• 대한예방한의학회지
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• 제22권3호
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• pp.1-10
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• 2018

Backgrounds : In 2017, National Health Insurance implemented the pilot insuring project for Chuna manual therapy(CMT). 65 Korean Medicine(KM) hospitals and clinics were selected in the project to monitor the provision of insured CMT. Objectives : This study aimed to evaluate the effectiveness of CMT for low back pain provided in the real world setting. Methods : Patients with low back pain who agreed to participated in the study were enrolled and requested to complete questionnaires. Patients who received CMT regardless of receiving other KM therapies were classified to Chuna group, and patient who received KM therapies without CMT to KM group. Pain(pain-VAS) and back function(KODI, Oswestry disability index-Korean version), quality of life were assessed at baseline, 4 weeks, and 8 weeks. Additionally, patients who received CMT twice and more, and who's pain-VAS 20 and over were included, and patients who used pain injection were excluded in the analysis. Results : Of 371 patients who completed all questionnaire (mean age=42.6years, SD=12.45; 61% female), 96 were excluded, 170 were in Chuna group, and 105 were in KM group. Proportions of patients who had low back pain for more than twelve weeks in the Chuna group and KM group were 57.7% and 24.8%, respectively. Pain and back function were significantly improved on 4weeks and 8weeks in both groups, but there was no difference between two groups. For the patients in the sub-acute and chronic stage(>=12 weeks), change of total KODI scores in the Chuna group was higher than KM group(p=0.013) at 4weeks. Conclusions : CMT with other KM therapies can improve back function in the sub-acute and chronic patients. For insurance policy decision, economic evaluation of CMT is needed.

• Tuberculosis and Respiratory Diseases
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• 제85권1호
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• pp.74-79
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• 2022

Background: The effect of underlying chronic obstructive pulmonary disease (COPD) on coronavirus disease 2019 (COVID-19) during a pandemic is controversial. The purpose of this study was to examine the prognosis of COVID-19 according to the underlying COPD. Methods: COVID-19 patients were assessed using nationwide health insurance data. Comorbidities were evaluated using the modified Charlson Comorbidity Index (mCCI) which excluded COPD from conventional CCI scores. Baseline characteristics were assessed. Univariable and multiple logistic and linear regression analyses were performed to determine effects of variables on clinical outcomes. Ages, sex, mCCI, socioeconomic status, and underlying COPD were selected as variables. Results: COPD patients showed older age (71.3±11.6 years vs. 47.7±19.1 years, p<0.001), higher mCCI (2.6±1.9 vs. 0.8±1.3, p<0.001), and higher mortality (22.9% vs. 3.2%, p<0.001) than non-COPD patients. The intensive care unit admission rate and hospital length of stay were not significantly different between the two groups. All variables were associated with mortality in univariate analysis. However, underlying COPD was not associated with mortality unlike other variables in the adjusted analysis. Older age (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.11-1.14; p<0.001), male sex (OR, 2.29; 95% CI, 1.67-3.12; p<0.001), higher mCCI (OR, 1.30; 95% CI, 1.20-1.41; p<0.001), and medical aid insurance (OR, 1.55; 95% CI, 1.03-2.32; p=0.035) were associated with mortality. Conclusion: Underlying COPD is not associated with a poor prognosis of COVID-19.

• 대한소아치과학회지
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• 제50권4호
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• pp.409-420
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• 2023

이 연구의 목적은 건강보험심사평가원의 자료를 이용하여 만 14세 이하 소아청소년들의 치아 우식 유병률의 경향성과 치료의 현황을 파악하는 것이다. 이 연구는 2011년부터 2020년까지 연도별로 전체 소아청소년이 포함된 모집단에서 약 100만명을 무작위 표본 추출한 집단의 진료내역을 이용하여 분석을 시행하였다. 이 연구에서 K02 치아우식 주상병명을 진단받는 아이들은 연도별로 증가하였고, 전반적으로 모든 연령군에서 치아 우식 치료를 받는 아이들도 증가하는 경향성을 보였다. 반면 중증의 치아 우식으로 인해 치수 치료 또는 발치를 경험한 10 - 14세 어린이들은 감소하는 경향을 보였다. 2021 - 2022년 아동 구강 건강 실태조사에서도 5세와 12세의 우식경험지수는 정체되거나 소폭 증가하는 경향을 보였으나 우식 유병자율은 감소하였다. 치료적 관점에서 개인적, 지역적 환경은 과거에 비해 전반적으로 개선된 것으로 나타났으나 예방적 관점에서 치아 우식 유병 상태와 예방 진료가 지난 10년간 개선되지 않고 정체 상태로 머물러 있던 것으로 해석된다. 따라서 대한민국에서 소아청소년을 대상으로 구강건강 증진 및 예방을 위해 시행되고 있는 구강 보건 사업에 대한 홍보와 효용성에 대한 평가가 필요하다.

• 한국콘텐츠학회논문지
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• 제16권3호
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• pp.22-32
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• 2016

인구구조의 급속한 고령화로 뇌졸중 질환의 발생빈도와 진료비가 지속적으로 증가하고 있다. 이에 본 연구는 대표성이 있는 퇴원손상심층조사 자료를 이용하여 뇌졸중 환자의 Charlson comorbidity index에 따른 사망률 현황을 살펴보고, 뇌졸중 환자의 사망에 영향을 미치는 요인을 분석해 보고자 시행하였다. 2005년에서 2010년까지의 6년간 퇴원손상심층조사 자료를 이용하였으며, 연령이 20세 이상이며 주진단명이 뇌졸중으로 분류된 21,494건을 대상으로 분석하였다. 분석대상자의 동반상병 분포와 CCI에 따른 사망률 현황을 파악하기 위해 기술통계를 실시하였으며, 뇌졸중 환자의 사망에 영향을 미치는 요인을 파악하기 위해서는 로지스틱 회귀분석 기법을 이용하였다. 분석 결과, 뇌졸중 환자의 사망에 유의한 영향을 미치는 독립변수는 연령, 보험유형, 거주지 도시규모, 병상규모, 의료기관 소재지, 입원경로, Physical therapy 유무, 뇌수술 시행 유무, 뇌졸중 유형, CCI로 나타났다. 이는 뇌졸중 환자의 연령, 뇌졸중 유형, 동반상병의 위험요인에 따른 좀 더 효율적인 접근법과 모니터링이 필요하며, 의료급여 환자의 지원 확대가 개선되어야 함을 시사해준다. 이러한 결과들은 향후 뇌졸중 환자들의 의료의 질 평가와 보건의료 정책 수립에 기초자료로 의미 있게 활용되어질 수 있으리라 여겨진다.

• 대한원격탐사학회지
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• 제38권6_1호
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• pp.1489-1503
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• 2022

드론(drone)과 센서(senor) 적용기술은 농업분야 작물의 성장 정보에 대한 디지털화를 가능하게 하면서 정밀농업 발전을 한층 가속화하고 있다. 이 기술은 자연재해 발생시 농작물 피해량 산정을 가능하게 하고, 현장 방문조사로 진행되고 있는 농작물재해보험 평가방법의 과학화에 기여할 수 있다. 본 연구는 콩을 대상으로 드론 기반 RGB영상을 취득하여 추출된 식생지수로 도복피해율을 산정하는 방법을 개발하고자 하였다. Support Vector Classifier (SVC) 분류 모델은 Crop Surface Model (CSM) 기반의 도복피해율에 식생지수를 추가하여 식생지수 적용성을 검토하였다. 식생지수 중 Visible Atmospherically Resistant Index (VARI), Green Red Vegetation Index (GRVI) 기반 콩의 도복피해율 분류 정확도는 각각 0.709, 0.705로 높은 분류정확도를 나타내었다. 연구 결과, 드론 기반 RGB 영상은 도복피해율 산정에 매우 유용한 도구로 활용 가능하다는 점을 확인할 수 있었다. 본 연구에서 얻어진 결과는 이상기후로 인한 광역 지역 자연재해에 대한 도복피해 산정 시 Sentinel-2, RapidEye 위성과 더불어 2025년 발사 예정인 농림업중형위성 영상과 연계해 활용 가능할 것으로 기대된다.

• 디지털융복합연구
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• 제11권8호
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• pp.281-291
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• 2013

본 연구는 국내 처음으로 2007년부터 2011년까지 지난 5개 년간 국민건강영양조사 자료를 근거로 19세 이상 성인을 대상으로 위암, 유방암, 자궁경부암, 간암, 대장암 및 폐암 환자의 인구사회학적 특성과 삶의 질을 EQ-5D 측정도구로 분석하였다. 측정 결과 전체 연구대상자 26,260명 중에서 암 유병은 201명으로 조사대상자의 약 0.8%이다. 암 환자의 삶의 질은 연령이 낮을수록(p<0.0001), 전문직 종사자일수록(p<0.0001), 고학력일수록(p=0.0002) 높았고, 또한 아파트 거주자(p<0.0001)와 미혼자(p<0.0001)의 암 환자 삶의 질이 높았다. 특히 우리나라 의료보장 형태변수에 따른 암 환자의 삶의 질 측정은 국내 최초로 시도한 연구이다.

• 보건교육건강증진학회지
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• 제23권2호
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• pp.109-119
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• 2006

Objectives: A number of studies in economically developed countries have shown occurrence of stroke and cardiovascular disease to be inversely related to socioeconomic class. The purpose of this study is to investigate socioeconomic differentials in stroke and cardiovascular disease mortality in Korea. Methods: Two data from two sources, registry data from National Health Insurance Corporation and death certification data from National Statistics Office, were used to calculate mortality rate for five socioeconomic classes. Poisson regression analysis was used to calculate relative indices of inequality as a measure of mortality differentials between socioeconomic classes. Results: For males, graded socioeconomic differentials in mortality were observed with higher mortality rates related to lower socioeconomic class for intracerebral hemorrhage, cerebral infarct, hypertension, ischemic heart disease, myocardial infarct, and arrhythmia. The relative index of inequality for stroke and cardiovascular disease was 1.61(95% CI=1.54-1.68). For females, these differentials were observed for arrhythmia and intracerebral hemorrhage. The relative index of inequality was 1.06(95% CI=1.02-1.11). Conclusions: This socioeconomic differential in mortality, consistent with the results of other studies performed in economically developed countries suggest that Socioeconomic class can influence mortality regardless of the developmental stage of the country.

• Journal of Preventive Medicine and Public Health
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• 제32권4호
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• pp.513-525
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• 1999

Objectives : High-normal blood pressure' is a factor influencing decision to initiate targeted intensive intervention strategy in westernized populations. JNC-VI offered the vigorous lifestyle modification for persons with 'high-normal blood pressure', who could be early detected. As a hypertension seems to be the result of multiple genetic factors operating in concert with associated environmental factors, it will be necessary to identify the high-normal blood pressure as a risk factor of hypertension for applying primary prevention strategy in Korean people. Methods : Although cohort study design might be adequate to recruit incidence cases, to keep time sequence of events, and to prevent information bias, nested case-control study was chosen for avoiding measurement errors because hypertension is a benign disease. Source population was the 'Seoul Cohort' participants and follow-up was done by using Korea Medical Insurance Corporation's database on the utilization of health services from 1 Jan93 to 30Jun97. Incidence cases were ascertained through the chart review, telephone contacts, and direct blood pressure measurements. Controls included the pairing of 4 individuals to each case on the basis of age. Results : As 75% of 247 incident cases had high-normal blood pressure, the crude odds ratio for hypertension was 2.04 (95% CI 1.47-2.83). Another statistically significant risk factors of hypertension were body mass index, dietary fiber, alcohol consumption, weekly activity and history of quitting smoking. The multivariate odds ratio of high-normal blood pressure adjusted for all risk factors was 1.84 (95% CI 1.31-2.56). Among high-normal blood pressure group, body mass index, weekly ethanol amounts, weekly physical activity, and dietary fiber except history of quitting smoking were still risk factors of hypertension. Conclusion : 'High-normal blood pressure' is a risk factor for hypertension in Korean middle-aged men, which represents that the vigorous lifestyle modification for persons with 'high-normal blood pressure' is need.

• 지역사회간호학회지
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• 제14권4호
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• pp.559-567
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• 2003

Background: We first launched the case management program for diabetic patients who were registered in NHIC (National Health Insurance Corporation) in Korea and conducted this study to assess the effectiveness of the program. Methods: During the period from October in 2002 to March in 2003, 30 case managers performed the program for 71 diabetic patients. We evaluated the effectiveness of the program based on the results of fasting blood sugar level, two hour post-prandial blood sugar level, knowledge for diabetes, difficulty index in diabetes management, and the health risk factor changes of them. We analyzed results related to these factors through $x^2$ test and paired t-test. Results: The ave rage age of the subjects was 58.9. and the numbers of women and men were 43 and 28 respectively. The fasting blood sugar level and two hour post-prandial blood sugar level decreased from 164.3mg/dl to 146.5mg/dl and from 224.0mg/dl to 203.0mg/dl respectively. The knowledge for diabetes and difficulty index in diabetes management changed from 8.13 to 9.10 and from 3.52 to 2.91 respectively, and these changes were the positive. We observed improvement in self-test of sugar level, foot management, oral hygiene and proper medication but not in self-test of nutritional management. Conclusions: This study revealed that the case management program for diabetic patients who were registered in NHIC is significantly effective. However, the program need to study further to understand its long-term effects.

• 가족자원경영과 정책
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• 제16권3호
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• pp.153-176
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• 2012

This study gives an account of the state of baby-boomer households in regard to assets and liabilities utilizing the 2006 Household Asset Survey and the 2011 Survey of Household Finances. Using the data gathered from each year, this study examined the proportion of households who had each type of asset and liability, and the amount of them. This study also compared the amount of assets and liabilities of baby-boomer households with those of non baby-boomer households in 2006 and 2011 respectively. Finally, this study examined the amount of change and composition ratio of assets and liabilities of baby-boomer households between 2006 and 2011. Selected financial ratios were also presented for both years. Major findings are as follows. The average asset amount for baby-boomer households was approximately 296 million in 2006 and 392 million in 2011. Of total assets, 78% and 76.5% were real assets in 2006 and 2011 respectively. The average financial assets of 2006 baby-boomer households were approximately 66 thousand and the average amount of debt was 42 thousand. For 2011 baby-boomer households, the average amount of financial assets was 92 thousand and the average amount of debt was 73 thousand. Results from the 2011 survey showed that baby-boomer households had a significantly higher proportion of total assets, total debt, and net worth than non baby-boomer households. The proportion of savings, saving insurance, stocks, and mutual funds were significantly higher for baby-boomer households than non baby-boomer households in 2011. In regard to financial ratios, the emergency fund index and debt burden index were appropriate to the guidelines of asset quality, although the propensity to investment indexes were not.