• 보건행정학회지
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• 제34권1호
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• pp.1-3
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• 2024

최근 필수의료에 대한 접근성 문제가 중요한 사회적 현안이 되고 있다. 정부는 필수의료 제공체계를 강화하기 위해 '필수의료 정책 패키지'를 종합적 대안으로 제시하고 2028년까지 10조 원 이상의 재원을 투입하겠다고 천명하였다. 의료체계의 틀을 바꾸는 중요한 내용을 담고 있는 만큼, 정책 추진 시 고려해야 할 몇 가지 논점을 제시하고자 한다. 첫째, 의사인력양성시스템 설계 시 정쟁화를 막는 기전이 강구되어야 한다. 둘째, 전공의 의존도를 줄이고 전문의 중심 병원으로 전환하는 것은 전공의 양성비용을 사회가 부담하는 한편, 전문의 서비스에 대한 대가로 고비용을 지불한다는 것을 의미한다. 이러한 변화로 인한 비용을 사회가 지불할 용의가 있는지를 숙고하고 적절하게 예산이 마련되어야 한다. 셋째, 세부 정책수단들 중 공유형 진료체계나 지역네트워크사업 등은 개념적 논의 수준에 있기 때문에 다양한 쟁점들이 내실 있게 검토되어야 하며, 국내 의료체계의 여건에 적합하도록 중장기적으로 검토해갈 필요가 있다.

• 보건의료생명과학 논문지
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• 제10권1호
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• pp.1-14
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• 2022

본 연구는 보건의료빅데이터를 활용한 보건의료행정 관련학과에서 빅데이터 관련 교육프로그램 활용 가능성에 대한 고찰이다. 본 논문에서는 크게 5가지 관점으로 보건의료빅데이터를 고찰하고자 한다. 첫째, '보건의료빅데이터개방시스템' 이외에도 '한국복지패널', '공공빅데이터', '서울시', '통계청' 등에서 공개하고 있는 공공빅데이터의 특징 및 활용기술에 대하여 살펴보고자 한다. 둘째, 해당되는 보건의료 빅데이터를 전문대학 보건의료행정 및 보건의료정보 관련학과의 정규과목 내에서 살아있는 데이터로써 활용이 가능한지에 대한 적정성 여부를 살펴보고자 한다. 셋째, 기존에 활용하고 있는 통계처리패키지 및 프로그래밍 언어를 활용한 실습실 강의 여부에 가장 적절한 툴을 선정하고자 한다. 넷째, 검증된 보건의료빅데이터와 적정 툴을 활용하여 수업에서 그래프 등의 표현가능성 여부 및 보고서 작성까지의 단계를 시험해보고자 한다. 마지막으로, 최종적으로 휴대성, 설치성, 비용성, 호환성, 빅데이터처리가능성 등을 만족할 수 있는 R언어의 상대적 이점을 기술하고자 한다.

• Journal of Preventive Medicine and Public Health
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• 제42권3호
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• pp.190-198
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• 2009

Objectives : The objective of this study is to estimate the economic costs of cancer on society. Methods : We estimated the economic burden of people with cancer in South Korea. To perform the analysis, we reviewed the records of people who were cancer patients and those who were newly diagnosed with cancer. The data was compiled from the National Health Insurance Corporation, which included the insurance claims database, a list of cancer patients, a database that records the cancer rates, the Korea Central Cancer Registry Center s cancer patient registry database and the Korea National Statistical Office s causes of death database. We classified the costs as related to cancer into direct costs and indirect costs, and we estimated each cost. Direct costs included both medical and non-medical care expenses and the indirect costs consisted of morbidity, mortality and the caregiver's time costs. Results : The total economic costs of cancer in South Korea stood at 14.1 trillion won in 2005. The largest amount of the cost 7.4 trillion won, was the mortality costs. Following this were the morbidity costs (3.2 trillion won), the medical care costs (2.2 trillion won), the non-medical care costs (1.1 trillion won) and the costs related to the caregiver's time (100 billion won). As a result, the economic cost of cancer to South Korea is estimated to be between 11.6 trillion won to 14.1 trillion won for the year 2005. Conclusions : We need to reduce the cancer burden through encouraging people to undergo early screening for cancer and curing it in the early stage of cancer, as well as implementing policies to actively prevent cancer.

• 한국병원경영학회지
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• 제25권4호
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• pp.76-93
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• 2020

Purpose: In this study, the general characteristics of subjects who spent more than a certain amount of cost for general medical examination at the general hospital health promotion center, and the characteristics of disease, family history, and lifestyle (smoking, alcohol, physical activity, oral care) significantly differed in cost expenditure. We intend to provide basic data for establishing an appropriate marketing strategy for comprehensive examination. Method: It was conducted for users who received comprehensive checkups at a health promotion center at a general hospital in Seoul. The research data collection period is for 979 people who performed comprehensive examinations from January 2019 to December 2020. In order to carry out a comprehensive examination, a questionnaire before the examination was distributed to the subjects who visited the hospital to prepare, and the investigation was conducted in a way that the subjects of the investigation directly filled in. Results: There was a significant influence on the difference in expenditure for comprehensive examination according to the gender, age, and type of health insurance of the subject. In addition, there were significant differences in expenditure according to the presence or absence of disease and the type of family history. Weight loss, smoking history, smoking period, smoking frequency, drinking history, and drinking frequency all had significant effects on cost expenditure. Also, strength training and oral treatment management showed a significant effect on the cost of comprehensive examination. The number of flossing and interdental brushing was also found to have a significant effect. According to the results of multiple regression analysis, disease history (t=2.683, p<.01) and mean smoking frequency (t=4.315, p<.001) appeared to have the most significant effect on expenditure statistically. In other words, when the subject has a history of disease and when the average number of smoking is large, it means that the comprehensive examination cost is remarkably large. Conclusion: By using these contents, hospitals can further refine the marketing of the examination center. In addition, a more convenient and specialized process should be used by patients by linking the general medical department and the examination center well. In terms of management of operating medical institutions, this can be expected to create patients and increase profits.

• 간호행정학회지
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• 제8권1호
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• pp.85-95
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• 2002

The purpose of this study was to develope a critical pathway for the chemotherapy of non-small cell lung cancer patients and to identify its effects after implementation. Critical pathway was developed through 5 steps including content and clinical validity tests with collaborative efforts of nurses, clinicians, and other allied healthcare professionals with the aim of improving the quality of patient care, while minimizing cost to the patients. This paper was described an evaluation of the impact of a developed critical pathway on complication rate, length of stay, costs, the interval of treatment and patient satisfaction by nonequivalent control group posttest-only non-synchronized research design.Results were compared between the two groups of patients. There were no significant differences in demographic variables and the occurrence of bone marrow suppression between experimental group and control group(t=-0.01, p=0.992). There were statistically significant decreases in the average length of stay(t=-10.45, p=0.000), in the average cost(t=-2.988, p=0.004), and in the interval of treatment(t=-6.75, p=0.000) after implementation of the critical pathway compared to control group. Also, there was a statistically significant improvement of the patient satisfaction after implementation of the critical pathway compared to control group(t=4.57, p=0.000). This paper concludes that critical pathway in chemotherapy for lung cancer, implemented in the context of an general hospital, is the useful tool to shorten the hospital stay, reduce treatment costs, and improve the quality of life in cancer patients. Further study needs to be conducted to identify other clinical outcomes including job satisfaction, collaboration among health professionals and potential for use in education. Also, it is recommended that nurses should revise continuously the developed critical pathway through clinical implementation and maintain their role of patient advocacy through monitoring pathway compliance.

• 전자공학회논문지
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• 제53권7호
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• pp.3-8
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• 2016

자기적응 등화기의 최적화에 널리 사용되는 판정의거(decision-directed: DD) least mean square(LMS) 알고리즘의 수정된 형태를 제안하고, 수정된 형태가 기존 알고리즘의 초기 수렴 특성을 크게 개선함을 보인다. 기존 DD LMS는 등화기 출력과 그에 대한 양자화 값의 차이를 오차로 간주하고, 오차의 제곱을 비용 함수로 하여 등화기 계수에 대해 이를 최소화함으로써 등화기의 최적화를 달성한다. 이 오차 발생 방법은 이진 신호 또는 단일레벨 신호에 유용하나, 다치레벨 신호의 경우 등화기의 초기화에는 효과적이지 못하다. 수정된 DD LMS에서는 오차 발생을 수정하여 이 문제를 해결하였다. 다치레벨 신호를 대상으로 한 모의실험을 통해 심볼간 간섭에 의한 왜곡과 부가 잡음 하에서 수정된 DD LMS의 유용성과 성능을 검증하였다.

• 보건행정학회지
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• 제26권2호
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• pp.107-114
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• 2016

Background: Over the last few decades, because hospitals in South Korea also have undergone dramatic changes, Korean hospitals traditionally have provided specialized health care services in the health care market. Inner Herfindahl-Hirschman Index (IHI) measures hospital caseloads based on patient proportions, independent of patient volumes. However, IHI that rely solely on patient proportions might be problematic for larger hospitals that provide a high number of diagnosis categories, as the patient proportions in each category are naturally relatively smaller in such hospitals. Therefore, recently developed novel measure, category medical specialization (CMS) is based on patient volumes as well as patient proportions. Methods: We examine the distribution of hospital specialization score by hospital size and investigate association between each hospital specialization and length of stay per case and hospital cost per case using Korean National Health Insurance Service-cohort sample data from 2002 to 2013. Results: Our results show that IHI show a decreasing trend according to the number of beds and hospital type but CMS show an increasing trend according to the number of beds and hospital type. Further, inpatients admitted at hospitals with higher IHI and CMS had a shorter length of stay per case (IHI: B=-0.104, p<0.0001; CMS: B=-0.044, p=0.001) and inpatients admitted at hospitals with higher IHI and CMS had a shorter hospital cost per case (IHI: B=-0.110, p=0.002; CMS: B=-0.118, p=<0.0001). Conclusion: This study may help hospital policymakers and hospital administrators to understand the effects of hospital specialization strategy on hospital performance under recent changes in the Korean health care environment.

• 한국임상약학회지
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• 제28권1호
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• pp.1-9
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• 2018

Polypharmacy is increasing owing to an increase in the elderly population and multimorbidities associated with the increased risk of administration of potentially inappropriate medications (PIMs). The negative effects of polypharmacy on various health conditions and aspects, such as fall, fracture, mortality, cognitive function, and dementia, have been reported. The management of excess and inappropriate polypharmacy through proper interventions and local or national guidelines has been highlighted. The purpose of polypharmacy management is to appropriately prescribe medicines that are essential to treat diseases in patients and to avoid inappropriate polypharmacy, such as interactive or duplicate medicines under prescription and PIMs for specific diseases. Community pharmacists in Australia, the EU, USA, and Japan are collaborating with prescribers to review medications to ensure that the patients can be prescribed appropriate medications. The service cost is reimbursed by public or private insurers. A study in the United States has shown that even with medication review costs, the overall medication cost has reduced. In Korea, various projects such as Drug Utilization Review service and safe use of medicines have been conducted; however, no national guidelines or management measures have been established. It is necessary to implement a national long-term plan on polypharmacy management. Furthermore, a phased implementation plan is required. Shortly, active medication review services and education programs for healthcare professionals with the support of the government should be considered in Korea with reference to other countries in order to raise awareness of seriousness and risks of inappropriate polypharmacy.

• 인터넷정보학회논문지
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• 제17권3호
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• pp.45-54
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• 2016

의료 이미지는 사람 신체의 비정상적인 상태를 발견하는데 효과적인 자료로 사용되고 있다. 일반적으로 환자는 다양한 이유로 다른 종류의 의료 기관을 방문하고, 심각한 질병 특징을 가지는 의료 이미지에 대해 2차 소견을 얻기를 원한다. 현재에는 개인의 의료 이미지가 여러 의료 기관에 산재되어 있기 때문에, 2차 소견을 얻을 때 자신과 관련된 모든 정보를 직접 가지고 다른 의료진을 찾아가야 하는 불편함이 있다. 이런 두 가지 동기로 인해, 본 논문에서는 의료 이미지 보관 및 판독 서비스를 제안하고자 한다. 그러므로, 의료 이미지 보관 및 판독 서비스의 설계 모델 및 구현 결과를 본 논문에서 제시하고, 저비용 개인 헬스케어 서비스로서의 실용적 가치를 증명하고자 한다. 환자는 제안하는 서비스를 사용함으로써 언제든 자신의 의료 이미지 정보를 확인할 수 있고 의료진을 찾아갈 필요 없이 간편하게 의료 이미지 분석을 할 수 있다.

• Transactions on Electrical and Electronic Materials
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• 제8권6호
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• pp.293-298
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• 2007

The aged are faced with increasing risk for falls. The aged have more fragile bones than others. When falls occur, it is important to detect this emergency state because such events often lead to more serious illness or even death. A implementation of PDA system, for detection of emergency situation, was developed using 3-axis accelerometer in this paper as follows. The signals were acquired from the 3-axis accelerometer, and then transmitted to the PDA through a Bluetooth module. This system can classify human activity, and also detect an emergency state like falls. When the fall occurs, the system generates the alarm on the PDA. If a subject does not respond to the alarm, the system determines whether the current situation is an emergency state or not, and then sends some information to the emergency center in the case of an urgent situation. Three different studies were conducted on 12 experimental subjects, with results indicating a good accuracy. The first study was performed to detect the posture change of human daily activity. The second study was performed to detect the correct direction of fall. The third study was conducted to check the classification of the daily physical activity. Each test lasted at least 1 min. in the third study. The output of the acceleration signal was compared and evaluated by changing various postures after attaching a 3-axis accelerometer module on the chest. The newly developed system has some important features such as portability, convenience and low cost. One of the main advantages of this system is that it is available at home healthcare environment. Another important feature lies in its low cost of manufacture. The implemented system can detect the fall accurately, so it will be widely used in emergency situations.