• 한국사회복지학
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• 제57권2호
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• pp.143-164
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• 2005

본 연구는 가족복지정책의 방향성을 모색하는 가운데 주요한 의제가 되고 있는 노인과 이혼가족 아동을 둘러싸고 발생하는 제반 부양관련 쟁점을 분석하였다. 우리나라는 급속한 고령화와 이혼율 증가라는 사회적 변화 속에서 사적 부양과 공적 부양간 영역 및 경계, 부양관계, 부양의무자 역할 등에 대한 쟁점이 본격화될 전망이다. 이에 따라 양 부양체계의 범위와 역할은 물론 가족부양의 성격, 방법, 기간, 성립요건 등에 대한 사회적 합의를 이루어내는 과정이 필요하다. 또 현행 가족구조와 인구구조의 변화로 고려해볼 때 가족을 통한 부양보다는 사회적 부양으로 전환되어야 할 것이다. 그러나 가족부양 및 사회부양에 대한 내용을 규율하는 현행 민법과 사회복지법은 여전히 가족부양의 정책기조를 강하게 유지하고 있었으며 사적-공적 부양체계 간 관계정립이나 부양방식에 대한 미흡한 규정으로 많은 논란을 내포하고 있는 것으로 나타났다. 특히 사회구성원의 기본적인 생활안정과 유지를 목적으로 하는 사회복지법의 취지에도 불구하고 부양과 관련하여 사회보험법은 형식적이고 피상적인 가족부양 원칙을, 공공부조법은 강한 가족부양의무를 부과하는 이중적인 기준을 적용하고 있었다. 결론에서는 급변하는 사회와 경제불안의 일상적 위협 속에서 노인과 이혼가족 아동부양에 대한 합리적이고 현실적인 방안을 모색해야 할 필요성을 제안하였다.

• Tuberculosis and Respiratory Diseases
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• 제40권5호
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• pp.595-601
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• 1993

연구배경 : 우리나라의 결핵은 그 예방 및 치료에 괄목할 만한 진전이 있었음에도 사망 순위 10위 안에 들어 있으므로 결핵환자 사망에 대한 역학적 조사를 통하여 분포특성을 제시하여 보고자 본 연구를 시도하였다. 방법 : 1986년부터 1990년까지의 5년동안에 걸쳐 한 결핵전문병원에 내원하여 사망하였던 총 684명의 환자를 대상으로 하여 일반 역학적 정보와 질병정보를 중심으로 조사하여 변수간의 연관성을 검정하였다. 결과: 1) 5년간의 총 결핵 입원환자 3441명중 684명 인 19.9%가 사망하였다. 2) 남자가 81.0%였으며 남자의 경우는 연령별 분포의 차이가 없었으나 여자의 경우 39세 이하군이 46.3%로 유의하게 많았다. 3) 사망의 의료보장별 분포는 의료보호군이 의료보험군의 42.3%로 매우 많았으며 비보장군도 전체의 11.8%나 차지하였다. 4) 치료를 중단한 경험이 있는 경우나 78.2%를 차지하여 지속적이지 못함을 나타내었다. 결론 : 대상병원의 특이성도 있지만 아직도 많은 폐결핵환자가 사망하고 있고 이들의 대부분이 치료를 받은 경험이 있었고 병의 정도가 중증인 경우와 재발한 경우가 많아 지속적인 공중보건학적 관리가 이루어져야 할 것으로 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8993-9004
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• 2014

Background: The incidence rate and the treatment costs of hepatocellular carcinoma (HCC) are high, especially in Thailand. Previous studies indicated that early detection by a surveillance program could help by down-staging. This study aimed to compare the costs and health outcomes associated with the introduction of a HCC surveillance program with no program and to estimate the budget impact if the HCC surveillance program were implemented. Materials and Methods: A cost utility analysis using a decision tree and Markov models was used to compare costs and outcomes during the lifetime period based on a societal perspective between alternative HCC surveillance strategies with no program. Costs included direct medical, direct non-medical, and indirect costs. Health outcomes were measured as life years (LYs), and quality adjusted life years (QALYs). The results were presented in terms of the incremental cost-effectiveness ratio (ICER) in Thai THB per QALY gained. One-way and probabilistic sensitivity analyses were applied to investigate parameter uncertainties. Budget impact analysis (BIA) was performed based on the governmental perspective. Results: Semi-annual ultrasonography (US) and semi-annual ultrasonography plus alpha-fetoprotein (US plus AFP) as the first screening for HCC surveillance would be cost-effective options at the willingness to pay (WTP) threshold of 160,000 THB per QALY gained compared with no surveillance program (ICER=118,796 and ICER=123,451 THB/QALY), respectively. The semi-annual US plus AFP yielded more net monetary benefit, but caused a substantially higher budget (237 to 502 million THB) than semi-annual US (81 to 201 million THB) during the next ten fiscal years. Conclusions: Our results suggested that a semi-annual US program should be used as the first screening for HCC surveillance and included in the benefit package of Thai health insurance schemes for both chronic hepatitis B males and females aged between 40-50 years. In addition, policy makers considered the program could be feasible, but additional evidence is needed to support the whole prevention system before the implementation of a strategic plan.

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.6041-6048
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• 2013

Background: Japanese women in their 40s or older have been encouraged to attend breast cancer screening. However, the breast cancer screening rate in Japan is not as high as in Europe and the United States. The aim of this study was to identify psychological and personal characteristics of women concerning their participation in breast cancer screening using the Health Belief Model (HBM). In addition, the attributes of screening more easily accepted by participants were analyzed by conjoint analysis. Materials and Methods: In this cross sectional study of 3,200 age 20-69 women, data were collected by an anonymous questionnaire. Questions were based on HBM and personal characteristics, and included attitudes on hypothetical screening attributes. Data of women aged 40-69 were analyzed by logistic regression and conjoint analysis to clarify the factors affecting their participation in breast cancer screening. Results: Among responses collected from 1,280 women of age 20-69, the replies of 993 women of age 40-69 were used in the analysis. Regarding the psychological characteristics based on HBM, the odds ratios were significantly higher in "importance of cancer screening" (95%CI: 1.21-2.47) and "benefits of cancer screening" (95%CI: 1.09-2.49), whereas the odds ratio was significantly lower in "barriers to participation before cancer screening" (95%CI: 0.27-0.51). Conjoint analysis revealed that the respondents, overall, preferred screening to be low cost and by female staff members. Furthermore, it was also clarified that attributes of screening dominant in decision-making were influenced by the employment status and the type of medical insurance of the women. Conclusions: In order to increase participation in breast cancer screening, it is necessary to disseminate accurate knowledge on cancer screening and to reduce barriers to participation. In addition, the attributes of screening more easily accepted were inexpensive, provided by female staff, executed in a hospital and finished in a short time.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4727-4731
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• 2013

Background: There have been no large-scale population-based studies to estimate the subsequent risk of primary liver cancer (PLC) among patients with pyogenic liver abscess (PLA). This study aimed to provide relevant data. Materials and Methods: The Taiwan Longitudinal Health Insurance Database for the years 2000 and 2005 was used. The PLA group were adult inpatients who were newly diagnosed with PLA from 2000 to 2008. The control group was randomly selected and matched with the PLA group in terms of age, sex, and date in which medical treatment was sought other than for PLA. Results: There were 1,987 patients each in the PLA and control groups. In total, 56 had PLC, 48 (2.4%, 601.5 per 100,000 person-years) from the PLA group, and 8 from the control group. After adjusting for potential covariates, the hazard ratio of PLC for the PLA group was 3.4 times that of the control group (95% confidence interval = 1.6-7.3, p <0.001). The PLC risk for the PLA group was significantly higher within the first year after PLA diagnosis (hazard ratio: 35.4) as compared with the control group and became insignificant (hazard ratio: 2.0, 95% confidence interval = 0.8-4.9) more than one year after PLA diagnosis. Conclusions: Patients with PLA have a higher rate of PLC than matched controls, especially within the first year after the diagnosis of PLA, suggesting PLA is a warning sign for PLC.

• Journal of Nutrition and Health
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• 제35권5호
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• pp.544-557
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• 2002

This study was performed to evaluate the quality of nutrient intakes of the hemodialysis patients (26 men and 23 women) according to the socioeconomic status by 3-day dietary recall in Daejeon city and Chungnam area, Korea. Mean age of the subjects was 50.7 yrs and BMI was 22.0 $\pm$ 0.4 kg/$m^2$. Education level was divided into two groups ($\leq$ 9 years： LE group, 9 years： HE group), and monthly family income level was divided into three groups (< 500,000 won: LI group, 500,000-1,499,999 won: MI group, $\geq$ 1,500,000 won : HI group). The data were analyzed by Student t-test and Oneway ANOVA using SPSS 9.0 version at p < 0.05 level. Intakes of energy, carbohydrates, cholesterol, potassium, thiamin and riboflavin were significantly higher in HE group than in LE group (p < 0.05). Intakes of all the nutrients except protein and phosphorus were less than Korean RDA, and INQs (Index of Nutritional Quality) of most nutrients were lower than 1.0 but cholesterol, phosphorus. thiamin and niacin being over 1.0 in HE group. MAR (Mean adequacy ratio) of all the nutrients (e.g., energy, protein, calcium, phosphorus, iron, vitamin A, vitamin C, thiamin, riboflavin and niacin) was significantly higher in HE group (0.61 $\pm$ 0.04) than in LE group (0.48 $\pm$ 0.03) at p = 0.036. Intakes of energy, protein (total, animal and plant), fat, cholesterol, potassium, calcium, phosphorus, iron, vitamin A, thiamin and riboflavin were also significantly higher in HI group than in LI and MI group (p < 0.05). Daily intakes of most nutrients were less than Korean RDA except protein ed phosphorus in HI poop, and INQs of thiamin, niacin and phosphorus were higher than 1.0, while those of calcium, iron, vitamin A and riboflavin were lower than 1.0. MAR of energy and 9 nutrients was significantly higher in HI group (0.70 $\pm$ 0.04) than in LI group (0. 56 0.04) and MI poop (0.47 $\pm$ 0.03) at p = 0.000. In conclusion, quality of nutrient intakes, especially energy and protein, was significantly influenced by socioeconomic status such as education and monthly income (p < 0.05). This result suggests that it would be very helpful to develop nutritional education programs considering hemodialysis patients' education levels, and to improve public supports (e.g., medical insurance system, low-rate lease system of dialysis equipments, etc.) focusing on the patients' family income levels f3r their better nutrition and health.

• 대한간호학회지
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• 제29권4호
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• pp.743-754
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• 1999

The purpose of this descriptive study was to identify the homecare needs of patients with cancer and to provide a basis of interventions. One hundred and two patients at one general hospital in Gyeongnam responded to a questionnaire developed on the basis of care needs perceived by nurses caring for hospitalized patients with cancer. The questionnaire was a Likert type 5 point scale with 56 items on five need categories ; 1) informational 2) physical care : 3) emotional care 4) socioeconomic care and 5) special care needs. Internal consistency of this questionnaire was Cronbach's $\alpha$＝.9101 for total items. The data was collected from March 1st to May 31th, 1998, by two graduate nurses. In the data analysis, mean & standard deviation were calculated to identify the degree of care need of each item, and the t-test & ANOVA were done to determine the effects of patients' demographic background on their care needs. The findings are summarized as follows ; 1) The mean score of total of need items was 3.048. Of the four need categories the highest score was informational at 3.4, followed by emotional care, 3.063, physical care, 2.623, and socioeconomic care, 2.599. 2) In the informational need category there were four subcategories with 19 items. Medication and pain control had the highest score, 3.755 ; second was diet and exercise, 3.613 ; third was disease and treatment process, 3.337 ; and last was personal hygiene and infection prevention at 2.687. 3) In the physical care need category there was nine items, IV infusion for nutrition and management of treatment complication was above 3.2 points and the remaining items were in the 2.847-2.070 score ranges. 4) In the emotional care need category there were seven items. The highest need was in support for relationships with health personnel, 3.673. The need for support of religions beliefs and support for having a religion were low at about 2 points. 5) In the socioeconomic care need category there were six items. Support for medical insurance expansion and financial support were above 3 points. Legal support and support for caring of children were low in the care needs. 6) In the special care need category the there were 15 items. Informational need about immunization and informational need about effects of disease on growth and development were high, above 4.1 points. Need for decubitus care and prevention, sitz bath and incontinence care were low, below 2 points. 7) There were significant differences in degree of care need according to admission rate, education level, marital status, religion and caregiver's religion. In conclusion, homecare needs perceived by hospitalized patient's with cancer was moderate, but informational need was higher than direct care need, leading to the conclusion that the provision of sufficient information to patients with cancer at discharge is needed. Nursing interventions should be developed considering the patient's background.

• 한방재활의학과학회지
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• 제28권1호
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• pp.73-84
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• 2018

Objectives While Temporomandibular disorders (TMD) is highly prevalent in Korea, studies examining its Korean medical treatment are currently lacking. The aim of this study was to assess current Korean medical treatment practice patterns for TMD. Methods A preliminary questionnaire was developed to investigate current practice patterns of TMD treatment and underwent further revision through external review. The final questionnaire was distributed as a web-based survey to 18,289 potential respondents by email. Results The response rate was 2.23%. Most participants replied that they received multiple Korean medicine interventions for TMD treatment consisting of such methods as acupuncture, chuna manipulation, electroacupuncture. The percentage of treatment services among uncovered services, which need to be covered by national health insurance was high in the order of pharmacopuncture, chuna manipulation, and herbal medicine. The most commonly used diagnostic examination tools for TMD was Physical examination and next was Imaging diagnosis. The frequency of TMD treatment was the highest at 2~3 times per week (76%) and the period was from 4 to 12 weeks (63%). Conclusions This survey study helps determine current practice patterns of TMD, and recognizes the need for use of diagnostic devices in TMD treatment. These results are further anticipated to provide basic data for clinical practice guide lines (CPGs).

• 정보화정책
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• 제18권4호
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• pp.22-41
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• 2011

국내산업의 고용없는 성장에 따라 고용창출효과가 큰 서비스산업 육성에 대한 정부의 관심이 증가하고 있다. 서비스산업의 양적 성장은 물론, OECD 국가대비 국내 서비스산업의 경쟁력은 매우 낮은 실정으로 나타나, 서비스산업의 경쟁력 강화방안에 관한 연구가 중요한 이슈로 제기되고 있다. 특히, 금융,교육,보험과 같이 대기업이 진출한 서비스산업은 상대적으로 경쟁력이 양호하나, 중소서비스 산업의 경쟁력은 매우 미진한 것으로 나타나, 중소서비스산업의 경쟁력강화를 위한 방안이 시급한 실정이다. 정보기술은 기업 경쟁력강화를 위한 핵심 인프라와 수단으로 활용되고 있어, 국내 서비스산업 경쟁력 강화에 적용가능한 것으로 인식되고 있다. 따라서, 본 연구의 목적은 국내 서비스산업의 IT 활용 실태를 조사하고, IT 활용 성공 요인을 중심으로 IT 도입 및 활용상의 문제점 및 요구사항을 분석하여, 서비스산업의 IT 활용 향상을 위한 정책적 방안을 도출하는 것이다. 본 연구를 위하여 국내 서비스기업 2,000개 업체에 대한 설문조사와 통계분석을 수행하였다. 분석결과, 국내 서비스산업의 IT활용 실태, 성공요인 관점에서 활용수준 및 기업규모와 업종간 비교분석, IT활용 저해요인에 대한 심층분석결과를 도출하였다. 마지막으로 심층분석결과를 토대로 서비스사업 IT 활용 향상을 위한 정책적 시사점이 제시되었다. 본 연구결과는 서비스기업 IT 도입 및 활용 담당자는 물론 IT 공급업체, 정책개발 전문가에게 서비스산업 IT 활용 제고를 위한 주요 요인과 요인별 IT 활용 향상을 위한 가이드라인을 제공할 것으로 기대된다.

• Journal of Preventive Medicine and Public Health
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• 제27권2호
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• pp.175-185
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• 1994

In order to anticipate disease pattern and health problems of Koreans in the 1st part of 21st century (by the year 2020), transition of population characteristics, mortality and morbidity data during the last 30 years Koreans have experienced were reviewed. On the actual basis of epidemiologic transition process that has undergone during last 30 years since 1960 along with socioeconomic development and successful implementation of selective national health policies (family planning, medical insurance and etc.), following changes can be expected in the 21st century in Korea, under the assumption that the current rate of progress is maintained. The population of South Korea alone will be doubled the population of 1960 by the year 2013 : aged Population older than 65 years will be increased from 3.3% in 1960 to 11.4% in 2020 with increased average age of the population from 23.6 year in 1970 to 39.2 year in 2020; urban population from 28% in 1960 to 83% in 2005. GNP/capita has increased tremendously from U.S. $120 in 1970 to $6,749 in 1992, and the government estimated it would be 519,350 in 2010 and $29,460 in 2020. Growth and developmental indices of children, educational achievement and social status of women also showed a remarkable improvement and anticipated to make futher progress. Leading causes of mortality and morbidity have shown a striking change during the last 30 years, from infectious diseases to chronic degenerative diseases and man-made injuries. Occurrence of communicable diseases may become minimal although viral hepatitis, venereal diseases Including AIDS, and well adapted herpes virus infections will maintain their endemic level. Newly evolving infectious agents, however, should be carefully monitored because of rapidly changing environments and human behaviours. Tuberculosis may increase up to the epidemic level when AIDS prevails. Ischemic heart diseases may increase steadily with increasing occurrence of hypertension and diabetes mellitus whereas cerebrovascular diseases may be decreased slowly. Musculaskeletal diseases which contribute a lot to the disability of aged people may be a major health problems due to increased aged population. Mental diseases, particularly that caused by alcohol and drug abuse, and senile dementia may become a prominent health problem. On the other hand injuries caused by traffic and industrial accidents that have shown most striking increase till now may be decreased considerably by intensive intervention. The health policies in the 21st century will be oriented to the health promotion for good quality life rather than life-savings.