• 가족자원경영과 정책
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• 제20권3호
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• pp.1-23
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• 2016

This study analyzes the effects of caring for grandchildren on Korean grandparents' health, using the Korean Longitudinal Study of Aging from 2006 to 2012. We investigate how caregiving is provided and analyze the effects of caregiving on grandparents' physical health, mental health, and health-related behaviors. As elderly people's health is generally frail, it is unclear whether the provision of childcare affects their health negatively. We control for the endogeneity of caregiving by an individual fixed effect (FE) model and instrumental variable-fixed effect (FE-IV) models. Using these models, we determine the endogeneity of caregiving and show that the significant effects of caregiving on health disappear as we control for endogeneity in the FE and FE-IV models. Even after controlling for endogeneity, we find that caregiving increases the probability of feeling pain as well as the number of different types of pain. Furthermore, caregiving increases the probability of restrictions on daily activities because of pain. On the other hand, caregiving reduces the symptoms of depression. In relation to health-related behaviors, caregiving reduces the probability of physical exercise and regular meals. Our results imply that although caregiving has a positive effect on mental health, the increase in physical pain and in non-healthy behaviors may lead to a deterioration of the caregiver's long-term health, which in turn may increase the medical costs of the elderly. Potential policy alternatives are discussed in the paper.

• 디지털융복합연구
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• 제13권9호
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• pp.323-332
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• 2015

본 연구는 고혈압 환자의 일차의료 지속성 수준을 파악하고, 일차 의료 지속성 수준이 환자의 입원 및 응급실이용에 미치는 영향을 실증하는 융복합적 결과연구(outcome research)이다. 후향적 코호트(retrospective cohort study)연구로써 건강보험 청구자료를 사용하여 고혈압을 주상병으로 진단받은 315,791명을 3년 동안 추척 관찰하였다. 지속성지표는 MFPC, MMCI, COC를 적용하였고 결과변수는 입원 및 응급실 방문을 고려하였다. 일차의료의 지속성 수준과 입원 및 응급실이용의 위험도를 분석한 결과, 지속성 낮은 군이 지속성 높은 군 보다 입원 할 위험도가 1.655배(95% CI: 1.547-1.771), 응급실이용은 1.669배(95% CI: 1.465-1.903) 높았다. 따라서 우리나라 고혈압 환자의 진료지속성을 높이는 정책은 급증하는 만성질환 의료비를 줄일 수 있을 것이다.

• 간호행정학회지
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• 제10권3호
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• pp.375-386
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• 2004

The purpose of this study was to identify the present use of caregiver services, to evaluate the degree of satisfaction with the services according to type of caregiver service, private or public, and to provide data for the development of a plan which will provide good quality service with less economic and psychological burden to the patients and their families. Survey data were collected from 130 patients in 4 general hospitals in Seoul, and their families. Data were collected during April, 2004, using a questionnaire which included the patient satisfaction scale developed by Jun (2001). Data were analyzed using frequencies, percentages, means and standard deviations, $X^2$ analysis, t-test. The SPSS computer program was used to facilitate analysis. The results of this study are summarized as follows; The total score for satisfaction was high for both groups. For the private caregiver group it was $52.38{\pm}11.08$, and for the public caregiver group, $58.14{\pm}9.64$. This difference was significant(t=-3.391, p=.001). In all of areas, the scores for satisfaction of the public caregiver service group were higher than private caregiver service group, ie. caregivers' attitude, role, confidence, performance, and service charge, and all the differences were significant. In conclusion, it was found that long-term hospitalization of older patients with high dependence resulted in more caregiver service. There were more severe patients in the public caregiver group, but the service charges, additional costs and paid holidays were less. Based on these results, patients and their families were significantly more satisfied with public caregiver service because it was not only less expensive but also had a high quality of service. Thus, caregiver services should be systemized so that patients and their families will get the best quality caregiver service

• Journal of Preventive Medicine and Public Health
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• 제40권4호
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• pp.329-335
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• 2007

Objectives : To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. Results : Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. Conclusions : We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.

• 대한지역사회작업치료학회지
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• 제5권1호
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• pp.35-43
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• 2015

목적 : 본 연구는 노인들의 사회적 환경을 알아보고 한국의 노인생활 실태와 노인정책의 효율성을 위한 기초자료를 제시하고자 하였다. 연구방법 : 본 연구는 통계청과 국민연금공단 및 보건복지부의 자료를 참고하였고 2014년 6월 일부지역 노인을 대상으로 우울증과 죽음불안을 설문조사하여 통계분석하였다. 결과 : 첫째, 저학력이 많고 부부가구가 가장 많으며 연간소득은 경제인구의 평균수준이었다. 둘째, 매년 의료비는 노인인구 증가에 비례하여 늘어나고 있다. 셋째, 노인의 우울 요인은 미래와 자신에 대한 부정적 생각으로 인한 우울감이 가장 높았다. 넷째, 노인의 죽음 불안 수준은 자신의 죽음 불안과 자신의 죽음과정의 불안이 중간이상의 수준으로 나타났고 전체적인 죽음 불안 수준도 중간 이상으로 나타났다. 결론 : 작업치료 등 다양한 전문영역에서 입증된 사회참여 프로그램과 가족지원 프로그램을 정부차원에서 정책적으로 시행하여 노인들의 여명수명의 삶의 질 향상과 신체적, 정신적, 사회적 건강의 도모가 필요하다.

• 보건행정학회지
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• 제22권4호
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• pp.467-496
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• 2012

Public participation in the decision making for scarce health resources is important because health policy requires trust based consensus, which can be achieved by public's understanding and involvement of related policies. In the past, opportunities for interaction between health policy decision makers and lay public were rare in Korea. As political impulses towards public participation in health policy have increased, a few of deliberation methods were attempted. However, there is little research, reporting such cases with a critical examination of relevant theories and previous studies. We first critically review the literature on public participation within theories of democracy, governance, and empowerment. Next, we report a case of a citizen council experiment, which was held to examine public's preferences among different benefit options regarding new drugs and medical technologies. Specifically, in an one-day long citizen council with a total of 28 lay public, twelve questions of whether a drug or a technology should be included in the benefit package of health insurance were asked. Pre- and post-surveys investigated participants' perception of public engagement in health policy. Although it was experimental, the citizen council ensured that lay public could be careful enough to rationally compare the costs and benefits of different options and collectively make decisions. Further, results from pre- and post-survey showed a strong willingness of members to be involved in health care decision making. In the conclusion, we emphasize that better theories and methods need to be developed for more cases of citizen participation in health care policy and management.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.24.1-24.7
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• 2020

Background: In daily practice, three-dimensional patient-specific jawbone models (3D models) are a useful tool in surgical planning and simulation, resident training, patient education, and communication between the physicians in charge. The progressive improvements of the hardware and software have made it easy to obtain 3D models. Recently, in the field of oral and maxillofacial surgery, there are many reports on the benefits of 3D models. We introduced a desktop 3D printer in our department, and after a prolonged struggle, we successfully constructed an environment for the "in-house" fabrication of the previously outsourced 3D models that were initially outsourced. Through various efforts, it is now possible to supply inexpensive 3D models stably, and thus ensure safety and precision in surgeries. We report the cases in which inexpensive 3D models were used for orthodontic surgical simulation and discuss the surgical outcomes. Review: We explained the specific CT scanning considerations for 3D printing, 3D printing failures, and how to deal with them. We also used 3D models fabricated in our system to determine the contribution to the surgery. Based on the surgical outcomes of the two operators, we compared the operating time and the amount of bleeding for 25 patients who underwent surgery using a 3D model in preoperative simulations and 20 patients without using a 3D model. There was a statistically significant difference in the operating time between the two groups. Conclusions: In this article, we present, with surgical examples, our in-house practice of 3D simulation at low costs, the reality of 3D model fabrication, problems to be resolved, and some future prospects.

• 한국임상약학회지
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• 제29권3호
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• pp.193-201
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• 2019

Background and Objective: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. Methods: A literature search of the following databases was performed: Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were "hospital pharmacist", "clinical pharmacist", and "Korea". Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. Results: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians' prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). Conclusion: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists' professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.

• 터널과지하공간
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• 제29권1호
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• pp.52-63
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• 2019

국가의 금융 정보나 의료 정보와 같이 국가 차원에서 안정성을 확보하고 주요하게 다뤄지는 자료는 안전한 보관 및 관리되어야 하므로 이를 위해서는 벙커형 지하 데이터센터를 건설하는 것이 요구된다. 특히 국가 차원의 데이터센터는 지진과 같은 외력에 의해 데이터센터의 기능이 마비되는 것을 방지하는 기능과 이를 충분히 관리할 요건을 갖추어야 할 것이다. 따라서 자연 위협이나 인적 위협에 대한 데이터를 안전하게 보관하고 지하 공간이 갖는 장점을 활용하여 각 국가에서는 지하 데이터센터를 건설하고 있는 추세이다. 본 보고에서는 이러한 세계적인 데이터센터 현황과 동향을 분석하고 우리나라가 진행되어야 할 전략에 대해 검토하였다.

• 한국인터넷방송통신학회논문지
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• 제19권1호
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• pp.187-195
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• 2019

최근 빅데이터 관련 기술들이 발전함에 따라 다양한 분야에서 생성되는 데이터들을 수집하여 저장하고 처리 및 분석할 수 있게 되었다. 이러한 빅데이터 기술들을 임상 결과 분석에 활용하고, 임상시험 설계 최적화를 통해 보건의료분야에 투입되는 막대한 비용을 절감할 수 있을 것으로 전망된다. 따라서 본 논문에서는 임상 결과를 분석하여 임상시험 기간과 비용 등을 줄일 수 있는 가이드 정보를 제시하고자 한다. 먼저 Sqoop을 사용하여 임상 결과 데이터가 저장된 관계형 데이터 베이스로부터 HDFS에 수집하여 저장하고, 하둡을 기반으로 동작하는 처리 도구인 Hive를 이용하여 데이터를 처리한다. 공공분야, 기업 등 각 분야에서 많이 활용되고 있는 빅데이터 분석 도구인 R을 이용하여 연관성 분석을 한다.