of total benefits of reducing sodium intake from 4.7 g to 3.0 g is 12.6 trillion Korean Won; and the size of its cost is 149 billion Won. Assuming that the effect of sodium intake reduction would become gradually evident over a 5-year period, the implied rate of average return to the sodium reduction policy is 7,790% for the following 25 years, suggesting a very high cost-effectiveness. Accordingly, development and implementation of a mid-to-long term plan for a consistent sodium intake reduction policy is extremely beneficial and well warranted.

• 문화기술의 융합
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• 제3권2호
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• pp.21-30
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• 2017

본 연구는 뇌혈관질환자의 년간 총직접비용에 대하여 조사하였다. 본 연구를 위하여 2012년 한국의료패널 조사자 중 2012년 한 해 동안 뇌혈관질환으로 응급, 입원, 외래서비스를 1건 이상 이용하였다고 응답한 265명을 대상으로 하였다. 뇌혈관질환자 일반사항은 2012년에 한국의료패널 응답자 중 뇌혈관질환으로 응급, 입원, 외래서비스를 이용한 응답자의 비율이다. 연구방법은 응급, 입원, 외래서비스의 평균의료비와 가중평균을 적용하여 직접비용을 산출한 후 년간 총직접비용을 산출하였다. 연구결과는 뇌혈관질환자가 1인당 연 평균 본인부담 의료비 지출액은 약 561,934원이고, 남성은 669,557원, 여성은 448,696원이다. 건강보험 가입자의 경우 뇌혈관질환으로 인한 1인당 본인부담액은 평균 634,459원이고 의료급여 수급자는 160,236원이었다. 뇌혈관질환자가 265명의 연 평균 총직접비용은 약 162,165,690이고, 남성은 193,223,955원, 여성은 129,486,685이다. 건강보험가입자의 경우 뇌혈관질환으로 인한 1인당 총직접비용은 평균 183,095,125원이고 의료급여 수급자는 46,241,705원이었다. 가구소득별로 보면, 가구 소득 3분위에 속한 환자는 672,268원으로 가장 높게 나타났으며, 5분위에 속한 환자는 108,970,650원 으로 뇌혈관질환자의 총직접비용이 가장 낮았다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권3호
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• pp.147-151
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• 2015

The difficult oral healthcare in intellectually disabled patients with poor behavioral control has led to debate over the cost-effectiveness and validity of implant treatment in these patients. The patient in the present report had schizophrenia that had led to poor oral care and severe dental caries in the full mouth. Tooth extraction and a removable prosthesis were planned, but the guardian wanted an implant procedure. Since the guardian showed strong will and cooperation with regard to the patient's oral healthcare, extraction followed by immediate implant placement was performed across two rounds of general anesthesia. Since the outcome appears successful, we present this case report. Immediate implant placement after tooth extraction requires fewer surgeries and rounds of general anesthesia, reduces horizontal bone resorption, and can achieve better esthetic results. Therefore, as long as a certain degree of oral care is possible, this can be a positive option for restoration of a partially edentulous mouth, even in intellectually disabled patients.

• 보건교육건강증진학회지
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• 제31권4호
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• pp.63-72
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• 2014

Objectives: The current study reviews the implementation and evaluation of the Chronic Disease Self-Management Program (CDSMP) in the United States (U.S.) to illustrate the program's potential contribution to improving health among Korean adults with chronic conditions while saving healthcare costs. Methods: This study examines existing literature on the history, theoretical background, essential elements, and delivery outcomes of CDSMP with special focus on the successes and challenges to be faced in the implementation of CDSMP to Koreans with chronic conditions. Results: CDSMP is designed to empower people with chronic conditions to develop skills necessary for medical, social role, and emotional management of chronic conditions. Recent studies show the utility of CDSMP in achieving the Triple Aim health reform goals (i.e., better care, better health, better value). Lessons learned from the U.S. experience emphasize the importance of establishing evidence-based studies, collaborating with community partners, and diversifying funding sources to make CDSMP more sustainable. Conclusion: The current study demonstrates the replicability of CDSMP and potential for expansion in Korea. More concerted efforts among academia, government, and communities are needed to deliver CDSMP to Korean adults and identify its effectiveness within the Korean context in terms of meeting the Triple Aim goals of better care, better health, and better value.

• 한국정보통신학회논문지
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• 제13권4호
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• pp.813-820
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• 2009

본 논문에서는 웨어러블 펄스 옥시미터를 이용하여 IEEE 802.15.4기반의 무선센서네트워크 환경에서 측정에 대한 외부의 자각 없이 자유스러운 생활 속에서 측정 가능한 유비쿼터스 헬스케어 시스템을 구현하고자 하였다. 환자로부터 산소포화도 데이터를 측정하기 위해 반사형 프로브, 산소포화도 모듈, 그리고 무선센서 노드로 구성된 저전력 웨어러블 펄스 옥시 미터를 구현하였다. TinyOS 어플리케이션기의 무선센서 노드는 제작된 프로브로부터 측정 된 데이터를 수집하여 무선통신을 위한 패킷을 구성하며, 무선센서 네트워크를 통해 베이스 스테이션으로 전송된 데이터는 서버 PC에서의 모니터링과 데이터 처리 및 저장이 가능하게 하였다. 서버 PC에서는 LabVIEW소프트웨어 프로그램을 통해 전송된 산소포화도 데이터가 실시간 모니터링 되며, PPG 파형의 2차 미분처리를 통해 동맥혈의 상태를 추정 할 수 있는 가속도 맥파(APG)를 검출하도록 하였다. 또한 실제 연령대별 실험을 통해 가속도 맥파에 의한 혈관 탄성도의 수치를 비교분석 하였다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제22권3호
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• pp.7-15
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• 2016

Purpose: As medicare services have gotten spreaded, clinical laboratory has been dominant position. So, it has been acted for quality control and clinical pathology accreditation. But there has been quite deficient information to evaluate working space and technical standards of medical laboratory for accreditation. This study goals to figure out accreditation standard and design guideline for clinical laboratory, and to give safe and efficient design information. Methods: This study has been searched by literature for accreditation standards and design guidelines of clinical pathology in USA, UK, and Germany. Results: Three countries have accredited based on working lab space, staff space, storage space, patient space and health and safety equipment. Design guidelines of three countries commonly have focused on worktable layout, worktable distance and module, and specific laboratory biosafety level. And USA guidelines stress on the architectural design such as design process and passage distance for escape, UK stress on the efficiency as functional work flow and construction cost, lastly Germany design guidelines stress on the operator's safety distance and workstation. Three countries have not only accreditation standards but also design guidelines for more specific quality management, separating from accrediting institute. Implications: In korea, it has been needed to make clinical laboratory design guideline for the safe and efficient environment and reliable and competitive medical service.

• Journal of Communications and Networks
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• 제17권5호
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• pp.453-462
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• 2015

Body area networks (BANs) have emerged as an enabling technique for e-healthcare systems, which can be used to continuously and remotely monitor patients' health. In BANs, the data of a patient's vital body functions and movements can be collected by small wearable or implantable sensors and sent using shortrange wireless communication techniques. Due to the shared wireless medium between the sensors in BANs, it may be possible to have malicious attacks on e-healthcare systems. The security and privacy issues of BANs are becoming more and more important. To provide secure and correct association of a group of sensors with a patient and satisfy the requirements of data confidentiality and integrity in BANs, we propose a novel enhanced secure sensor association and key management protocol based on elliptic curve cryptography and hash chains. The authentication procedure and group key generation are very simple and efficient. Therefore, our protocol can be easily implemented in the power and resource constrained sensor nodes in BANs. From a comparison of results, furthermore, we can conclude that the proposed protocol dramatically reduces the computation and communication cost for the authentication and key derivation compared with previous protocols. We believe that our protocol is attractive in the application of BANs.

• 서비스연구
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• 제5권2호
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• pp.25-33
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• 2015

데이터마이닝은 방대한 데이터를 기반으로 정보를 추출하는 방법으로 많은 분야에 적용하고 있으며 특히 보건의료 데이터를 다루는 기법으로 많이 활용 되고 있다. 하지만 데이터가 다양하고 방대해짐에 따라 데이터들을 완벽하게 다룰 수 있는 알고리즘이 개발되지 못한 현황이다. 따라서 본 논문에서는 군집화 알고리즘 중의 하나인 DBSCAN 알고리즘과 EM 알고리즘의 성능을 동일한 데이터에 대하여 분석을 시도하였다. 이를 위하여 DBSACN과 EM 알고리즘에 따른 변화를 Health expenditure 실험데이터의 결과를 기반으로 분석 하였고 더욱 정확한 실험과 더욱 정확한 결과를 알아내기 위하여 Kernel Filtering을 통하여 정확한 데이터분석을 시도하였다. 본 연구에서는 알고리즘의 기술적 성능을 비교한 것을 물론이고 성능을 높이기 위한 시도를 하였다. 이를 통하여 확장한 알고리즘에 따른 성능의 변화와 실험데이터의 적용결과를 기반으로 비교하고 이를 분석하게 되었다. 특히 의료기관을 이용하는 다양한 군집으로부터 데이터 레코드를 수집하여 의료 서비스에 대한 효과적인 비용 지출을 권장할 수 있도록 실험하였다.

• 대한예방한의학회지
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• 제6권2호
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• pp.36-47
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• 2002

Over thousands of years oriental traditional medicine has developed a theoretical and practical approach to treat and prevent diseases and to promote people's health in China and Korea. In China, the integration of traditional Chinese medicine into the national healthcare system began in the late 1950s. This was in response to national planning needs to provide comprehensive healthcare services. On contrary to China, South Korea established the parallel operation of two independent medical systems in 1952. Hence there has been a political conflict between oriental and modern medicine over issues of fee, the ability to sell and prescribe herbal medicines, and the licensing of practitioners in traditional medicines. Given this background. This study is to compare peoples' attitudes and opinions for oriental traditional medicine by ethnicity (Chinese, Korean-Chinese and Korean). Chinese and Korean-Chinese were more used and satisfied with traditional medicine treatment and traditional practitioners compared with Koreans. The proportion of Koreans who reported the cost of traditional treatments was expensive was higher than those of Chinese and Korean Chinese. Most of Chinese, Korean-Chinese, and Koreans reported that they would use traditional medicine: 1) when they would have some disease to be treated best through traditional medicine; and 2) when traditional practitioner had a reputation and lots of experiences for those diseases. Most Korean people reported that oriental and western practitioners should cooperate each other to improve the quality of care. Therefore, policy framework including integration of traditional and western medicine, regulation, etc. is needed. In addition, research is needed to determine which diseases is treated best through traditional medicine.