• 제목/요약/키워드: Medical Insurance

검색결과 2,441건 처리시간 0.031초

한국인 성인 비만의 사회경제적 비용 (Socioeconomic Costs of obesity for Korean Adults)

  • 문옥륜;김남순;강재헌;윤태호;이상이;이신재;정백근
    • Journal of Preventive Medicine and Public Health
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    • 제35권1호
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    • pp.1-12
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    • 2002
  • Objective : To estimate the socioeconomic costs of obesity in Korea,1998. Methods : The 1998 National Health and Nutrition Examination Survey(1998 NHNES) data was used and 10,880 persons who had taken health examinations were selected for study. Essential hypertension, NIDDM(non insulin-dependent diabetes mellitus), dyslipidemia, osteoarthritis, coronary heart disease, stroke were included as obesity related disease. The data of direct costs of obesity was obtained from the National Federation of Medical Insurance. The category of indirect costs was the loss of productivity caused by premature death and admission, time costs, traffic costs, nursing fees due to obesity. Multiple logistic regression model was developed to estimate prevalence odds ratio by obesity class adjusted demographic and socio-ecnomic factors and calculate PAF(Population Attributable Fraction) of obesity on obesity related disease. And we finally calculated the socioeconomic costs of obesity in relation to BMI with PAF. Results : The direct costs of obesity were 2,126 billion${\sim}965$ billion Won in considering out of pocket payment to uninsured services, and the indirect costs of obesity were 2,099 billion${\sim}1,086$ billion Won. Consequently, in considering out of pocket payment to uninsured services, the socioeconomic costs of obesity were 4.225 billion${\sim}2,050$ billion Won, which corresponded to about $0.094%{\sim}0.046%$ of GDP and $1.88%{\sim}0.91$ of total health care costs in Korea. Conclusions : Obesity represents a major health problem with significant economic implications for the society. This results are conservative estimates as far as all obesity related disease and all health care and indirect costs were not included due to missing information. further studies are needed to caculate socioeconomic costs of obesity more exactly.

21세기 초 한국의 인구구조 및 질병양상 (Perspective on Population Characteristics and Health Problems of Koreans in 21st Century)

  • 김정순
    • 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.

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간 질환력과 원발성 간암에 관한 환자-대조군 연구 (A Case-Control Study of Primary Liver Cancer and Liver Disease History)

  • 김동현;박병주;유근영;안윤옥;이효석;김정룡;이상일;이무송;안형식;김헌;박태수
    • Journal of Preventive Medicine and Public Health
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    • 제27권2호
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    • pp.217-225
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    • 1994
  • The relationship between past liver disease history and the risk of primary liver cancer was analyzed in a hospital-based case-control study conducted in Seoul on 165 patients with histologically or serologically confirmed hepatocellular carcinoma and individually age- and sex-matched 165 controls in hospital for ophthalmologic, otologic, or nasopharyngeal problems. Significant association were observed for liver deseases occurring 5 or more years before liver cancer diagnosis [OR,4.9;95% confidence interval (CI), $1.6{\sim}14.0$) and family history of liver disease(OR, 9.0;95% CI, $2.1{\sim}38.8$). These associations were not appreciably modified by allowance for major identified potential confounding factors. From these results, it is possible to speculate that liver cell injuries caused by various factors might be a common pathway to developing primary liver carcinoma. Considering the significant effect of family history of liver diseases on PLCA risk after adjusting past liver disease history, there might be genetic susceptibility in the carcinogenic mechanism of liver cancer. Further investigations are needed to clarify the effect of family history of liver disease on PLCA risk.

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민간조사업법의 도입방향에 관한 연구 (A Study on the Introduction Direction of Private Investigation Law)

  • 이승철
    • 시큐리티연구
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    • 제17호
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    • pp.255-276
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    • 2008
  • 민간조사업의 주체는 다양한 서비스를 제공한다는 측면에서는 자연인, 법인 모두를 허가해야 되지만 공익성을 확보라는 측면위해서는 경비업법과 마찬가지로 법인으로 해야 할 것이며 허가제로 시행해야 할 것이다. 민간조사업 도입범위는 개인과 기업을 대상으로 하는 가출인 미아에 대한 소재 확인 조사, 특정인이나 특정집단의 신원확인, 습관, 행동방식, 동기, 소재파악, 친자확인, 교제, 거래, 명성, 성격 등을 조사, 실종된 자 또는 귀속되거나 포기된 재산의 소유자 및 부동산의 상속인 등의 소재확인 조사, 분실 또는 절취 된 재산의 행방조사, 화재, 명예훼손, 비방, 손해, 사고, 신체장애, 부동산이나 동산에 대한 침해의 원인 조사, 교통사고, 보험사고, 의료사고 등 각종사고에 대한 조사, 저작권침해 등으로 규정할 수 있다. 자격시험에 있어서는 25세 이상이 바람직 할 것이며, 1차 시험 면제자는 타 자격증과의 형평성을 고려하여 관련분야 경력 10년 이상인 자로 해야 할 것이다. 감독기관에 있어서는 민간조사업과 프랑스(경찰), 일본(공안위원회) 등 다수의 국가들이 경찰기관이 감독기관인 점과 민간조사업 업무의 성격이 경찰과의 관련이 높다는 점을 고려하면 경찰청이 감독기관이 되어야 한다. 벌칙에 있어서 특히, 개인정보에 대한 관리를 명확히 하여 고객의 기본권 침해를 방지해야 한다.

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한국인 남녀에서 이상지질혈증 관련 건강생활 실천 규명 -국민건강영양조사 2012년 자료 이용- (Investigation of Healthy Life Practices among Korean Males and Females in relation to Dyslipidemia Using data from the 2012 Korea National Health and Nutrition Examination Survey)

  • 이선희;서문경애
    • 디지털융복합연구
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    • 제14권1호
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    • pp.327-338
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    • 2016
  • 본 연구의 목적은 이상지질혈증군과 정상군을 구분하여 한국인 남녀에서 이상지질혈증 발생과 건강생활 실천의 영향을 파악하기 위함이다. 연구대상은 제5기(2010년~2012년) 국민건강영양조사에서 공개된 제3차년도(2012년) 자료 중에서 건강 설문 자료를 분석대상으로 하였으며, 대상자는 우리나라의 질병 발생 양상 및 의료 환경 등을 고려해 만든 한국지질 동맥경화학회(KSLA: Korean Society of Lipidology and Atherosclerosis, 2009)의 이상지질혈증 치료지침을 적용하여 만 19세 이상 이상지질혈증군 2,092명(남자 1,042명, 여자 1,050명)과 정상군 1,944명(남자 740명, 여자 1,204명)인 4,036명이었다. 본 연구는 SPSS 18.0 프로그램을 이용하여 서술적 통계의 t-test와 ${\chi}^2-test$, 로지스틱 회귀분석을 사용하였다. 본 연구의 결과를 토대로 이상지질혈증 관련 건강생활 실천 프로그램은 혈청 지질 농도에 차이를 보이고 있는 한국인 남녀의 특성을 고려하여 적용하여야 하며, 이를 위해 지속적인 연구 및 건강생활 실천의 효과를 적용한 체계적인 국가 차원의 맞춤교육이 필요하다고 사료된다.

MDVP, Praat, TF32에 따른 음향학적 측정치에 대한 비교 (Comparisons of voice quality parameter values measured with MDVP, Praat, and TF32)

  • 고혜주;우미령;최예린
    • 말소리와 음성과학
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    • 제12권3호
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    • pp.73-83
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    • 2020
  • 음질 분석에 매우 유용한 Multi-Dimensional Voice Program (MDVP), Praat, Time-Frequency Analysis software (TF32)는 각각의 음향학적 검사에 사용된 알고리즘 차이로 인해 그 측정치에 차이가 있을 수 있다. 그러므로 본 연구에서는 각각의 음향학적 검사 도구로 음성 측정치를 비교 분석하여 분석 도구에 따른 음향학적 검사 변수의 차이를 살펴보고자 하였다. 정상 성인 총 35명 (남성 19명, 여성 16명)을 대상으로 모음 /아/를 수집한 후, 동일한 음성을 MDVP, Praat, TF32 각각의 음향학적 검사 도구로 분석하였다. 그 결과 jitter 변수(J local, J abs, J rap, J ppq), shimmer 변수(S local, S dB, S apq), noise-to-harmonics ratio (NHR) 평균의 경우, 남성과 여성 모두 MDVP보다 Praat의 수치가 통계적으로 유의하게 낮았다(p<.01). 또한 J local, J abs, S local 평균의 경우, 남성과 여성 모두 MDVP, Praat, TF32 순으로 통계적으로 유의하게 낮아졌다. 결론적으로 각 음향학적 검사 도구에 사용된 알고리즘 차이로 인해 도구 간의 측정치에 차이가 있었다. 그러므로 임상가들이 임상현장에서 각각의 음향학적 검사 도구를 사용할 때 각 도구의 알고리즘에 대해 이해한 후 병적 음성을 분석하는 것이 중요할 것이다.

The Influence of Asian Dust, Haze, Mist, and Fog on Hospital Visits for Airway Diseases

  • Park, Jinkyeong;Lim, Myoung Nam;Hong, Yoonki;Kim, Woo Jin
    • Tuberculosis and Respiratory Diseases
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    • 제78권4호
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    • pp.326-335
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    • 2015
  • Background: Asian dust is known to have harmful effects on the respiratory system. Respiratory conditions are also influenced by environmental conditions regardless of the presence of pollutants. The same pollutant can have different effects on the airway when the air is dry compared with when it is humid. We investigated hospital visits for chronic obstructive pulmonary disease (COPD) and asthma in relation to the environmental conditions. Methods: We conducted a retrospective study using the Korean National Health Insurance Service claims database of patients who visited hospitals in Chuncheon between January 2006 and April 2012. Asian dust, haze, mist, and fog days were determined using reports from the Korea Meteorological Administration. Hospital visits for asthma or COPD on the index days were compared with the comparison days. We used two-way case-crossover techniques with one to two matching. Results: The mean hospital visits for asthma and COPD were $59.37{\pm}34.01$ and $10.04{\pm}6.18$ per day, respectively. Hospital visits for asthma significantly increased at lag0 and lag1 for Asian dust (relative risk [RR], 1.10; 95% confidence interval [CI], 1.01-1.19; p<0.05) and haze (RR, 1.13; 95% CI, 1.06-1.22; p<0.05), but were significantly lower on misty (RR, 0.89; 95% CI, 0.80-0.99; p<0.05) and foggy (RR, 0.89; 95% CI, 0.84-0.93; p<0.05) days than on control days. The hospital visits for COPD also significantly increased on days with Asian dust (RR, 1.29; 95% CI, 1.05-1.59; p<0.05), and were significantly lower at lag4 for foggy days, compared with days without fog (RR, 0.85; 95% CI, 0.75-0.97; p<0.05). Conclusion: Asian dust showed an association with airway diseases and had effects for several days after the exposure. In contrast to Asian dust, mist and fog, which occur in humid air conditions, showed the opposite effects on airway diseases, after adjusting to the pollutants. It would require more research to investigate the effects of various air conditions on airway diseases.

호스피스 자원봉사활동의 실태 및 지원에 관한 연구 - 대전ㆍ충청권을 중심으로

  • 황영숙;모선희
    • 호스피스학술지
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    • 제5권1호
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    • pp.14-25
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    • 2005
  • This study was conducted to examine the present state, types of services, difficulties, education programs, motivation, satisfaction and attitude of hospice volunteers and also to suggest supporting programs for the volunteer. For these purposes, a questionnaire was distributed among the 200 hospice volunteers in ten hospice organizations in Daejeon and Chungcheong province. In this research, 85.5% of the respondents were women and most of them were housewives in their forties and fifties. The majority of hospice volunteers had an education background of more than high school. Christianity (94%) was the dominant religion of volunteers. Among the service area of the hospice, emotional caring, such as listening closely and establishing empathy were the most frequently done by the respondents and the next one was spiritual care. Hospice volunteers who had started with altruistic motivation show more dynamic activities in emotional, spiritual, physical caring and so on, than those with non-altruistic motivation. Most of the respondents expressed that they felt a hospice volunteer was valuable. However they had a hard time to overcome the sorrow coming from sharing empathy with the dying patients. Those who had started with altruistic motivation usually took part in two times per a week and had more positive attitude. Volunteers who had been working more than five years showed better attitude than those who had been working less than three years. The longer the voluntary services, the more positive attitude experienced by volunteers. Hospice volunteers encountered the most considerable difficulty with lack of background knowledge and their actual capability. Insufficiency of time was the next reason for the considerable difficulty of the hospice volunteer. On the other hand, those who served more than twice per week replied that lack of background knowledge and their capability were the least considerable difficulty. Insufficiency of time was the reason of difficulty for male volunteers, as well as for females under thirty and those in their forties and fifties respectively. Generally most of the hospice volunteers (70%) were satisfied with their services and they usually satisfied with physical caring, spiritual caring, hospice's family caring. The less difficulty in voluntary services, more satisfaction for the volunteers in the end. There is a positive correlation between a attitude of the hospice volunteer and frequency of voluntary services while the volunteers' difficulty affect negatively their attitude as well as the frequency of voluntary services. Most of the hospice volunteers want to have more education about basic skills, volunteer's attitude and role, spirituality, the way of attending on the hospice and so on. Most of them considered discussion and sharing different cases as the most effective method. They also wish to had more supporting programs for the hospice volunteers(in the order of their needs) such as regular events, newsletters, personal concern, social meetings among the volunteers, insurance and minimum expenses. Based on the study results, more programs should be run in order to activate the voluntary services regardless of their gender and education background. A continuous practical supporting policy and education programs are required in order to provide special education and training courses considering every field of voluntary services. Expanding the role of the volunteers allows them more opportunities to take part in voluntary services and th activate participation. It is necessary to establish a new hospice system as a part public medical system, which can not only facilitate the voluntary services for a hospice but also enhance professional hospice volunteers. Finally, experts are needed to operate the voluntary services effectively.

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Respite Care와 영적케어의 고찰

  • 신민선
    • 호스피스학술지
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    • 제5권1호
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    • pp.50-62
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    • 2005
  • The elderly people was over 8.3% in 2003. This seament is projected to grow to 14.4% by 2019(Aged society) and over 20% by 2026(Super aged society). As the elderly population is increasing and young population is declined social issues around elderly care are emerged in Korea. As a result of that, they are in the condition of poor system of the welfare of the old and it is the worst one in Korea. And because of the worst financial independence and difficulty in Korea, welfare facilities and medical instruments are so insufficient and deteriorated, so the quality of service is getting low. Furthermore the mortality of cancer is rapidely increased in recent years. So it is expected that the number of families who are caring for terminal cancer patient will be increased. We can not solve those problems only with government's policy such as to secure ample budget and to enlarge the aged welfare institutions. Definitely, to acheve the suggetions persistence concern about old people is most important, and family, community and national government should be linked to accomplish to goal. Accordingly, for this study attempts to provide conceptual framework of the respite care, spiritual care and home hospice, nursing home for the elderly. And this study is to discuss the necessity and effect about the construction of housing welfare infrastructure and to make a cooperation and linkage system among the aged welfare institutions, government and the aged welfare programs. As is well known, the issue of the increasing aged people is neither a matter of individuals nor of the family, but rather a complex matter of whol society. Therefore it can be resolved by the active participation of government. Conclusively this study tries to provide an direction of the improvement with regard to the welfare policy for the elderly. The study is as follwos: Chapters 1: The theological base, conception, essentiality, respite care, spiritual care and home hospice, nursing home for the elderly. Chapters 2: Definitions of respite care, spiritual care, hospice, patient of termina cancer and quality of life. And relations between respite care and nursing home. Chapters 3: The necessity of long-term care insurance and the perspectives of spiritual care. Chapters 4: Conclusions and summarizing(The directions of improvement of welfare policy for the elderly). To sum up, the problems of the aged people has not effects only to the aged people. This means that the problems of aged is the problems of the young generation today. Because young generation will be the old generation in the near future.

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고혈압 환자의 구강건강관리 행태와 주관적 치주건강수준의 상관관계 연구 (Relationship between Oral Health Care Behaviors and Perceived Periodontal Disease on Hypertension Patients)

  • 안은숙;김민영
    • 치위생과학회지
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    • 제16권1호
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    • pp.101-109
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    • 2016
  • 이번 연구는 2013년도 지역사회건강조사 원시자료를 이용하여 만 19세 이상 성인을 대상으로 하였다. 치주질환에 취약한 고혈압 환자를 대상으로 구강건강관리 행태와 라이프 스타일에 주관적 치주건강수준에 미치는 영향을 분석하고자 하였다. 고혈압 환자의 연령이 증가할수록 본인의 치주상태를 건강하다고 인식하고, 기혼에 비해 미혼에서 치주건강수준을 나쁘게 인식하는 것으로 조사되었다. 구강건강과 관련된 라이프 스타일과 구강건강행태도 치주건강 인식에 유의한 영향을 미치는 것으로 나타났다. 그러나, 본인이 '치주질환이 있다'라고 인식하는 정도에 거주지역은 통계적으로 유의한 차이를 보이지 않았다. 고혈압 환자의 주관적 치주건강수준에 영향을 미치는 요인으로 성별, 연령, 결혼상태, 교육수준, 경제활동 유무, 소득수준, 민간의료보험 가입여부, 라이프 스타일, 구강건강관리 행태에서 점심식사 후 칫솔질, 구강검진 경험, 치석제거 경험으로 나타났다. 연구 결과를 토대로 고혈압 환자의 구강건강관리 행태와 주관적 치주건강수준의 상관관계가 있음이 확인되었다. 향후 단면적 연구보다 치주질환에 영향을 미치는 요인들의 인과성을 규명하는 종단적 연구를 통해 건강한 사람에 비해 치주질환에 취약한 집단의 구강건강증진을 위한 대안 마련이 필요할 것이다.