• 제목/요약/키워드: Hierarchical Policy Model

검색결과 132건 처리시간 0.025초

건강검진 수검 및 검진유형 선택의 결정요인 (Determinants of the Use and Type of Comprehensive Medical Examination Services)

  • 문관식;김양균;장혜정
    • 보건의료산업학회지
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    • 제10권2호
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    • pp.83-97
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    • 2016
  • Objectives : This study analyzed the factors that determine the use and type of medical examination services (MES) to develop a model explaining the use behavior of MES which could consequently contribute to policy implications for medical examinations. Methods : Based on Anderson's healthcare utilization model, the MES utilization model was developed by including the perceived needs for MES. The data were collected from an online survey of a population aged 20-39 years and from a telephone survey of a population aged 40 years or older, respectively. Chi-Square tests and hierarchical logistic regression analyses were done with SAS version 9.3. Results : Generally, as health status became lower, the use of MES increased. However, patients with two or more chronic diseases were less likely to use private MES compared to patients with one chronic disease. The perceived needs for MES were only related to the use of service and not to the choice of the MES type. Conclusions : There were different results for the significant determinants between the use of the MES and the choice of the MES type. The healthcare industry needs to aware of consumer needs to provide MES based on empirical findings.

계층적 구조의 보안 정책 모델과 연동 방식 설계 (Design of Hierarchical Security Policy Model and its Working Mechanism)

  • 황윤철;이용주;이종태;이상호
    • 한국통신학회논문지
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    • 제26권8A호
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    • pp.1378-1387
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    • 2001
  • 인터넷 서비스의 다양화와 네트워크의 대형화로 인하여 서브 도메인(Subdomain) 및 도메인을 포함한 인터넷 전체에 걸쳐 적용할 수 있는 계층적 구조의 보안 모델의 정의와 이 모델을 기반으로 하는 보안 정책 프로토콜의 표준화가 요구되고 있다. 이 논문에서는 기존 보안 정책 서버 구조를 기존의 Internet-Draft 문서를 통해 분석하고 그것을 바탕으로 계층적 보안 정책 구조를 제시한 후 보안 정책 연동 프로토콜을 설계한다. 이를 위해 보안정책 프로토콜을 확장하고 그룹개념을 위한 질의와 레코드를 확장 설계하고 계층적 보안 모델에서 효과적인 보안정책 상속 및 수정을 위한 갱신 레코드를 정의한다. 또한 동일한 정책 속성을 갖는 호스트들의 모임을 그룹으로 정의하고, 이 개념을 기반으로 효율적인 연동 메커니즘을 설계한다.

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한국여성의 제왕절개술 영향요인에 관한 생태학적 접근 (Impact Factors of Korean Women's Cesarean Section according to Ecological Approach)

  • 김현경
    • 여성건강간호학회지
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    • 제17권2호
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    • pp.109-117
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    • 2011
  • Purpose: This study examined the impact factors of cesarean section based on the ecological approach in Korea. Methods: Population-based data (Korea Institute for Health and Social Affairs) were used from 2,849 delivery cases during 2003~2009. Data were analyzed using geographic statistics with STATA 10.0 and hierarchical logistic regression with SPSS/WIN 12.0. Results: The range of cesarean section rate was 28.8~44.7% with geographic distribution. The proportion of mother's problem was increasing in choice of cesarean section. According to the ecological model, age of mother (OR=1.08), time of birth (OR=0.79), delivery in hospital (OR=1.83), delivery in clinic (OR=1.46), and education of mother (OR=2.61) had significant impact on cesarean section. Conclusion: This study contributes to provide the impact factors of the high cesarean rate in Korea ecologically. Policy maker and health care provider can consider these results to reduce cesarean section rate.

유전 알고리즘을 이용한 계층구조 시스템에서의 최적 중복 구조 설계 (Optimal redundancy allocation in hierarchical systems using genetic algorithm)

  • 윤원영;김종운
    • 한국신뢰성학회지:신뢰성응용연구
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    • 제1권1호
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    • pp.1-8
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    • 2001
  • Redundancy allocation problems have been considered at single-level systems and it may be the best policy in some specific situations, but not in general. With regards to reliability, it is most effective to allocate the lowest objects, because parallel-series systems are more reliable than series-parallel systems. However, the smaller and lower in the system an object is, the more time and accuracy are needed for duplicating it, and so, the cost can be decreased by using modular redundancy Therefore, providing redundancy at high levels like as modules or subsystems, can be more economical than providing redundancy at low levels or duplicating components. In this paper, the problem in which redundancy is allocated at all level in a series system is addressed, a mixed integer nonlinear programming model is presented and a genetic algorithm is proposed. An example illustrates the procedure.

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The Effects of Social Resources on Depression Among Family Caregivers Caring for the Elderly in Need of Long-term Care: The Mediating Effect of Spiritual Well-being

  • Kim, Kyung Ho;Choi, Young Ho
    • 한국컴퓨터정보학회논문지
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    • 제24권7호
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    • pp.143-151
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    • 2019
  • The purpose of the present study was to investigate the causal relationships between social support, spiritual well-being, and depression among family caregivers caring for the elderly in need of long-term care. Based on previous studies and theoretical backgrounds, a mediation research model including the aforementioned variables was proposed. A total of 383 family caregivers from 25 long-term care facilities in G Metropolitan City were included in the present study and hierarchical regression was used. The primary results were as follows. First, family caregivers' social support was negatively associated with depression. Second, family caregivers' social support was positively associated with spiritual well-being. Third, family caregivers' spiritual well-being was negatively associated with depression. Fourth, social support was positively associated with spiritual well-being, which was related to weaker depression among family caregivers. Finally, theoretical implications of these findings and recommendations for policy and practice were also discussed.

건강보험 청구자료를 이용한 일반 질 지표로서의 위험도 표준화 재입원율 산출: 방법론적 탐색과 시사점 (Developing a Hospital-Wide All-Cause Risk-Standardized Readmission Measure Using Administrative Claims Data in Korea: Methodological Explorations and Implications)

  • 김명화;김홍수;황수희
    • 보건행정학회지
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    • 제25권3호
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    • pp.197-206
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    • 2015
  • Background: The purpose of this study was to propose a method for developing a measure of hospital-wide all-cause risk-standardized readmissions using administrative claims data in Korea and to discuss further considerations in the refinement and implementation of the readmission measure. Methods: By adapting the methodology of the United States Center for Medicare & Medicaid Services for creating a 30-day readmission measure, we developed a 6-step approach for generating a comparable measure using Korean datasets. Using the 2010 Korean National Health Insurance (NHI) claims data as the development dataset, hierarchical regression models were fitted to calculate a hospital-wide all-cause risk-standardized readmission measure. Six regression models were fitted to calculate the readmission rates of six clinical condition groups, respectively and a single, weighted, overall readmission rate was calculated from the readmission rates of these subgroups. Lastly, the case mix differences among hospitals were risk-adjusted using patient-level comorbidity variables. The model was validated using the 2009 NHI claims data as the validation dataset. Results: The unadjusted, hospital-wide all-cause readmission rate was 13.37%, and the adjusted risk-standardized rate was 10.90%, varying by hospital type. The highest risk-standardized readmission rate was in hospitals (11.43%), followed by general hospitals (9.40%) and tertiary hospitals (7.04%). Conclusion: The newly developed, hospital-wide all-cause readmission measure can be used in quality and performance evaluations of hospitals in Korea. Needed are further methodological refinements of the readmission measures and also strategies to implement the measure as a hospital performance indicator.

우리나라 성인의 고감도 C-반응성 단백과 대사증후군의 관련성: 성별 분석 (Association between High Sensitivity C-Reactive Protein and Metabolic Syndrome in South Korea: A Gender-Specific Analysis)

  • 신은영;이용재;김태현;정금지;정우진
    • 보건행정학회지
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    • 제31권2호
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    • pp.158-172
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    • 2021
  • Background: Metabolic syndrome has been known as a risk of cardiovascular disease. Meanwhile, high sensitivity C-reactive protein (hs-CRP) is used as a predictor of cardiovascular disease. In this paper, we aimed to investigate the association between hs-CRP and metabolic syndrome. Method: A total of 7,633 were chosen as the study population from the 7th Korea National Health and Nutrition Examination Survey dataset (2016-2017). Our dependent variable was whether an individual had metabolic syndrome or not, and the independent variable of interest was hs-CRP which was categorized into three groups. The chi-square tests and hierarchical logistic regression analyses reflecting survey characteristics were conducted. All analyses were stratified by gender. Results: According to the adjusted model with all covariates, compared to individuals having the low risk of hs-CRP, those having its average risk were more likely to have metabolic syndrome in men (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.12-1.76) and women (OR, 1.69; 95% CI, 1.33-2.16). Individuals having the high risk was not significantly different in men; however, they were more likely to have metabolic syndrome in women (OR, 2.03; 95% CI, 1.28-3.23). Conclusion: In an upcoming aging society, it is important to reduce the risk of metabolic syndrome to improve population health. This study suggests that hs-CRP may be used as a marker of the risk of metabolic syndrome in a gender-specific way, thereby contributing to enhancing awareness of the risk of metabolic syndrome among the general public.

계층적 군집분석(최단, 최장, 평균, 중앙연결)방법에 의한 아시아 컨테이너 항만의 클러스터링 측정 및 실루엣방법과 2단계(Type II) 교차효율성 메트릭스 군집모형을 이용한 실증적 검증에 관한 연구 (A Study on the Asia Container Ports Clustering Using Hierarchical Clustering(Single, Complete, Average, Centroid Linkages) Methods with Empirical Verification of Clustering Using the Silhouette Method and the Second Stage(Type II) Cross-Efficiency Matrix Clustering Model)

  • 박노경
    • 한국항만경제학회지
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    • 제37권1호
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    • pp.31-70
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    • 2021
  • 본 논문에서는 계층적 군집모형(최단, 최장, 평균, 중앙연결), 실루엣방법, 2단계(Type II) 교차효율성 메트릭스 군집모형으로, 아시아 38개 컨테이너항만 들의 2009년부터 2018년까지의 자료와 선석길이, 수심, 총면적, 크레인 수를 투입물, 컨테이너화물처리량을 산출물로 하여 국내대표 컨테이너항만 들(부산, 인천, 광양항)이 클러스터링 해야만 하는 항만들을 적출해 내는 측정방법을 보여 주고 비교, 분석, 검증하였다. 실증분석의 주요한 결과는 다음과 같다. 첫째, 10년간의 자료를 이용한 분석에서 클러스터링 후의 효율성의 증가가 큰 순서대로 살펴보면 실루엣(0.4052 증가), 계층적 군집분석(0.3097 증가), 2단계(Type II) 교차효율성(0.1057 증가)의 순서로 나타났다. 둘째, 실루엣모형과 2단계(Type II)교차효율성 모형에 의한 국내항만들의 클러스터링을 살펴보면 부산항은 8번(두바이), 11번(홍콩), 17번(탄중프리옥)항과 클러스터링 되고, 인천항과 광양항은 대부분의 항만들과 클러스터링 해야만 하는 것으로 나타났다. 셋째, 윌콕슨 부호순위 검정결과를 보면 평균적으로 보았을 때, P값(유의확율)이 평균 0.852 수준에서 모형들의 평균효율성 수치에 의한 순위가 서로 일치함을 보여 주었다. 넷째, 정치경제학적인 측면에서 아세안 항만들과 국내 항만들과 가장 클러스터링 횟수가 많은 항만들을 살펴보면, 부산항은 싱가포르 항만, 인천항은 탄중프리옥, 탄중퍼락, 마닐라,다바오,방콕항만, 광양항은 탄중프리옥, 탄중퍼락, 포트 클랑, 마닐라, 싱가포르, 림찬방, 방콕항만들과 클러스터링 하는 것이 좋을 것으로 나타났다. 또한 중국과 일본의 항만들과의 클러스터링을 고려해 보면, 부산항은 홍콩, 상해, 광저우, 도쿄 요코하마, 고베, 나고야, 오사카항, 인천항은 닝보, 칭타오, 도쿄, 요코하마, 고베, 나고야, 오사카항, 광양항은 홍콩, 상해, 도쿄 요코하마, 고베, 나고야, 오사카 항들과 클러스터링 하는 것이 좋은 것으로 나타났다. 다섯째, 본 연구에서 사용한 모형들과 기존연구들과의 타 모형들과의 검증에서는 실루엣 모형이 가장 크게 효율성을 증진시키는 것으로 검증되었다. 본 논문이 제안하고 있는 정책적인 측면의 의미는 항만정책입안자, 항만운영관리자들이 본 연구에서 사용한 모형들을 항만의 클러스터링에 도입하여 벤치마킹항만들을 선정해야만 하고, 그들 항만들의 항만개발, 운영방안 등에 대한 내용을 비교·분석하고 벤치마킹이 필요한 부분은 신속하게 도입하여 실시하는 것이 필요하다는 점이다.

지역사회역량이 건강에 미치는 영향에 대한 다수준 분석: 사회의 질 증진에 주는 함의 (A Multi-level Study of Contextual Effects of Community Capacity on Health Status among Seoul Residents: Focused on Social Quality)

  • 정민수;조병희
    • 보건교육건강증진학회지
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    • 제28권4호
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    • pp.1-14
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    • 2011
  • Objectives: The aim of the present study is to elucidate the relationship of community capacity to health in a metropolitan area in Korea. To do so, a multi-level model to verify the contextual effects of community capacity is presented. Methods: The study materials are the "The 4th Seoul Citizens Health Indicators Surveys" on 404 dong in Seoul. The community capacity indicators were developed in two strata: individual-level indicators with community identity domain; and community-level indicators with participation in community organizations, number of non-profit organizations, degree of organizing of community-based organizations, and volunteer activities. Results: Higher unhealthy probability occurs among those with lower community capacity at the community level, lower individual income, and lower community satisfaction at the individual level. It contributed to explaining self-rated health status and showed that there were contextual effects of the community going beyond the compositional effects of the individual. Conclusions: In the process of building community capacity, a community autonomously finds pending issues and solves related problems, and in so doing, raises the social quality and establishes the conditions for health promotion. Thus, the significance of neighborhood needs to be discovered and created in a new way through the development of community capacity.

ICF에 기반한 산업재해 여성 근로자의 업무수행능력에 영향을 미치는 요인연구 (Factors Related to Job Performance of Female Patients with Workplace Injuries by using ICF Model)

  • 이민재;김환
    • 대한물리의학회지
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    • 제13권2호
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    • pp.21-31
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    • 2018
  • PURPOSE: This study examined the differences between male and female workers by investigating the various factors that affected the workers' abilities to return to work according to the International Classification of Functioning standards. METHODS: We analyzed the personal factor, environmental factor, work performance and participation factor related to ICF according to worker's gender. For this purpose data from the third Worker's Compensation Insurance panel survey conducted by the Korea Workers' Compensation & Welfare Service were analyzed. In order to verify the research model, we used frequency analysis, cross analysis to compare the differences between male and female workers according to personal, environmental, work performance, and participation factors and hierarchical regression analysis to identify significant factors affecting job performance. RESULTS: The results, indicate that the level of education, license status, working period, socioeconomic status and employment type of female workers were lower than those of male workers. Factors that have the greatest influence on job performance are grade of disability, status of disability, economic activity status, and instrumental activities of daily living (p<.05). CONCLUSION: It is necessary to provide socially stable employment support and social policy support without discrimination to allow disabled female workers to return to work and maintain their jobs and to study factors influencing job performance further.